The Human Teratomas

Human teratocarcinoma has long held a fascination to the pathologist be cause of the diversity of the seemingly benign differentiated tissues asso ciated with the tumor. An understanding of this diversity came with the demonstration of the pluripotent nature of the embryonal carcinoma cell, the stem cell of the tumor, in experimental animals. Single cell clones of murine embryonal carcinomas were derived and the resultant cell lines injected into immunosuppressed hosts, where the embryonal carcinoma stem cell itself gave rise to the wealth of differentiated tissues seen in teratocarcinomas. It was also shown that teratocarcinomas could be pro duced experimentally by transplantation of staged early mouse embryo to extrauterine sites; subsequent experiments suggested that the embryonal carcinoma stem cell was, in fact, comparable to a normal cell of the em bryonic ectoderm. Many elegant experiments have since been built on this early work; murine embryonal carcinoma cells are providing the ex perimental material for a first biochemical evaluation of the earliest dif ferentiation events in mammalian embryogenesis. In this volume, we relate the beginnings of experimental research on human teratoma. The human embryonal carcinoma cells have been char acterized and established in vitro, providing an experimental model to study the unique biology of these cells. Monoclonal antibodies, estab lished from work with these in vitro cultures, provide cell surface probes that define populations of embryonal cells and their derivatives in tumor sections.

Klappentext

Human teratocarcinoma has long held a fascination to the pathologist be­ cause of the diversity of the seemingly benign differentiated tissues asso­ ciated with the tumor. An understanding of this diversity came with the demonstration of the pluripotent nature of the embryonal carcinoma cell, the stem cell of the tumor, in experimental animals. Single cell clones of murine embryonal carcinomas were derived and the resultant cell lines injected into immunosuppressed hosts, where the embryonal carcinoma stem cell itself gave rise to the wealth of differentiated tissues seen in teratocarcinomas. It was also shown that teratocarcinomas could be pro­ duced experimentally by transplantation of staged early mouse embryo to extrauterine sites; subsequent experiments suggested that the embryonal carcinoma stem cell was, in fact, comparable to a normal cell of the em­ bryonic ectoderm. Many elegant experiments have since been built on this early work; murine embryonal carcinoma cells are providing the ex­ perimental material for a first biochemical evaluation of the earliest dif­ ferentiation events in mammalian embryogenesis. In this volume, we relate the beginnings of experimental research on human teratoma. The human embryonal carcinoma cells have been char­ acterized and established in vitro, providing an experimental model to study the unique biology of these cells. Monoclonal antibodies, estab­ lished from work with these in vitro cultures, provide cell surface probes that define populations of embryonal cells and their derivatives in tumor sections.

