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Post-pubertal Teratoma : Prognosis

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Prognosis: Post-pubertal teratomas present with metastases in 22-37% of cases. The individual components (epithelial vs mesenchymal), the presence of cytologic atypia, and the presence or absence of immature elements have no impact on prognosis and should not be mentioned in the final report, as long as such foci are small.

If a dysplastic focus forms a pure nodule larger than a single field of view at 4x magnification, a diagnosis of somatic-type malignancy arising in a teratoma is made.

In treated mixed germ cell tumors (GCTs) with residual malignancy, teratoma is the most common component. When teratoma is the only component in lymph node metastases, the prognosis is usually good. Late recurrences (> 2 yrs. after complete response to therapy) are usually teratomas and are associated with better prognosis than post-chemotherapy recurrence with non-teratomatous GCTs. When pure teratomas metastasize, the whole spectrum of GCTs may be seen in the metastatic deposits.

This image from a post-pubertal teratoma shows enteric-type glands on the right and neuroectodermal elements forming rosettes on the left.

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