Germ cell tumors

Topic Completed: 1 December 2012

Minor changes: 12 July 2020

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PubMed Search: mature teratoma ovary

See Also: malignant change in cystic teratoma below

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Cite this page: Ehdaivand S. Teratoma-mature. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorteratomamature.html. Accessed September 20th, 2020.
Definition / general
  • Mature if only contains adult tissues
  • Usually teenage women (solid) or children (cystic)
  • Excellent prognosis, even if peritoneal implants are present
  • Rarely associated with hemolytic anemia
  • May rupture into peritoneal cavity causing foreign body reaction that simulates metastatic carcinoma or miliary tuberculosis
  • Tumors arise from a single germ cell after first meiotic division
  • Cystic tumors may contain squamous cell carcinoma, carcinoid tumor or adenocarcinoma
  • Dermoid cyst: usually mature teratoma which resembles skin; some use these terms interchangeably
  • Gliomatosis peritonei: peritoneal implants exclusively composed of mature glial tissue; benign if all tissue is mature and other teratomatous elements are absent
Case reports
Gross description
  • Solid or cystic
  • Cystic content may contain greasy material composed of keratin, hair and teeth
  • Rarely is "fetiform" (partial human body-like structure) or contains partial mandible
  • Teeth may be found in Rokitansky's protuberance - a well-defined, nipple-like structure covered with hair
Gross images

AFIP images

Dermoid cyst-like

Fetiform teratoma

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Dermoid cyst-like

With sebum, hair and teeth

With hair, fat and teeth

Microscopic (histologic) description
  • Ectodermal structures in 100%, mesodermal in 93% and endodermal in 71%
  • Skin and glial tissue common; prostate tissue in 10%
  • Still considered mature if microscopic foci of immature tissue
Microscopic (histologic) images

Contributed by Dr. Max Agaronov and Dr. Carmen Tornos

History: 25 year old woman with 1 month history of decreased appetite, early satiety and 2 month history
of increasing abdominal girth. Further work-up revealed a 17 cm smooth walled cyst on ultrasound.
Gross: 15 cm unilocular cyst with a 4 x 3.5 x 1.5 cm solid intracavitary mass which contained hair, skin
with subcutis, bone and cartilage.

Case #371

Figures 1-3

Figures 4-5

Figures 6-7: GFAP

AFIP images

Tubular structures

Islands of cartilage, glia, several cysts

Skin with appendages

Mucinous glands, cartilage

Well developed cerebellar tissue

Thyroid tissue and cartilage in collapsed cyst

Gastric mucosa

Foreign-body giant cell reaction

Lipogranulomatous reaction

With melanosis

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Thyroid, cartilage, fat and GI

Glomus tumor

Electron microscopy images

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Glomus tumor


Dermoid cyst

Benign teratoma

Differential diagnosis

Malignant change in cystic teratoma
Definition / general
  • Tumor is apparently derived from germ cell elements of teratoma, but behavior is based on phenotype
  • Squamous cell carcinoma: most common malignant change in cystic teratoma; 5 year survival is 52%, dependant on histologic grade and vascular invasion; appears to arise from columnar epithelium (Am J Surg Pathol 1989;13:397)
  • References: Am J Surg Pathol 2003;27:650

Case reports

Gross images

AFIP images

Squamous cell carcinoma arising in dermoid cyst

Microscopic (histologic) images

AFIP images

Squamous cell carcinoma arising in dermoid cyst

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Carcinosarcoma arising from dermoid cyst

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