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Mature Cystic Teratoma : Gross Pathology

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GROSS PATHOLOGY: Mature teratomas of the ovary are large tumors with an average size of about 15 cm (range 1-40 cm). Tumors associated with anti-NMDA encephalitis are small (avg. 1.9 cm). The external surface is smooth and bosselated.

Most are multiloculated cystic tumors. Some may be predominantly solid with variable cystic areas. The interior is filled with greasy, yellow-white keratin, sebaceous material and tufts of hair. Most cases have a well-defined solid area (Rokitansky protuberance) (clearly seen in images 38-43) composed of fibro-fatty tissue, projecting into the cyst lumen and containing hair, teeth and/or bone. This focus should be thoroughly sampled as it tends to contain the most variety of tissues.

Other grossly recognizable mature somatic tissues that are frequently seen include: cartilage, mucin-filled cysts, brain, adipose tissue, and thyroid. Rare cases show partially developed organs or even a malformed human fetus (fetiform teratoma). Image courtesy of Ed Uthman, MD, Houston, Texas. Used with permission

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