CT features of benign and malignant teratomas in children

Computed tomography of 15 pediatric patients with teratomas of the chest, abdomen, and pelvis was reviewed to compare the features of benign and malignant lesions. Particular attention was paid to the frequency of characteristic CT features of this lesion, namely fat, calcification, and mural nodules. Of the 10 benign masses, 8 were predominantly cystic, usually containing less than 10% soft tissue components. One benign lesion was complex and one was nearly solid. Fat was found in 9 of 10 lesions (90%), calcification in 7 (70%), and mural nodules in 7 (70%). All five malignant teratomas were predominantly solid, containing primarily soft tissue contents. Approximately 80% of malignant tumors had CT evidence of local invasion or distant metastases. Three of five malignant lesions (60%) contained calcifications and two of five (40%) had fat. None had recognizable mural nodules. Our experience suggests that typical CT features of teratomas occur more often in benign than in malignant lesions.