Ovary tumor
Germ cell tumors

Topic Completed: 1 December 2012

Revised: 8 February 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

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 February 18th, 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

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 of the Week #371

Figures 1-3

Figures 4-5

Figures 6-7: GFAP

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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Sebaceous glands and cartilage

Thyroid, cartilage, fat and GI

Glomus tumor

Electron microscopy images

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Glomus tumor


Left: dermoid cyst; right: benign teratoma

Differential diagnosis

Definition / general
Malignant change in cystic teratoma

  • 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

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Squamous cell carcinoma arising in dermoid cyst

Microscopic (histologic) images

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Squamous cell carcinoma arising in dermoid cyst

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Carcinosarcoma arising from dermoid cyst

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