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A teratoma is a kind of tumor (neoplasm). Definitive diagnosis of a teratoma is based on its histology: a teratoma is a tumor with tissue or organ components resembling normal derivatives of all three germ layers. There are rare occasions when not all three germ layers are identifiable. The tissues of a teratoma, although normal in themselves, may be quite different from surrounding tissues, and may be highly disparate; teratomas have been reported to contain hair, teeth, bone and very rarely more complex organs such as eyeball[citation needed], torso[citation needed], and hands, feet, or other limbs[1] . Usually, however, a teratoma will contain no organs but rather one or more tissues normally found in organs such as the brain, thyroid, liver, and lung. A teratoma is an encapsulated tumor. Sometimes the capsule encompasses one or more fluid-filled cysts and when a large cyst occurs there is a potential for the teratoma to produce a structure within the cyst that resembles a fetus. In part because it is encapsulated, a teratoma usually is benign, although several forms of malignant teratoma are known and some of these are common. A mature teratoma typically is benign and more commonly is found in females, while an immature teratoma typically is malignant and more commonly is found in males.
Teratomas are thought to be present at birth (congenital), but often they are not diagnosed until much later in life.
The word teratoma comes from classical Greek and means roughly “monstrous tumor”.
Teratomas belong to a class of tumors known as nonseminomatous germ cell tumor (NSGCT). All tumors of this class are the result of abnormal development of pluripotent cells: germ cells and embryonal cells. Teratomas of embryonal origin are congenital; teratomas of germ cell origin may or may not be congenital (this is not known). The kind of pluripotent cell appears to be unimportant, apart from constraining the location of the teratoma in the body.
Teratomas derived from germ cells occur in the testes in males and ovaries in females. Teratomas derived from embryonal cells usually occur on the body midline: in the brain, elsewhere inside the skull, in the nose, in the tongue, under the tongue, and in the neck (cervical teratoma), mediastinum, retroperitoneum, and attached to the coccyx. However, teratomas may also occur elsewhere: very rarely in solid organs (most notably the heart and liver) and hollow organs (such as the stomach and bladder), and more commonly on the skull sutures. Embryonal teratomas most commonly occur in the sacrococcygeal region: sacrococcygeal teratoma is the single most common tumor found in newborn babies.
Of teratomas on the skull sutures, approximately 50% are found in or adjacent to the orbit[2]. Limbal dermoid is a choristoma, not a teratoma.
Teratoma qualifies as a rare disease, but is not extremely rare. Sacrococcygeal teratoma alone is diagnosed at birth in 1 out of 40,000 babies. Given the current world population birth rate, this equals 5 per day or 1800 per year. Add to that number sacrococcygeal teratomas diagnosed later in life, and teratomas in other locations, and the incidence approaches 10,000 new diagnoses of teratoma per year.
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