It is a common disease among young women of childbearing age, but there is a flagship disease when it is discovered. Unlike normal tumors, tissues such as hair, teeth, sebum, fat, and cartilage grow inside the tumor. The identity of this strange disease is an ovarian teratoma, a benign tumor caused by abnormal differentiation of stem cells in the ovary.
If menstrual cramps are severe, you should suspect ovarian teratoma ㅣSource: Getty Image Bank
Ovarian teratoma common in women of reproductive age
Women are born with protocells, which are the source of reproductive cells. When the primordial cell in the ovary matures through the oocyte, it becomes an egg, and then the egg is ovulated and meets a sperm to become a fetus through fertilization and differentiation. However, one of the primitive cells goes beyond this process, differentiates and grows on its own, and makes a lump in the ovary with hair, teeth, scalp, and nerve cells. This lump is called an ovarian teratoma.
Ovarian teratomas, which account for 10-20% of ovarian tumors, are mostly benign tumors called mature cystic teratomas, which are not fatal enough to interfere with life. Although teratoma grows up to 25 cm, it does not show any special symptoms. However, over time, as the tumor grows, menstrual cramps get worse and pressure on the surrounding organs can cause symptoms such as abdominal pain, back pain, frequent urination, and constipation.
If left untreated, ovarian function declines, leading to delirium and aphasia
Teratomas are composed of relatively light material, such as fat or hair, which can float the ovary and cause it to become twisted easily. This is why 10% of patients with ovarian teratomas suffer from ‘ovarian torsion’, in which the ovaries are twisted. Ovarian torsion shows symptoms of being extremely painful and then suddenly getting better. The longer the twisted time, the lower the ovarian function and, in severe cases, need to be removed.
Even if it is not an ovarian torsion, if the teratoma is neglected and the symptoms become severe, delirium or aphasia may occur. This is because teratomas secrete substances that cause ‘anti-NMDA receptor encephalitis’. Anti-NMDA receptor encephalitis is an autoimmune disease in which antibodies to NMDA receptors located in the brain attack the brain. NMDA receptors play an important role in memory and learning by facilitating signal transmission between cells. Antibodies secreted by teratomas interfere with the binding of NMDA receptors. Anti-NMDA encephalitis is caused by poorly bound NMDA receptors. Because ovarian teratoma is not a tumor that disappears naturally, it is desirable to remove it surgically as soon as it is discovered.
Recurrence rates vary according to tumor characteristics
In ovarian resection, only the tumor is removed in young women, leaving the ovarian parenchyma to preserve fertility. However, there is a high risk of recurrence, and there is a problem that surgery due to recurrence cannot avoid ovarian damage. In the midst of this, domestic medical staff found the characteristics of patients with a high recurrence rate of mature cystic teratoma. Samsung Seoul Hospital Obstetrics and Gynecology Professor Doo-Seok Choi, Dong-Yoon Lee, and Seong-Eun Kim, and their team followed up 442 patients aged 10 to 29 who underwent their first ovarian surgery between January 2000 and November 2018. was confirmed and published in the International Journal of Gynecology & Obstetrics. According to the research team’s analysis, 11.2% of patients who underwent cystectomy and 20.3% of patients who underwent oophorectomy had a recurrence within 5 years. In particular, in the group of patients who underwent cystectomy, the risk of recurrence was higher if the preoperative tumor was large or the tumor was located on both sides of the ovary. The research team said, “Through this study, we were able to respond quickly with more precise follow-up by specifying a patient group with a high rate of recurrence of mature cystic teratoma.”
Teratoma occurs mostly in women before and after their teens, but the exact cause of the disease is not known. Therefore, if you are a woman of childbearing age, the only prevention is to make sure that there are no abnormalities through regular checkups. When menstrual cramps are severe, it may be a torsion in which the tumor and ovary are twisted, so it is also a good idea to get a checkup at a nearby obstetrician and gynecologist.
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