adult central nervous system mature teratoma

Adult Central Nervous System Mature Teratoma: A Rare and Benign Tumor

A mature teratoma that arises from the central nervous system (CNS) in adults is a rare disease with symptoms that can vary according to tumor location. Most lesions are benign, meaning they are non-cancerous.

Characteristics of Mature Teratomas

Mature teratomas are cystic or solid tumors composed of mature tissues. They contain well-differentiated, adult-type tissues, such as skin, brain, cartilage, bone, fat, and muscle (both skeletal and smooth). These tissues are arranged in a pattern resembling normal tissue relationships.

Symptoms and Clinical Features

The main symptom endured by adult patients with CNS mature teratomas includes numbness or weakness of the lower extremities, occasionally accompanied by pain. The symptoms can vary depending on the tumor's location within the CNS.

Classification and Treatment

Mature teratomas are classified as a type of germ cell tumor that contains different types of tissues. They are composed exclusively of fully differentiated, 'adult-type' tissue elements with low or absent mitotic activity. The treatment for CNS mature teratomas is typically surgical removal of the tumor.

References:

• [1] Most lesions are benign (Takeuchi, 2022)
• [3] Central nervous system (CNS) mature teratoma is a rare disease with symptoms that can vary according to tumor location (Takeuchi, 2022)
• [5] Mature teratomas are cystic or solid tumors composed of mature tissues (Zygourakis, 2015)
• [13] According to the level of differentiation of the tissues which comprise the tumor, teratomas are classified as mature or immature (Fujimaki, 2009)

Symptoms of Adult Central Nervous System Mature Teratoma

Adult central nervous system (CNS) mature teratomas are rare tumors that can cause a range of neurological symptoms depending on their location and size. According to various medical sources [7, 11], the main symptom endured by adult patients includes:

• Numbness or weakness of the lower-extremities: This is often accompanied by pain [9].
• Difficulty starting or stopping the flow of urine: A feeling of not being able to empty the bladder completely can also occur.
• Blood in the urine or semen: Pain with urination or ejaculation may be experienced as well.

These symptoms can vary depending on the type and location of the teratoma. In some cases, the tumor may cause no noticeable symptoms until it grows larger [13].

Other Possible Symptoms

In addition to these primary symptoms, other possible signs and symptoms of adult CNS mature teratoma include:

• Pain: Pain at the site of the tumor can occur.
• Bleeding: Bleeding or swelling at the site of the tumor may be experienced.
• Neurological deficits: Depending on the location of the tumor, neurological deficits such as weakness, numbness, or paralysis may occur.

Diagnosis and Treatment

A diagnosis of adult CNS mature teratoma is typically made through a combination of imaging studies (such as MRI or CT scans) and biopsy. Treatment options for this type of tumor include surgery, radiosurgery, radiation therapy, chemotherapy, surveillance, and targeted therapy [10].

References:

[7] by S Takeuchi · 2022 [9] by Y LI · 2013 · Cited by 44 [10] Adult central nervous system tumor treatment may include... [11] Central nervous system (CNS) teratoma is a rare, non-cancerous tumor that arises from embryonic cells and can be found in the brain or spinal cord. [13] As the tumor grows larger, signs and symptoms can include difficulty starting or stopping the flow of urine...

Diagnostic Tests for Adult Central Nervous System Mature Teratoma

The diagnosis of a mature teratoma in the central nervous system (CNS) can be challenging, but various diagnostic tests are employed to confirm the presence and extent of the tumor.

• Imaging Studies: Imaging studies such as computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are essential for identifying the location and size of the teratoma. These studies help in differentiating mature teratomas from other types of tumors, such as gliomas or meningiomas [12].
• Histological Examination: A definitive diagnosis is made through histological examination of tissue samples obtained during surgery or biopsy. Histopathological analysis helps in identifying the presence of mature tissues, such as skin, muscle, and hair follicles, which are characteristic of teratomas [13].
• Cytogenetic Analysis: Cytogenetic analysis may be performed to identify any chromosomal abnormalities that could be associated with the tumor.
• Tumor Marker Tests: Tumor marker tests, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG), may be used to monitor the tumor's response to treatment.

Important Considerations

Proper histological diagnosis and long-term follow-up are crucial for managing mature teratomas in the CNS. The temporal lobe is an unusual location for these tumors, and diagnostic challenges may arise [14].

Treatment Strategy

The treatment strategy for mature teratoma still remains controversial and includes radical resection whenever possible. However, since the residual portion of mature teratoma may contain part of immature or malignant tissue, tumor recurrence after surgical removal is possible [15].

Differential Diagnosis of Adult Central Nervous System Mature Teratoma

Adult central nervous system (CNS) mature teratomas are rare tumors that can be challenging to diagnose due to their similarity in appearance with other intracranial neoplasms. The differential diagnosis for adult CNS mature teratomas includes:

• Embryonal Tumors with Multilayered Rosettes (ETMR): These tumors are characterized by the presence of multilayered rosettes and can be difficult to distinguish from mature teratomas [4].
• Atypical Rhabdoid/Teratoid Tumor (ATRT): ATRT is a highly malignant tumor that can mimic the appearance of mature teratomas, especially in young children [4].
• Choroid Plexus Carcinoma: This tumor type can be mistaken for mature teratomas due to its cystic and solid components [4].
• Intracranial Dermoid Cysts: These cysts are composed of skin and other tissues and can be confused with mature teratomas, especially in young children [8].
• Lipoma Craniopharyngioma: This tumor type is a rare, benign neoplasm that can be mistaken for mature teratomas due to its solid and cystic components [8].
• Hamartoma, Choristoma, Ectopia, Encephalocele, Neuroblastoma, Rhabdomyosarcoma, and Malignant Germ Cell Tumors: These tumors are all potential differential diagnoses for adult CNS mature teratomas due to their similar appearance and location [9].

Key Points

• Adult CNS mature teratomas are rare and can be challenging to diagnose.
• Differential diagnosis includes ETMR, ATRT, choroid plexus carcinoma, intracranial dermoid cysts, lipoma craniopharyngioma, and other tumors.
• Accurate diagnosis requires a combination of clinical presentation, imaging studies, and histopathological examination.

References

[4] Raguž M, Marčinković P, et al. Intracranial mature teratoma in an adult patient: a case report. J Neurol Surg Rep. 2019; 80 (1):e14. [8] Patibandla MR, et al. Teratomas in central nervous system: a clinico-morphological study with review of literature. Neurol India 2010;58(06):841. [9] KI, Parsa AT J Clin Neurosci 2015 Jan;22(1):98-104. Epub 2014 Aug 21 doi: 10.1016/j.jocn.2014.03.039. PMID: 25150764. Diagnosis and treatment of intracranial immature teratoma.