Inhalt
1 History of Teratomas.- Early Morphologic and Clinical Studies of Ovarian Teratomas.- Theories of the Origin of Teratomas.- Early Morphologic and Clinical Studies of Testicular Teratomas.- Extragonadal Teratomas.- Teratomas in Animals.- Experimental Studies.- References.- 2 The Pathology of Human Teratomas.- Classification of Germ Cell Tumors.- Origin of Teratomas.- Testicular Teratomas.- Ovarian Teratomas.- Extragonadal Teratomas.- Histopathology.- Embryonal Carcinoma.- Somatic Tissues.- Extraembryonic Tissues.- Nonneoplastic Components of Teratomas.- Variant Forms of Teratomas and Related Lesions.- Monophyletic or Unilaterally Differentiated Teratomas.- Mixed Teratoid Tumors.- Mixed Mullerian Tumors.- Fetus in Fetu.- Site of Origin of Teratomas.- Ovarian Teratomas.- Testicular Teratomas.- Sacrococcygeal Teratomas.- Retroperitoneal Teratomas.- Mediastinal Teratomas.- Teratomas of the Neck.- Intracranial Teratomas.- Teratomas in Unusual Locations.- Associated Lesions and Abnormalities.- Twinning.- Association of Teratomas and Malformations.- Chromosomal Abnormalities and Genetic Predisposition to Teratomas.- Disturbances in the Immune System.- References.- 3 The Origin of Teratomas.- Dermoid Cyst (Benign Cystic Teratoma) of the Ovary.- Genetic Evidence in Favor of a Postmeiotic (Parthenogenic) Origin of Dermoid Cysts.- Teratomas of Testis.- The Application of Genetic Techniques to Germ Cell Tumors of the Testis.- Germ Cell Tumors of the Pineal Gland (and Its Environs).- Teratomas of the Mediastinum.- The Origin of Teratomas of the Pineal Gland, Mediastinum, and Sacrococcygeal Region in the Neonatal Period and in Infancy.- Genetic and Chromosomal Observations on Extragonadal Teratomas and on Individuals Who Have Extragonadal Teratomas.- Teratomas Associated with Sex Chromosome Abnormalities.- X Chromosome Differentiation, Barr Body Formation, and Teratomas.- Discussion.- References.- 4 The Epidemiology of Human Teratomas.- Frequency.- Teratomas of the Ovary.- Testicular Teratomas.- Sacrococcygeal and Presacral Teratomas.- Mediastinal Teratomas.- Retroperitoneal Teratomas.- Renal Teratomas.- Intracranial Teratomas.- Intraspinal Teratomas.- Thyroid and Cervical Teratomas.- Nasopharyngeal Teratomas.- Cardiac, Gastric, Orbital, Hepatic, and Uterine Teratomas.- Conclusions.- References.- 5 Malignant Alteration in Benign Teratomas.- Ovary.- Squamous Cell Carcinoma.- Age and Incidence.- Symptoms.- Gross Pathology.- Histology.- Spread.- Diagnosis and Treatment.- Prognosis.- Carcinoid.- Adenocarcinoma.- Malignant Melanoma.- Sarcoma.- Miscellaneous Tumors.- Etiology and Pathogenesis of Malignant Alteration.- Malignant Alteration in Extraovarian Teratomas.- References.- 6 The Metastasis of Human Teratomas.- Metastasis of Germ Cell Tumors of the Testis.- Incidence and Natural History of Metastasis.- Experimental Data.- Patterns of Metastasis.- History of Metastases.- Effect of Chemotherapy on Metastasis.- Experimental Data.- Metastasis of Germ Cell Tumors of the Ovary.- Metastasis of Extragonadal Germ Cell Tumors.- Conclusions.- References.- 7 Neural Tissues in Human Teratomas.- Frequency of Nervous Tissue in Teratomas.- Types of Neuroectodermal Tissues Present in Teratomas.- Embryonal and Fetal Structures and Tissues.- Mature Structures and Tissues.- Reactive Phenomena in Teratoid Nervous Tissue.- Implants and Neurogenic Metastases in Teratomas.- Ultrastructural Findings in Teratoid Neuroectodermal Tissues.- Clinicopathological Significance of the Neural Components of Teratomas.- References.- 8 Biological Markers of Human Teratomas and Related Germ Cell Tumors.- Pathology.- Malignant Teratomas.- Seminoma.- Immunocytochemical Approach.- Localization of Placental Proteins.- Human Chorionic Gonadotropin (HCG).- Other Placental Proteins.- Markers of Yolk Sac Differentiation.- Alphafetoprotein (AFP).- Other Yolk Sac Products.- Fibronectin.- Carcinoembryonic Antigen (CEA).- Epithelial Membrane Antigen (EMA).- Ferritin.- Lactate Dehydrogenase.- Tumors Devoid of Distinct Markers.- Radioimmunolocalization.- Multiple Markers.- Classification of Testicular Tumors.- References.- 9 Endocrine Aspects of Germ Cell Tumors.- Mechanisms Underlying Endocrine Manifestations.- Associated Clinical Syndromes.- Syndromes Associated with HCG Production.- Syndromes Arising from Steroid Hormone Production in the Absence of HCG.- Syndromes Resembling Those of Thyroid Hyperfunction.- Carcinoid Syndrome.- Syndromes of Ectopic Hormone Secretion.- References.- 10 Polypeptide Hormone-Producing Cells in Human Teratomas.- Testicular Teratomas.- Ovarian Teratomas.- Related Ovarian Neoplasms.- Ovarian Carcinoids.- Cystic Mucinous Tumors.- Biological Implications and Clinical Significance of Polypeptide Hormone-Producing Cells in Teratomas.- References.- 11 Chemotherapy of Ter…