Mature cystic teratoma of the ovary

By Jason Wasserman MD PhD FRCPC
June 7, 2023

What is a mature cystic teratoma?

A mature cystic teratoma is a type of non-cancerous ovarian tumour. It develops from the germ cells in the ovary. It is the most common non-cancerous ovarian tumour in adults. Because teratomas start from a type of cell that has the ability to turn into any other type of cell, teratomas may contain a variety of tissue types including skin, teeth, hair, brain, and muscle. Despite this potential, most teratomas are made up almost entirely of one or two types of tissue with skin being the most common. Many tumours made of skin contain a hollow centre called a cyst.

Special types of mature teratomas

Some mature teratomas are given special names if they contain specific types of tissue.

  • Dermoid cyst – This is a teratoma made up almost entirely of skin.
  • Struma ovarii – This is a teratoma that contains thyroid gland tissue.

How do pathologists make this diagnosis?

The diagnosis of mature teratoma is usually only made after the entire tumour has been removed and the tissue sent to a pathologist for examination.​ Most teratomas are called ‘mature’ because, when viewed under a microscope, the tissue inside the tumour looks like the normal mature tissue found in adults. For example, the ‘skin’ inside a mature teratoma would look the same under the microscope as the skin on your arm.

Tumour size

This is the size of the tumour measured in centimetres (cm). Tumour size will only be described in your report after the entire tumour has been removed. The tumour is usually measured in three dimensions but only the largest dimension is described in your report. For example, if the tumour measures 4.0 cm by 2.0 cm by 1.5 cm, your report will describe the tumour as being 4.0 cm.

Immature tissue

As described above, mature teratomas contain tissue that resembles adult tissue. Some teratomas, however, also contain tissue immature tissue which is normally found in a developing human (embryo or fetus). Your pathologist will closely examine the tumour to make sure there is no immature tissue before making the diagnosis of mature teratoma. A mature teratoma should contain no immature tissue.

Can cancer start in a mature teratoma?

Mature teratomas are non-cancerous tumours. However, in rare situations, cancer can develop from one of the tissues inside the teratoma. Because teratomas are made up of different types of tissue, almost any type of cancer can start inside a teratoma. For example, if cancer starts in an area of tissue that looks like skin, the cancer will look very similar to adult-type skin cancer.

In situations where cancer is seen inside of a teratoma, the diagnosis will include both the mature teratoma and the name of the cancer. Cancer found inside a mature teratoma can spread to other parts of your body. Talk to your doctor about the treatment options for this type of cancer.

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