WTF Life? (Episode 95): Spooky Scary Teratomas

**KuriousKatKommittee** · 03-10-2019, 08:46 PM

Umbrella Corporation is real. It's called Life, dawg.

Content
All from scientific articles, popular articles, and Wikipedia because I know y'all niggas don't wanna read my shit lul.

Introduction
Cases
Risk Factors

1. Introduction

https://www.health24.com/Medical/Cancer/Real-life-story/When-tumours-contain-hair-teeth-and-other-body-organs-20141124
A teratoma is a tumor made up of several different types of tissue, such as hair, muscle, bone, lung, brain, umbilical cord etc. They typically form in the ovaries, testicles, or tailbone and less commonly in other areas. Symptoms may be minimal if the tumor is small. A testicular teratoma may present as a painless lump. Complications may include ovarian torsion, testicular torsion, or hydrops fetalis.

They are a type of germ cell tumor (a tumor that begins in the cells that give rise to sperm or eggs). They are divided into two types: mature and immature. Mature teratomas include dermoid cysts and are generally benign. Immature teratomas may be cancerous. Most ovarian teratomas are mature. In adults, testicular teratomas are generally cancerous. Definitive diagnosis is based on a tissue biopsy.

Treatment of tailbone, testicular, and ovarian teratomas is generally by surgery. Testicular and immature ovarian teratomas are also frequently treated with chemotherapy.

Teratomas occur in the tailbone in about 1 in 30,000 newborns making them one of the most common tumor in this age group. Females are affected more often than males. Ovarian teratomas represent about a quarter of ovarian tumors and are typically noticed during middle age. Testicular teratomas represent almost half of testicular cancers. They can occur in both children and adults. The term comes from the Greek words for "monster" and "tumor".

2. Cases
Case Study #1: Ovarian Teratomas

Subject A
(Tiny brain, skull, and hair have been extracted from a teen's ovary)
https://www.sciencealert.com/a-tiny-brain-skull-and-hair-have-been-extracted-from-a- teen-s-ovary
https://www.newscientist.com/article...d-girls-ovary/

Abstract
In the surgical case of a mature cystic teratoma of the ovary that arose in a 16-year-old girl, a large amount of well-differentiated and highly organized cerebellar tissue was found. Three layers of the cerebellar cortex were well formed, and synaptophysin-positive “glomeruli” were found in the granule cell layer. Some Purkinje cells exhibited focal expansion and a dysmorphic appearance of the dendrites. Adjacent to the cerebellar tissue, a large space lined by the ependymal layer and a club-shaped CNS tissue mass resembling the brainstem were found, and structures reminiscent of the midbrain tectum and pontine nuclei were distinguished within this mass. The CNS tissue was surrounded by the leptomeninges and a skull-like, bony shell. Structures consistent with the supra- tentorial CNS tissue were not found. This case represents an example of infra-tentorial CNS tissue that was well-differentiated and organized to an exceptionally high degree in an ovarian mature teratoma. Various degenerative changes have been documented in CNS tissue in ovarian teratomas, but the dendritic abnormalities of Purkinje cells seen in the present case are novel findings.

Case Study #2: Intracranial Teratomas

In contrast, teratomas in the brain are relatively rare. Among brain tumors, just 0.5 to 3 percent are germ cell tumors, and of these, about 20 percent are teratomas, Dehdashti said. Still, "this is not something totally unknown to neurosurgeons," said Dehdashti, adding that he has seen about three or four teratoma cases in his career. Teratomas are usually benign, meaning that they don't spread to other parts of the body. Once treated, survival rates are very high, Dehdashti, said.

Subject B: 26-year-old female.
https://www.livescience.com/50600-em...-teratoma.html
An Indiana woman's brain tumor turned out to contain hair, bone and teeth, and has been dubbed her "embryonic twin" — but experts say that such tumors are not actually twins, nor are they embryos.

Subject C: 16-year-old female.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387452/

Abstract
The authors describe a case of a giant intracranial mature cystic teratoma in a 16-year- old girl presenting acutely with a severe headache, vomiting and a complex generalised seizure with a background history of intermittent headaches for 3 years. CT and MRI brain demonstrated a ruptured large cystic teratoma encapsulating two large teeth within the diffusely dense fatty heterogeneous lesion. Surgical debulking of the cyst was performed and the calcific remnants were left behind owing to dense adhesion to the brain.

Case presentation

(Axial fluid attenuated inversion recovery MRI demonstrating large intraventricular mass with teeth and fat filling the lateral ventricles superiorly.)

A 16-year-old young girl with a 3-year history of ‘migraines’, presented with an acutely progressively worsening temporo-occipital headaches associated with vomiting, dizziness and disorientation. This was then followed by collapse, eye rolling, jerking of all four limbs and urinary incontinence. She denied any photophobia, neck stiffness or limb weakness.

On clinical examination she was alert, orientated in time, place and person, with a Glascow Coma Scale (GCS) of 15/15 and neurological examination revealed no neurological deficit. Visual acuity, fields and optic discs were all normal, indicating no ocular involvement. Neuro cognitive assessment was normal. She was noted to be of short stature for her age. Her medical history included febrile convulsions.

Subject D: 4-month-old term male infant.
https://www.nejm.org/doi/full/10.1056/NEJMicm1308260
Multiple structures along the right periphery of the mass showed characteristics similar to those of teeth in the mandible (arrows). The patient underwent tumor resection through a right pterional approach; multiple fully formed teeth were seen in the tumor mass (Panel B).

Case Study #3: Teratomas of the Testis

https://www.ncbi.nlm.nih.gov/pubmed/23784831
Early studies with 129 mice lead to the discovery of embryonal carcinoma (EC) cells which played a foundational role in the embryonic stem (ES) cell field and the study of pluripotency. The cells of origin of testicular teratomas are germ cells. During early development, primordial germ cells diverge from somatic differentiation and establish their pluripotent nature, maintaining or re-expressing core pluripotency genes; Oct4, Sox2 and Nanog. It is believed that a misregulation of male germ cell pluripotency plays a critical role in teratoma development. Several mouse models of teratoma development have now been identified, including a chromosome substitution strain, 129- Chr19(MOLF), conditional Dmrt1 and Pten alleles and the Ter mutation in the Dnd1 gene.

3. Risk Factors

3.1. For testicular teratoma:
https://www.myvmc.com/diseases/testicular-cancer-teratoma-of-the-testicle/

Cryptorchidism: Almost 10% of testicular tumors are found in patients with cryptorchidism (maldescended testes) but this can occur in either of the testes.
Genetic predisposition - Specific genes have been identified that play a role in testicular cancer.
Previous testicular cancer
Family history of testicular cancer
HIV infection
Abnormalities of testicular development
Exposure to estrogens (female sex hormones) in utero
Possible testicular torsion (twisting of the spermatic cord disrupting blood supply to the testes), mumps orchitis, testicular trauma and occupational exposure to chemicals.

3.2. For ovarian teratoma:
https://www.medscape.com/answers/255865-25770/what-are-the-risk-factors-for-ovarian-cyst-formation

Infertility treatment - Patients being treated for infertility by ovulation induction with gonadotropins or other agents, such as clomiphene citrate or letrozole, may develop cysts as part of ovarian hyperstimulation syndrome
Tamoxifen - Tamoxifen can cause benign functional ovarian cysts that usually resolve following discontinuation of treatment
Pregnancy - In pregnant women, ovarian cysts may form in the second trimester, when hCG levels peak
Hypothyroidism - Because of similarities between the alpha subunit of thyroid- stimulating hormone (TSH) and hCG, hypothyroidism may stimulate ovarian and cyst growth
Maternal gonadotropins - The transplacental effects of maternal gonadotropins may lead to the development of neonatal and fetal ovarian cysts
Cigarette smoking - The risk of functional ovarian cysts is increased with cigarette smoking; risk from smoking is possibly increased further with a decreased body mass index (BMI)
Tubal ligation - Functional cysts have been associated with tubal ligation sterilizations

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663225/
Risk factors for malignant transformation of MCT (benign mature cystic teratoma) include elevated CA-125 levels, older age, large tumor masses, and postmenopausal status.