Prepubertal vs Postpubertal Teratomas

Prepubertal-type teratomas typically present before the age of 6 years. Clinically and biologically, they are distinct from postpubertal teratomas. Prepubertal-type teratomas:

• are not associated with germ cell neoplasia-in-situ
• lack cytologic atypia
• do not show chromosome 12p amplification
• are not associated with gonadal dysgenesis, microliths, or parenchymal scarring
• behave in a benign fashion with no risk of recurrence and metastasis
• can be appropriately treated with conservative (testis-sparing) approach

Prepubertal-type teratomas can rarely present in adults. It has been suggested that cases detected in adult life may have been present since childhood but remained undiagnosed until much later.

This orchiectomy specimen from an adult male shows an epidermoid cyst. It is filled with yellow-white keratinous material with a hint of concentric or lamellar arrangement. The surrounding testis appears normal and did not show any atypia or germ cell neoplasia-in-situ upon extensive sampling.