Teratoma Health Dictionary

A malignant tumour of the testis (see TESTICLE) that appears as an often painless swelling. This tumour usually occurs in an older age-group of men than does TERATOMA. The treatment is surgical removal. (See also TESTICLE, DISEASES OF.)... seminoma

A noncancerous tumour with a cell structure similar to that of skin.

It contains hairs, sweat glands, and sebaceous glands.

Dermoid cysts may also contain fragments of cartilage, bone, and even teeth.

The cysts may occur in various parts of the body.

Ovarian dermoid cysts account for 10 per cent of all ovarian tumours.

Only rarely do they become cancerous.

In the skin, dermoid cysts most commonly occur on the head or neck.

Surgical removal is usually recommended.

(See also teratoma).... dermoid cyst

A protein that is produced in the liver and gastrointestinal tract of the fetus and by some abnormal tissues in adults.

Alpha-fetoprotein (AFP) can be measured in the maternal blood from the latter part of the 1st trimester of pregnancy, and its concentration rises between the 15th and 20th weeks.

Raised levels of are associated with fetal neural tube defects, such as spina bifida or anencephaly, and certain kidney abnormalities. High levels of also occur in multiple pregnancies (see pregnancy, multiple) and threatened or actual miscarriage. levels may be unusually low if the fetus has Down’s syndrome. For this reason, measurement of blood is included in blood tests, which are used to screen pregnant women for an increased risk of Down’s syndrome.

levels are commonly raised in adults with hepatoma (see liver cancer), cancerous teratoma of the testes or ovaries, or cancer of the pancreas, stomach, or lung.

For this reason, is known as a tumour marker.

(AFP) levels can be used to monitor the results of treatment of certain cancers; increasing levels after surgery or chemotherapy may indicate tumour recurrence.

However, levels are also raised in some noncancerous conditions, including viral and alcoholic hepatitis and cirrhosis.... alpha-fetoprotein

The use of naturally occurring isotopes, or arti?cially produced X-rays, in the killing of tumour cells. The amount of radiation is the adsorbed dose; the SI unit is the gray (Gy).

Di?erent tumours seem to be particularly sensitive to radiation; radiotherapy plays an important role in the management of germ-cell tumours (SEMINOMA; TERATOMA) and lymphomas (see LYMPHOMA). Many head and neck tumours, gynaecological cancers, and localised prostate and bladder cancers are curable with radiotherapy. It may be used to reduce the pain

– for example, from bone metastases.

Unwanted effects Generalised: lethargy, loss of appetite. Skin: ERYTHEMA, dry desquamation with itching, moist desquamation. Patients should keep the treated area(s) dry and clean and avoid soap, antiseptic mouthwashes, smoking and spicy food if possible. (See ISOTOPE; RADIATION SICKNESS; RADIOTHERAPY).... irradiation

The management of MALIGNANT disease – a major health problem since successful management requires close liaison between the patient, surgeons, physicians, oncologists, haematologists, paediatricians and other specialists. Diagnosis may involve various investigations and often requires a BIOPSY. Once a diagnosis has been established, treatment may involve surgery, radiotherapy or chemotherapy (or various combinations as required) – see below, and main dictionary entries.

Surgery may be most common, and is often the only treatment, for some gastrointestinal tumours, soft-tissue tumours, gynaecological tumours and advanced cancers of the head and neck.

Radiotherapy uses ionising radiation to kill tumour cells. Radiation is by naturally occurring isotopes (see ISOTOPE) or arti?cially produced X-RAYS. Germ-cell tumours (see SEMINOMA; TERATOMA) and malignant lymphomas (see LYMPHOMA) appear to be particularly sensitive to irradiation, and many head and neck tumours, gynaecological cancers, and localised cancers of the PROSTATE GLAND and URINARY BLADDER are curable with radiotherapy. It is also a valuable means of reducing pain from bone metastases (see METASTASIS). Unpleasant side-effects are common: chie?y lethargy, loss of appetite and dry, itchy skin symptoms.

