What are the other Names for this Condition? (Also known as/Symptoms)
- Primary Benign Lung Teratoma
- Primary Benign Pulmonary Teratoma
- Pulmonary Germ Cell Tumor - Primary Benign Teratoma
What is Primary Benign Teratoma of Lung? (Definition/Background Information)
- A teratoma of lung is the most common type of germ cell tumor of the lung. However, the lung is a very uncommon site for such a tumor, and hence, the origin of the teratoma from other common sites (such as gonads) should be eliminated prior to establishing a diagnosis of primary teratoma of lung
- There are 2 main forms of pulmonary teratomas:
- Mature teratoma of lung
- Immature teratoma of lung
- Teratoma of lung may be cancerous or benign. A majority of benign teratomas are mature teratomas, while a majority of malignant teratomas are immature teratomas
- Teratoma of lung is typically seen in childhood and young adulthood. The cause of formation of Primary Benign Teratoma of Lung is unknown. Also, presently the risk factors are not well-established
- The tumors may grow to large sizes and obstruct the lung airways. The presenting signs and symptoms of Primary Benign Teratoma of Lung may include shortness of breath, chest pain, and blood in sputum
- The treatment of Primary Benign Teratoma of Lung involves surgery to remove the tumors. In a majority of cases, the prognosis of Primary Benign Lung Teratoma is excellent with adequate treatment
Who gets Primary Benign Teratoma of Lung? (Age and Sex Distribution)
The specific demographics on Primary Benign Teratoma of Lung are unavailable. However, the following may be noted:
- Teratoma of lung is rare and is mostly observed in older children and young adults; the peak age range is between 10-40 years
- Infants, very young children, and older adults may also be affected. The overall age range is between 10 months to 68 years
- Both males and females are affected, although a slight preference for females is observed
- No specific racial or ethnic group predilection is noted
What are the Risk Factors for Primary Benign Teratoma of Lung? (Predisposing Factors)
- Currently, no definite risk factors have been identified for Primary Benign Teratoma of Lung
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Primary Benign Teratoma of Lung? (Etiology)
The cause of development of Primary Benign Teratoma of Lung is generally unknown.
- It is believed that abnormal differentiation of germ cells gives rise to cancerous cells that lead to the formation of this condition
- The tumor is thought to arise from abnormally-placed pharyngeal tissues (from the pharyngeal pouch or Zenker’s diverticulum); pharyngeal pouches are known to form during embryological development
What are the Signs and Symptoms of Primary Benign Teratoma of Lung?
The signs and symptoms of Primary Benign Teratoma of Lung may include the following:
- Presence of a well-circumscribed lesion in the upper lobes of the lung
- Cystic tumors may involve the airways/bronchus
- The tumors may range in size from 3 to 30 cm
- The growth of the tumor mass may obstruct the airway
- Tumors affecting the bronchus can cause obstructive symptoms including chest pain, cough, breathing difficulties, and blood in sputum
- Trichoptysis: It is the most unusual and ‘specific’ sign of a teratoma, where the individual coughs-up hair or hair-like particles. This may occur from pulmonary teratomas or mediastinal teratomas (that have invaded the lung)
How is Primary Benign Teratoma of Lung Diagnosed?
There are a variety of tests the healthcare provider may employ to diagnose Primary Benign Teratoma of Lung, which may include:
- Physical examination and complete medical history screening: During the physical exam, the healthcare provider may listen to the lung with a stethoscope, to detect the presence of any abnormal lung sounds
- Imaging studies that may include a chest X-ray, MRI or CT scan of the lungs
- Arterial blood gases
- Lung function test
- Sputum cytology: This procedure involves the collection of mucus (sputum), coughed-up by the patient, which is then examined in a laboratory by a pathologist
A tissue biopsy refers to a medical procedure that involves the removal of cells or tissues, which are then examined by a pathologist. This can help establish a definitive diagnosis. The different biopsy procedures may include:
- Bronchoscopy: During bronchoscopy, a special medical instrument called a bronchoscope is inserted through the nose and into the lungs to collect small tissue samples. These samples are then examined by a pathologist, after the tissues are processed, in an anatomic pathology laboratory
- Thoracoscopy: During thoracoscopy, a surgical scalpel is used to make very tiny incisions into the chest wall. A medical instrument called a thoracoscope is then inserted into the chest, in order to examine and remove tissue from the chest wall, which are then examined further
- Thoracotomy: Thoracotomy is a surgical invasive procedure with special medical instruments to open-up the chest. This allows a physician to remove tissue from the chest wall or the surrounding lymph nodes of the lungs. A pathologist will then examine these samples under a microscope after processing the tissue in a laboratory
- Fine needle aspiration biopsy (FNAB): During fine needle aspiration biopsy, a device called a cannula is used to extract tissue or fluid from the lungs, or surrounding lymph nodes. These are then examined in an anatomic pathology laboratory, in order to determine any signs of abnormality. Nevertheless, FNAB is not a preferred method for the biopsy of lung tumors
- Autofluorescence bronchoscopy: It is a bronchoscopic procedure in which a bronchoscope is inserted through the nose and into the lungs and measure light from abnormal precancerous tissue. Samples are collected for further examination by a pathologist
Tissue biopsy from the affected lung:
- A biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
- Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
- Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, flow cytometric analysis and very rarely, electron microscopic studies, to assist in the diagnosis
A differential diagnosis with respect to other lung cancer types may be necessary prior to establishing a definite diagnosis, by excluding the following cancers:
- Teratoma that has spread from other body sites
- Other pulmonary germ cell tumors
- Pulmonary hamartoma
- Glial heteropia affecting the lung (observed in children with neural tube defects)
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Primary Benign Teratoma of Lung?
The complications of Primary Benign Teratoma of Lung may include the following:
- Severe obstruction of the airways in case of a large-sized tumor
- Recurrence of the tumor following its incomplete surgical removal. However, mature teratomas of lung can be completely removed in most cases, and recurrences are not commonly noted
How is Primary Benign Teratoma of Lung Treated?
The treatment of Primary Benign Teratoma of Lung may involve the following:
- Generally, the treatment of choice is complete surgical excision for all teratomas (mature or immature)
- Follow-up care with regular screening and check-ups are important and encouraged
How can Primary Benign Teratoma of Lung be Prevented?
Currently, there are no known methods to prevent the development of Primary Benign Teratoma of Lung.
What is the Prognosis of Primary Benign Teratoma of Lung? (Outcomes/Resolutions)
- The prognosis of Primary Benign Teratoma of Lung is typically excellent with complete surgical removal of the tumor
- However, infrequently it may recur following an incomplete excision and removal
Additional and Relevant Useful Information for Primary Benign Teratoma of Lung:
The following article link will help you understand other cancers and benign tumors: