Dermoid cyst

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Author: Mikael Häggström [notes 1]

Fixation

Generally 10% neutral buffered formalin.

Gross processing

Example gross report:

(Optionally: A. Labeled - __ The specimen is received in formalin and consists of) tan-pink to yellow cystic ovarian tissue measuring __ cm. The cyst lining reveals multiple patches of hair with associated greasy yellow keratinous material. Cross-sections show several plate-like areas of rubbery grey-white cartilage. Representative sections are submitted for microscopic examination in three cassettes.

Tissue sampling

Generally sample approximately 3 cassettes in order to be able to rule out immature elements.

There is no need to sample by Rokitansky nodules as these do not have any significant risk of containing immature elements.

Microscopic evaluation

The main components are:

  • Diagnosis as a teratoma
  • Ruling out an immature teratoma, and thereby establishing a diagnosis as a "mature (cystic) teratoma".

Teratoma diagnosis

Mature cystic teratoma (dermoid) cyst, showing components from several germ layers.

The diagnostic criterion is a well-differentiated components from at least two germ layers (ectoderm, mesoderm and/or endoderm).[1] Representative tissues of these are:

  • Ectoderm:
  • Mesoderm:

Striated muscle, smooth muscle

  • Endoderm:
  • Thyroid tissue
  • Gastrointestinal mucosa

Immature teratoma

The finding of immature tissues confer a diagnosis of immature teratomas:

Immature neuroepithelium is the most common finding, but immature cartilage and/or skeletal muscle are occasionally seen.[2]

See also

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
  2. Teeth also contain ectodermal (outer) layers of embryonic tissues.
    - . Tooth germ. Encyclopaedia Britannica. Retrieved on 2021-03-31.

Main page

References

  1. Sahin, Hilal; Abdullazade, Samir; Sanci, Muzaffer (2017). "Mature cystic teratoma of the ovary: a cutting edge overview on imaging features ". Insights into Imaging 8 (2): 227–241. doi:10.1007/s13244-016-0539-9. ISSN 1869-4101. 
  2. Modern surgical pathology (2nd ed.). Philadelphia, PA: Saunders/Elsevier. 2009. ISBN 9781416039662. OCLC 460883320.