Pay attention if you have these symptoms and be alert to mediastinal teratoma!

Teratoma is a common type of ovarian germ cell tumor. The ovaries have a great impact on female fertility, so if you have a teratoma, you must pay attention to it. Teratoma can be divided into several types, mediastinal teratoma is one of them. Patients with benign teratoma do not have any symptoms, so timely treatment is necessary!

Causes:

The origin of teratomas is believed to be totipotent embryonic cells that have escaped the influence of primitive embryonic bodies. The cells are distributed in the area where the yolk sac passes as it migrates along the hindgut toward the genital ridge to the primitive gonad, and therefore tend to occur in the midline and para-midline areas. Therefore, teratomas can occur not only in the gonads, but also in the retroperitoneum and mediastinum. Another explanation is that mediastinal teratoma originates from the cell group in the third pair of branchial clefts and depression area, which sink into the chest cavity along with the blood vessels during embryonic development.

Clinical manifestations:

Patients with benign teratomas have no symptoms and may not feel any discomfort even if the tumor is large. Symptoms mainly include chest pain, cough and difficulty breathing. Occasionally, the tumor ruptures and penetrates into the tracheobronchial tree, and the contents of the cyst can be coughed up, often containing bean curd-like sebum and even hair and teeth. Tumor perforating the pericardium can cause acute cardiac tamponade. Perforation of the mediastinal pleura can cause pleural effusion. A huge tumor will cause compression symptoms on the surrounding tissues. For example, compression of the trachea and bronchi will not only cause coughing and difficulty breathing, but also easily lead to symptoms such as atelectasis and pneumonia. Hoarseness may occur if the tumor compresses the recurrent laryngeal nerve, and superior vena cava syndrome may occur if the tumor compresses the superior vena cava. Most malignant tumors will have different symptoms, still mainly chest pain, cough and difficulty breathing, accompanied by weight loss and fever. If the tumor grows rapidly and invades or metastasizes to surrounding organs, corresponding symptoms and signs will appear.

examine:

1. Laboratory examination

Benign teratomas may test negative for tumor markers, but teratomas with malignant tissue components, especially those containing embryonic components, may test positive for tumor markers. Such as AFP, HCG, LDH, or CA19-9, and the titers of the above indicators decrease after tumor resection. If the tumor contains leiomyosarcoma components, the myosin test may be positive; tumors containing neural components are positive for S-100 protein; positive keratin staining indicates that the tumor cells contain adenocarcinoma and squamous cell carcinoma components.

2. Other auxiliary examinations

(1) It can be detected by routine X-ray examination. Generally, it only protrudes to one side of the mediastinum, but in some cases it may protrude to both sides. Sometimes the size of the tumor varies greatly, and a large tumor can even fill one side of the chest cavity. Teratomas are usually round, oval, or lobed in multicystic cases. The tumor has a clear and smooth outline. Some dermoid cysts have slightly irregular outlines due to secondary infection, inflammatory adhesions and pleural thickening around them. The presence of bone and tooth shadows within the tumor is characteristic of this type of tumor. If a tumor increases significantly in size within a short period of time, it should be considered malignant, and malignant tumors are more likely to be solid tumors.

(2) The characteristic findings of CT examination are that the mass with mainly fat density contains calcified solid nodules, or the mass is combined with fluid. The fat part is at the top and the liquid part is at the bottom. There is a fat-liquid surface between the two, and at this interface, linear or cord-like circular shadows of mixed density can be seen, which are hair clumps. When the tumor is secondary infected, there will be inflammatory adhesions and pleural thickening around it, and its outline will be blurred. CT scan can roughly determine the size of the tumor and its relationship to surrounding tissues.