Chemotherapy is also an important treatment in germ-cell tumours (see above); in some forms of LEUKAEMIA and lymphoma; in ovarian cancer (following surgery – see OVARIES, DISEASES OF); and in small-cell lung cancer (although most patients die within 18 months – see LUNGS, DISEASES OF). It is also used in some breast cancers (see BREASTS, DISEASES OF); advanced myeloma (see MYELOMATOSIS); sarcomas (see under CANCER); and some childhood cancers (such as WILMS’ TUMOUR).

More than 20 substances are in common use, the major classes being ALKYLATING AGENTS (e.g. cyclophosphamide, chlorambucil, busul fan); ANTIMETABOLITES (e.g. methotrexate); VINCA ALKALOIDS (e.g. vincristine, vinblastine); and antitumour ANTIBIOTICS (e.g. actinomycin D). Choice of agent and the appropriate regimen requires expert guidance. Common side-effects include nausea and vomiting, bone-marrow suppression and ALOPECIA, with each substance having its own spectrum of unwanted effects.

Good doctor-patient communication, with the sharing of information and bringing the patient into the decision-making process, is vital even if time-consuming and exhausting.

Equally imortant treatment is PALLIATIVE, for example to ensure e?ective pain or nausea control. Common sources of pain in cancer may involve bone, nerve compression, soft tissue, visceral, myofascial, constipation, muscle spasm, low-back pain, joint pain (e.g. capsulitis) and chronic post-operative pain. Patients may be suffering from more than one pain, all of which should be identi?ed. The aim should be to eliminate pain.

There are three rungs of the analgesic ladder; if one rung fails, the next one should be tried:

(1) non-opioid drugs – for example, aspirin, PARACETAMOL, NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS); (2) weak opioids – for example, CODEINE, DIHYDROCODEINE, dextropropoxyphene; (3) strong opioids

– for example, MORPHINE, DIAMORPHINE, buprenorphine. Oral treatment is always preferable, unless prevented by severe vomiting. (See also CANCER; ONCOLOGIST; PAIN; PALLIATIVE CARE.)... oncology

The treatment of disease (mainly CANCER) with penetrating RADIATION. For many years RADIUM and X-RAYS were the only sources available, but developments in knowledge led to the use of powerful X-rays, beta rays or gamma rays, either produced by linear accelerator machines or given o? by radioactive isotopes (see ISOTOPE). The latter is rarely used now.

Beams of radiation may be directed at the tumour from a distance, or radioactive material

– in the form of needles, wires or pellets – may be implanted in the body. Sometimes germ-cell tumours (see SEMINOMA; TERATOMA) and lymphomas (see LYMPHOMA) are particularly sensitive to irradiation which therefore forms a major part of management, particularly for localised disease. Many head and neck tumours, gynaecological cancers, and localised prostate and bladder cancers are curable with radiotherapy. Radiotherapy is also valuable in PALLIATIVE CARE, chie?y the reduction of pain from bone metastases (see METASTASIS). Side-effects are potentially hazardous and these have to be balanced against the substantial potential bene?ts. Depending upon the type of therapy and doses used, generalised effects include lethargy and loss of appetite, while localised effects – depending on the area treated – include dry, itchy skin; oral infection (e.g. thrush – see CANDIDA); bowel problems; and DYSURIA.... radiotherapy

A tumour of the THYMUS GLAND. Such tumours are rare and are classi?ed according to the variety of thymus tissue from which they develop. Epithelial thymomas grow slowly and rarely spread. If the tumour arises from LYMPHOID TISSUE, it may progress to a generalised non-Hodgkin’s LYMPHOMA. Another variety is a thymic TERATOMA which is normally benign in women but malignant in men. Thymomas may affect the working of the immune system (see IMMUNITY), increasing the likelihood of infection. They are also associated with MYASTHENIA GRAVIS – an autoimmune disorder; removal of the gland may cure the disorder.... thymoma

The SCROTUM may be affected by various skin diseases, particularly eczema (see DERMATITIS) or fungal infection. A HERNIA may pass into the scrotum. Defective development of the testicles may lead to their retention within the abdomen, a condition called undescended testicle.

