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Among all the astonishing medical discoveries, the ovarian teratoma is undoubtedly one of the most intriguing cases. Imagine a cyst containing... hair, or even teeth. Yet, this is neither a horror scenario nor an extremely rare anomaly: it is a well-documented reality in gynecology.

So, what exactly is an ovarian teratoma? Is it dangerous? How common is it? We explain it all, without sensationalism but with plenty of curiosity — as always at Luneale.

1- What is an ovarian teratoma?

An ovarian teratoma (also called a dermoid cyst) is a benign tumor that develops in the ovary. What makes it special is its origin: it forms from a germ cell.

🔍 But what is a germ cell?

To put it simply, these are basic cells present in the embryo, which then migrate to the ovaries (or testicles). Their role is to later give rise to eggs or sperm. They have a rare characteristic: they are capable of transforming into almost any tissue in the human body (they are said to be totipotent).

🧘 In 90% of cases, these are mature cystic teratomas, which are benign and encapsulated (they do not spread elsewhere in the body). They are therefore not cancerous in the vast majority of cases.

2- What can be found in a teratoma?

In rare cases, a germ cell in the ovary can "malfunction" and start haphazardly manufacturing various human tissues. Their contents can be surprising: we often find a mixture of tissues that normally shouldn't be in the ovary:

• hair (extremely common),
• keratinized skin,
• cartilage,
• teeth,
• sometimes even nerve or eye tissue.

This is explained by the cyst's origin: a germ cell initially capable of producing any tissue in the body. It is this potential, normally present at the very beginning of embryonic development, that can give rise to this unexpected mixture inside the cyst.

   

⚠️ Warning: The medical image below may be disturbing to some viewers.

        

       

            👁️ View a photo of a teratoma (Hair/Teeth)        

                

                       

Example of a mature dermoid cyst after surgical extraction.

       

   

And no, it's not an urban legend: there are scientific publications with very explicit images of these heterogeneous contents.

3- How common are ovarian teratomas?

Ovarian teratomas are not extremely rare anomalies. Here is what the numbers say:

• They represent 10 to 20% of all ovarian tumors[1].
• Among ovarian germ cell tumors, about 95% are mature teratomas[2].
• A British study estimates their annual incidence at 8.9 cases per 100,000 women[3].

What does that mean, practically speaking? Here are a few points of comparison to help you get your bearings:

• Polycystic Ovary Syndrome (PCOS) affects about 1 in 10 women.
• Diagnosed endometriosis also affects about 1 in 10 women.
• Ovarian teratoma is estimated to occur in about 1% of women during their lifetime (i.e., about 1 in 100 women)[4].

In summary: it is much less common than PCOS or endometriosis, but common enough to be regularly seen in gynecology.

4- Symptoms: how do they manifest?

In many cases, teratomas are asymptomatic and discovered by chance, for example during an ultrasound for another reason.

But certain signs can alert you:

• Pelvic pain, especially unilateral,
• Feeling of pressure or a mass,
• Discomfort when inserting a menstrual cup or a tampon,
• Bloating or digestive issues (if the cyst is large).

⚠️ Note: in rare cases, a teratoma can cause an ovarian torsion (a medical emergency). This manifests as sudden, intense pelvic pain, sometimes accompanied by nausea or vomiting.

5- Treatment: when should you intervene?

An ovarian teratoma is generally removed by laparoscopy (minimally invasive surgery), when it is:

• too large,
• symptomatic,
• or potentially at risk of torsion.

The surgery consists of removing the cyst while preserving the ovary if possible. However, you should know that:

• the procedure can reduce the ovarian reserve, especially if the cyst is bilateral,
• a discussion with a gynecologist is essential to weigh the benefits and risks.

Simple ultrasound monitoring may be sufficient if the cyst is small, stable, and does not bother the patient.

6- What to remember

Ovarian teratomas or dermoid cysts are surprising but frequent benign tumors in gynecology. No, it is not serious in the majority of cases. Yes, it can be shocking (especially when you learn they can contain hair or teeth!).

But what matters is vigilance without panic. Persistent pelvic pain or discomfort upon insertion is never "all in your head". If you feel that something is not right, talk to a healthcare professional.

At Luneale, we believe in transparency and information. Because your body deserves to be understood, not feared.