Types and Frequency of Neural Elements in Mature Ovarian Teratomas: An 11-Year Study from Rural India

Teratomas are those tumors which are derived from the totipotent cells. They may manifest at any site. Ovary is the most common site for teratomas. Ovarian teratomas may be immature and mature depending on the elements they harbor. Mature ovarian teratomas may contain ectoderm, endoderm, and mesoderm. Ectoderm mainly comprises the skin and its adnexa, followed by neural tissue, whereas mesodermal elements are blood vessels, adipose tissue, cartilage, and hematopoietic tissue, similarly, endoderm consists of respiratory tissue, thyroid gland, and gastrointestinal tissue.

This study was conducted in the histopathology section from January 2008 to April 2019 and included 54 cases of mature ovarian teratomas. The slides of ovarian tumors were evaluated, and the relationship between clinical and pathological findings was studied with emphasis predominantly on neural elements.

The most common age group among the women with ovarian teratoma was 21-30 (31.48%) years, the youngest patients been 8 years, and oldest of 60 years. The chief complaints were pain in 37 (68.51%), followed by mass per abdomen 25 (46.29%). On gross examination, most of the tumors were unilateral 53 (98.14%), having tufts of hairs with sebaceous material 34 (61.81%). Microscopic examination confirmed the presence of squamous epithelium and its adnexal structure 52 (94.54%). Neural elements were seen in 14 (25.45%) cases. In every case with neural elements, skin, its adnexa, and adipose tissue were also seen.

Teratomas have diversity in the age of presentation, gross findings, and microscopy features. Neural elements are commonly found in 25.45% of ovarian teratoma which is mostly found in association with skin and adipose tissue. The combination of neural elements with adipose tissue signifies an association between them because both arise from different dermal elements.