Hydrocoele is a collection of ?uid distending one or both sides of the scrotum with ?uid. Treatment is by withdrawal of the ?uid using a sterile syringe and aspiration needle.

Hypogonadism Reduced activity of the testes or ovaries (male and female gonads). The result is impaired development of the secondary sexual characteristics (growth of the genitals, breast and adult hair distribution). The cause may be hereditary or the result of a disorder of the PITUITARY GLAND which produces GONADOTROPHINS that stimulate development of the testes and ovaries.

Varicocoele is distension of the veins of the spermatic cord, especially on the left side, the causes being similar to varicose veins elsewhere (see VEINS, DISEASES OF). The chief symptom is a painful dragging sensation in the testicle, especially after exertion. Wearing a support provides relief; rarely, an operation may be advisable. Low sperm-count may accompany a varicocele, in which case surgical removal may be advisable.

Orchitis or acute in?ammation may arise from CYSTITIS, stone in the bladder, and in?ammation in the urinary organs, especially GONORRHOEA. It may also follow MUMPS. Intense pain, swelling and redness occur; treatment consists of rest, support of the scrotum, analgesics as appropriate, and the administration of antibiotics if a de?nitive microorganism can be identi?ed. In some patients the condition may develop and form an ABSCESS.

Torsion or twisting of the spermatic cord is relatively common in adolescents. About half the cases occur in the early hours of the morning during sleep. Typically felt as pain of varying severity in the lower abdomen or scrotum, the testis becomes hard and swollen. Treatment consists of immediate undoing of the torsion by manipulation. If done within a few hours, no harm should ensue; however, this should be followed within six hours by surgical operation to ensure that the torsion has been relieved and to ?x the testes. Late surgical attention may result in ATROPHY of the testis.

Tuberculosis may occur in the testicle, especially when the bladder is already affected. Causing little pain, the infection is often far advanced before attracting attention. The condition generally responds well to treatment with a combination of antituberculous drugs (see also main entry for TUBERCULOSIS).

Tumours of the testes occur in around 600 males annually in the United Kingdom, and are the second most common form of malignant growth in young males. There are two types: SEMINOMA and TERATOMA. When adequately treated the survival rate for the former is 95 per cent, while that for the latter is 50 per cent.

Injuries A severe blow may lead to SHOCK and symptoms of collapse, usually relieved by rest in bed; however, a HAEMATOMA may develop.... testicle, diseases of

Rare, but increasing in most countries. Three main types: teratomas, seminomas and lymphomas. The latter affect older men.

Symptoms. A hard usually painless mass in the scrotum can give rise to gynaecomastia – abnormal enlargement of the male breasts.

Of possible value. Alternatives: – Abundant herb teas – Cornsilk, Red Clover, Violet leaves.

Decoction. Echinacea 2; Kava Kava 1; Sarsaparilla 1. Mix. Half an ounce (15g) to 1 pint (500ml) water simmered gently 20 minutes. Cup thrice daily.

Formula. Sarsaparilla 2; Kava Kava l; Pulsatilla half; Thuja quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily. Vinchristine.

Diet. See: DIET – CANCER. Researchers from Cambridge University found that an extra pint of milk a day during adolescence was associated with 2 and a half times increased risk of testicular cancer. (Journal of Epidemiology and Community Health, Oct. 1993)

Treatment by or in liaison with a general medical practitioner. ... cancer – testicles

