Teratoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]


  • 1. World Health Organization classification of CNS Germ Cell Tumors[1]
  • Germinomas
  • Nongerminomatous germ cell tumor (NGGCT) groups
  • Choriocarcinoma.
  • Embryonal carcinoma.
  • Mixed germ cell tumor.
  • Teratoma.
  • Immature.
  • Mature.
  • Teratoma with malignant transformation.
  • Yolk sac tumor.
  • 2. Childhood Extracranial Germ Cell Tumors classification
  • 2.1 GCTs arise from primordial germ cells, which migrate during embryogenesis from the yolk sac through the mesentery to the gonads.[2][3] Childhood extracranial GCTs can be divided into the following two types:
  • Gonadal.
  • Extragonadal.
  • 2.2 Most childhood extragonadal GCTs arise in midline sites (i.e., sacrococcygeal, mediastinal, and retroperitoneal); the midline location may represent aberrant embryonic migration of the primordial germ cells.Childhood extracranial GCTs are broadly classified as the following:
  • Mature teratomas.
  • Immature teratomas.
  • Malignant GCTs.
  • 2.3 GCTs comprise a variety of histologic diagnoses and can also be divided into the following histologic types:
  • Germinoma.
  • Germinoma.
  • Dysgerminoma (ovary).
  • Seminoma (testis).
  • Nongerminoma.
  • Teratoma (mature and immature).
  • Yolk sac tumor (endodermal sinus tumor).
  • Choriocarcinoma.
  • Embryonal carcinoma.
  • Gonadoblastoma.
  • Mixed GCT
  • 2.4 Pediatric GCT Biology
  • The following biologically distinct subtypes of GCTs are found in children and adolescents:
  • Testicular GCTs.
  • Ovarian GCTs.
  • Extragonadal extracranial GCTs.
  • 3. Cellular Classification of Ovarian Germ Cell Tumors
  • The following histologic subtypes have been described.[4][5]
  • Dysgerminoma.
  • Other germ cell tumors:
  • Endodermal sinus tumor (rare subtypes are hepatoid and intestinal).
  • Embryonal carcinoma.
  • Polyembryoma.
  • Choriocarcinoma.
  • Teratoma:
  • Immature.
  • Mature:
  • Solid.
  • Cystic:
  • Dermoid cyst (mature cystic teratoma).
  • Dermoid cyst with malignant transformation.
  • Monodermal and highly specialized:
  • Struma ovarii.
  • Carcinoid.
  • Struma ovarii and carcinoid.
  • Others (e.g., malignant neuroectodermal and ependymoma).
  • Mixed forms.
  • 4. Cellular Classification of Testicular Cancer [6][7][8]
  • Intratubular germ cell neoplasia, unclassified.
  • Malignant pure germ cell tumor (showing a single-cell type):
  • Seminoma.
  • Embryonal carcinoma.
  • Teratoma.
  • Choriocarcinoma.
  • Yolk sac tumor.
  • Malignant mixed germ cell tumor (showing more than one histologic pattern):
  • Embryonal carcinoma and teratoma with or without seminoma.
  • Embryonal carcinoma and yolk sac tumor with or without seminoma.
  • Embryonal carcinoma and seminoma.
  • Yolk sac tumor and teratoma with or without seminoma.
  • Choriocarcinoma and any other element.
  • Polyembryoma.


  1. Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N; et al. (1997). "Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases". J Neurosurg. 86 (3): 446–55. doi:10.3171/jns.1997.86.3.0446. PMID 9046301.
  2. Dehner LP (1983). "Gonadal and extragonadal germ cell neoplasia of childhood". Hum Pathol. 14 (6): 493–511. PMID 6343221.
  3. McIntyre A, Gilbert D, Goddard N, Looijenga L, Shipley J (2008). "Genes, chromosomes and the development of testicular germ cell tumors of adolescents and adults". Genes Chromosomes Cancer. 47 (7): 547–57. doi:10.1002/gcc.20562. PMID 18381640.
  4. Gershenson DM (1993). "Update on malignant ovarian germ cell tumors". Cancer. 71 (4 Suppl): 1581–90. PMID 8381708.
  5. Serov SF, Scully RE, Robin IH: International Histologic Classification of Tumours: No. 9. Histological Typing of Ovarian Tumours. Geneva: World Health Organization, 1973.
  6. Woodward PJ, Heidenreich A, Looijenga LHJ, et al.: Germ cell tumours. In: Eble JN, Sauter G, Epstein JI, et al.: Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon, France: IARC Press, 2004, pp 221-49.
  7. Ulbright TM, Berney DM: Testicular and paratesticular tumors. In: Mills SE, Carter D, Greenson JK, et al., eds.: Sternberg's Diagnostic Surgical Pathology. Philadelphia, Pa: Lippincott Williams & Wilkins, 2010, pp 1944-2004.
  8. Bosi GJ, Feldman DR, Bajorin DE, et al.: Cancer of the testis. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1280-1301