Teratoma Diagnosis and Characteristics

Clinical Presentation

The American College of Radiology notes that teratomas typically present as a pelvic or abdominal mass with subacute pain, pelvic pressure, and menstrual irregularities, although up to half of patients may be asymptomatic 1, 2
The American College of Radiology recommends considering teratomas in the differential diagnosis for women with pelvic pain and menstrual irregularities, as they can cause subacute pain and pelvic pressure 1, 2

The Journal of the American College of Radiology states that teratomas have specific ultrasonographic characteristics, including an echogenic attenuating component 3, 4
The Journal of the American College of Radiology notes that computed tomography (CT) scans can show characteristic calcifications, such as teeth, and macroscopic fat 4, 6
The American College of Radiology recommends using magnetic resonance imaging (MRI) to evaluate teratomas, as it can show the presence of fat and calcifications 4, 6
The Annals of Oncology notes that alpha-fetoprotein (AFP) is a useful tumor marker for evaluating residual or recurrent disease 7

The Journal of the American College of Radiology advises against assuming that all cystic masses are benign and recommends continuing evaluation until a definitive diagnosis is obtained 5
The Journal of the American College of Radiology warns against confusing pedunculated fibromas with teratomas and recommends identifying normal ovaries and the vascular supply of the uterine vessels 3, 4, 6