F. Edegbe1, C.O. Okani2, A.A. Obasi3 and P.O. Ezeonu4
- Department of Histopathology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
- Department of Histopathology, Chukwuemeka Odumegwu Ojukwu University, Awka Campus, Anambra State, Nigeria (Formerly, Anambra State University, Awka Campus.)
- Department of Surgery, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
- Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
Any neoplastic growth within a tissue or an organ harboring components derived from more than one germ layer is called a teratoma. Teratoma may be monodermal or polydermal in origin and they can also be classified as mature or immature teratomas. In a retrospective study of teratomas histologically diagnosed in the Department of Pathology, Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, the entire specimens received at the Department for histological assessment over a fifteen-year period (2000-2014), was 6,548. However, only 28 (0.4%) of the entire specimens represented teratoma. Twenty five (89.3%) of the teratomas were females and only 3(10.7%) were males, giving a male to female gender ratio of 1:8.3. The most common site of occurrence was the ovary accounting for 18(64.3%) followed by the sacrococccyx representing 4(14.3%) cases. All the 28(100%) cases of teratomas were benign neoplasm (mature cystic teratomas) containing two or three germ cell layers with one of the cases noted as a giant teratoma. We observed an important bimodal age distributions; with a first peak occurring between 0-10 years (in the first decade of life) and a second peak (in the 3rd decade) between 20-30 years of age.
Keywords: Teratoma, Germ cells
Dr. C.O. Okani
Department of Histopathology,
Teratomas refer to neoplasms composed of multiple tissues arising from the three germ layers foreign to the site in which they arise and are known as germ cell tumours. Germ cell tumours are diverse group of neoplasms that originate in the primordial germ cells of the yolk sac. These primordial germ cells are formed in the gonads and extragonadal sites during embryogenesis. There are migration anomalies in tissue differentiation, leading to development of one tumour cell that has full range of histogenetic tissue elements of ectoderm, mesoderm and endoderm1. Teratomas occurrence is worldwide.2-5
Several publications on teratomas from Africa are available. Akang (Ibadan, South-West Nigeria) documented that teratomas occurred more in females with the ovary being the commonest site of involvement.2 From outside Africa, Petr Havránek and co-workers, and Girwalkar-Bagle and co-workers have also noted that sacrococcyx is another common site of involvement in childhood teratoma.6-8 Several other researchers also documented teratomas involving the cervical9, gastric10 and renal11 tissues. It is pertinent to note that there is paucity of documentation on teratoma which have emanated from South-East Nigeria. This review, therefore, aims at establishing a hospital-based incidence and histopathological features of teratomas in Abakaliki, Ebonyi State, South-East Nigeria.
MATERIALS AND METHODS
Surgical specimens received at the Department of Pathology, Federal Teaching Hospital, Abakaliki, Ebonyi State, between January, 2000 and December, 2014 constituted the materials for the study. All the cases of teratoma diagnosed during the period under review were retrieved from the Histopathology Department’s Surgical Daybook and from the requisition forms. The corresponding clinical data, gross descriptions of histopathologically diagnosed cases were extracted and carefully recorded. The H&E (haematoxylin and eosin) stained slides of each case were also retrieved for reconfirmation of the original diagnosis. If the slides were unavailable, new slides were produced from the archived formalin-fixed paraffin-embedded tissue blocks (FFPB).
The tumours were classified according to 2004 WHO classification12. Cases in which the demographic data were absent and both the histology slides and blocks could not be retrieved were excluded from the study.