KidsMD Health Topics

Teratoma

  • A teratoma is a congenital (present prior to birth) tumor formed by different types of tissue.

    • Teratomas in newborns are generally benign and don't spread. They can, however, be malignant, depending on the maturity and other types of cells that may be involved.

    • Benign teratomas tend to grow aggressively, although they do not spread.

    • Malignant teratomas tend to grow aggressively and spread to other parts of the body.

    Individualized care, new treatments

    Through Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, a 50-year partnership between Dana-Farber Cancer Institute and Boston Children's Hospital, your child will receive individualized care to treat every aspect of his condition from an expert team of specialists.

    Your child will also benefit from a team of researchers striving to understand the scientific causes of teratomas, which results in continual introduction of new treatment options.

    Boston Children's Hospital
    300 Longwood Ave
    Fegan 2
    Boston MA 02115 

    617-355-6021
    fax: 617-730-0456

  • What causes teratomas?

    The cause of most teratomas is not completely understood. Teratomas are often associated with a number of inherited defects that affect the central nervous system, genitourinary tract and lower spine.

    What are the symptoms of a teratoma?

    Each child may experience symptoms differently and symptoms vary widely depending on the size and location of the tumor.

    Your child's symptoms may include:

    • a tumor, swelling, or mass that can be felt or seen

    • elevated levels of alpha-fetoprotein (AFP)

    • elevated levels of beta-human chorionic gonadotropin (B-HCG)

    • constipation, incontinence and leg weakness - if the tumor is in the sacrum (a segment of the vertebral column that forms the top part of the pelvis)

  • How are teratomas diagnosed?

    They can often be seen on prenatal ultrasound.

    Other diagnostic procedures can include:

    • Biopsy- a sample of tissue removed from the tumor and examined under a microscope
    • Complete blood count (CBC)- a measurement of size, number, and maturity of different blood cells in a specific volume of blood
    • Additional blood tests - may include blood chemistries, evaluation of liver and kidney functions and genetic studies
    • Multiple imaging studies, including:
      • Computerized tomography scan (also called a CT or CAT scan) - A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
      • Magnetic resonance imaging (MRI) - A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
      • X-ray- A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
      • Ultrasound (also called sonography) - A diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
  • What is the treatment for a teratoma?

    Specific treatment for teratoma depends on the type of teratoma your child has.

    Treatment generally includes:

    • Surgery - Biopsy and surgical removal of tumors or involved organs, performed by a pediatric surgeon.

    If the tumor is malignant, treatment may also include:

    • Chemotherapy- A drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Chemotherapy may be used alone for some types of cancer or in conjunction with other therapy such as radiation or surgery.

      While chemotherapy can be quite effective in treating certain cancers, the agents do not differentiate normal healthy cells from cancer cells. Because of  this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help the care team, parents, and child prepare, and, in some cases, prevent these symptoms from occurring, if possible.
    • Radiation therapy - Using high-energy rays (radiation) from a specialized machine to damage or kill cancer cells and shrink tumors.
    • Supportive care -Any type of treatment to prevent and treat infections, side effects of treatments, and complications, and to keep your child comfortable during treatment.
    • Continual follow-up care- A schedule of follow-up care determined by your child's physician and other members of your care team to monitor ongoing

    What is the recommended long-term care for children treated for a teratoma?

    Your child should visit a survivorship clinic every year to:

    • manage disease complications
    • screen for early recurrence of cancer
    • manage late effects of treatment

     A typical follow-up visit may include some or all of the following:

    • a physical exam
    • laboratory testing
    • imaging scans

    Through the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute, childhood cancer survivors receive a comprehensive follow-up evaluation from their cancer care team.

    • Our childhood cancer survivorship clinic is held weekly.
    • In addition to meeting with your pediatric oncologists, your child may see one of our endocrinologists, cardiologists, neurologists, neuro-psychologists or alternative/complementary therapy specialists.

          We also offer the following services:

    • patient and family education
    • psychosocial assessment
    • genetic counseling
    • reproductive and fertility evaluation and counseling
    • opportunities to speak with other childhood cancer survivors
  • A benign oral teratoma

    When Tricia Coblentz was four months into her second pregnancy, an ultrasound revealed a large, solid mass growing from her baby's mouth. At Boston Children's Hospital's Advanced Fetal Care Center, an MRI confirmed that her baby, Gracie, had a benign oral teratoma—a rare type of non-cancerous tumor that was growing down into Gracie's throat. Fearing that her windpipe would be blocked if the tumor got any bigger, Reza Rahbar, MD, and his team rushed Gracie to the operating room right after she was delivered and removed the majority of the mass. She weighed just 2 pounds, 9 ounces after the removal of the tumor, and stayed in Boston Children's Neonatal Intensive Care Unit for three months. Her struggle was featured in the Children's News.

    Gracie turned 4 last October, and she's had more than a dozen operations, including one to remove the remaining bits of the tumor from her mouth and one to reconstruct her windpipe. She has some hearing and speech problems caused by nerve damage from the tumor, so she's in a special education pre-school and wears a hearing aid. Her protective big brother, Kyle, who's 6, is quick to translate for her when people can't understand what she's saying, but her speech difficulty will be greatly improved after speech therapy and her next surgery.

    Gracie's impairment hasn't affected her demeanor one bit, according to Tricia, who says her daughter is "always beaming and smiling." She loves playing with her dog, Scruffy, riding scooters with Kyle and playing dress-up. She's also got her ABCs down pat, just learned how to write "mom" and can spell her own name.

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