Moderators: C_arola, Coby, Nicole288, Dyonne
Citaat:Ovarian teratoma
Complications of ovarian teratomas include torsion, rupture, infection, hemolytic anemia, and malignant degeneration.
Torsion is by far the most significant cause of morbidity, occurring in 3.2-16% of cases. Several series have demonstrated that increasing tumor size correlates with increased risk of torsion.
Rupture of a cystic teratoma may be spontaneous or associated with torsion and occurs in approximately 1-4% of cases. Rupture may occur suddenly, leading to shock or hemorrhage with acute chemical peritonitis. Chronic leakage also may occur, with resultant granulomatous peritonitis. Prognosis after rupture usually is favorable, but the rupture often results in formation of dense adhesive disease.
Infection is uncommon and occurs in only 1% of cases. Coliform bacteria are the organisms most commonly implicated.
Autoimmune hemolytic anemia has been associated with mature cystic teratomas. In several series, removal of the tumor resulted in complete resolution of symptoms. Theories behind the pathogenetic mechanism include (1) tumor substances that are antigenically different from the host and produce an antibody response within the host that cross reacts with native red blood cells, (2) antibody production by the tumor directed against host red blood cells, and (3) coating of the red blood cells by tumor substance that changes red blood cell antigenicity. In this context, radiologic imaging of the pelvis may be indicated in cases of refractory hemolytic anemia.
In its pure form, mature cystic teratoma of the ovary always is benign, but in approximately 2% of cases, it may undergo malignant transformation into one of its elements. The prognosis for patients with malignant degeneration is dismal, with 5-year survival rates reported in the range of 15-31%. The prognosis appears to be somewhat better if the malignant element is squamous rather than adenocarcinoma.