A rare, cancerous tumour of the testis. Testicular cancer is most common in young to middle-aged men, and the risk increases in individuals with a history of undescended testis (see testis, undescended). The most common types of testicular cancer are seminomas, which are made up of only 1 type of cell, and teratomas. The cancer usually appears as a firm, painless swelling of 1 testis. There may also be pain and inflammation. Biopsy, followed by orchidectomy, is the usual treatment, and may be combined with chemotherapy. The tumours usually respond well to treatment.... testis, cancer of

n. difficult birth, caused by abnormalities in the fetus or the mother (see obstructed labour). Dystocia may arise due to uterine *inertia, which is more common in a first labour; abnormal fetal lie or presentation; absolute or relative *cephalopelvic disproportion; or (rarely) a massive fetal tumor, such as a sacrococcygeal teratoma. Synthetic oxytocin (Syntocinon) is commonly used to treat uterine inertia. However, pregnancies complicated by dystocia often end with assisted deliveries, including forceps, ventouse, or (commonly) Caesarean section. See also shoulder dystocia.... dystocia

a tumour arising in *germ cells, commonly in the testis and ovary but also found at other sites. Examples are *teratomas, *seminomas, *dysgerminomas, and *choriocarcinomas. They may be benign or malignant and typically occur in children and young adults. Tumour markers, including *alpha-fetoprotein and beta *human chorionic gonadotrophin, can be used to monitor disease.... germ cell tumour

(hCG) a hormone, similar to the pituitary *gonadotrophins, that is produced by the placenta during pregnancy. hCG maintains the secretion of *progesterone by the corpus luteum of the ovary, the secretion of pituitary gonadotrophins being blocked during pregnancy. Large amounts are excreted in the urine, and this is used as the basis for most *pregnancy tests. Serum hCG monitoring is used for tracking early pregnancy and detecting *ectopic pregnancies (in which the level will not double over a 48-hour period, as it does with normal pregnancies). The level of hCG in the serum is also one of the indicators used in *prenatal screening tests: levels are higher in pregnancies affected by Down’s syndrome in comparison with normal pregnancies (see also papp-a; triple test). Levels of hCG are very high in *gestational trophoblastic neoplasia. Some malignant tumours (e.g. malignant teratoma, choriocarcinoma, endodermal sinus tumour) secrete hCG, which can be used as a *tumour marker. A preparation of hCG is given by injection to treat fertility problems due to ovulation disorders and to induce *superovulation in in vitro fertilization.... human chorionic gonadotrophin

n. fine hair covering the body and limbs of the human fetus. It is most profuse at about the 28th week of gestation and is shed around 40 weeks. Lanugo is often found in teratomas.... lanugo

a receptor on synapses that binds the *neurotransmitter glutamate and also binds its *agonist NMDA (N-methyl-D-aspartate). This receptor is involved in learning, memory, mood, and cognition; its overactivity is associated with chronic pain. NMDA-receptor antibodies are associated with an *encephalitis preceded by psychiatric symptoms, often in patients with ovarian malignancy (teratoma). NMDA-receptor antagonists (e.g. *amantadine, *memantine hydrochloride, *riluzole) are used in the treatment of (among other conditions) epilepsy, Alzheimer’s disease, and chronic pain syndromes.... nmda receptor

n. surgical removal of a testis. A radical orchidectomy, using an incision in the inguinal region, is performed for malignant tumours within the testis (usually germ-cell tumours, such as *seminoma or *teratoma). Orchidectomy may also be performed for *infarction of the testis. Removal of both testes (bilateral orchidectomy: see castration) causes sterility and reduces levels of testosterone by 90%, which is an effective treatment for advanced prostate cancer.... orchidectomy

a *teratoma of the ovary containing thyroid tissue that becomes overactive and causes thyrotoxicosis. It is diagnosed by radioiodine scanning showing a high uptake in the pelvis; the treatment is surgical removal of the affected ovary.... struma ovarii

a substance produced by a tumour that can be used to aid detection of the tumour and to monitor its size and the effects of treatment. An example is *alpha-fetoprotein, which is used to monitor treatment of malignant *teratomas. See also CA125; CA19-9; carcino-embryonic antigen; human chorionic gonadotrophin.... tumour marker