Please cite this article in press as: Hultman I, et al. Experimental teratoma: At the crossroad of fetal- and onco-development. Semin
Cancer Biol (2014), http://dx.doi.org/10.1016/j.semcancer.2014.08.005
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Seminars in Cancer Biology xxx (2014) xxx–xxx
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Seminars in Cancer Biology
j o ur na l ho me page: www.elsevier.com/locate/semcancer
Review
Experimental teratoma: At the crossroad of fetal- and
onco-development
Isabell Hultman, Lars Björk, Evelina Blomberg, Bengt Sandstedt, Lars Ährlund-Richter
*
Q1
Department of Women’s and Children’s Health, Karolinska Institutet, 17176 Stockholm, Sweden
a r t i c l e i n f o
Keywords:
Stem cells
Pluripotency
Teratoma
Cancer
a b s t r a c t
Xenografting is the so far only available in vivo model for assessing pluripotency of human stem cells. This
review describes known biological features of experimental teratoma from human pluripotent stem cells.
We focus on the dual nature mimicking both normal and abnormal development, and propose this model
system to be particularly interesting for investigations of the relationship between developmentally
controlled differentiation and neoplasia of embryonic origin.
In resemblance to the wide range of clinical teratomas, pluripotent stem cell (PSC) induced teratoma
(PSCT) typically shows a mixture of developing tissues in randomly distributed compartments. The com-
bined literature suggests that for teratomas derived from human diploid bona fide PSC the embryonic
development in the separate tissue-niches can show a controlled differentiation into organoid patterns
closely mimicking early development.
In the experimental situation such PSCT human homologous in vivo tissue-niches have been shown to
provide also matching microenvironment for a micrometastatic colonization and outgrowth of embryonic
tumors transplanted directly from patients. Single or small clusters of normal and neoplastic cells can
easily be visualized together in microscope-based imaging systems, enabling multi-parameter detection
of in the scans of tissue slides/specimens.
© 2014 Published by Elsevier Ltd.
1. Human teratoma: short version of a long chronicle
Germ cell tumors (GCT), to which teratoma belongs, is a het-
erogeneous group of tumors that can appear at various anatomic
sites, either gonadal or extragonadal [1]. The pluripotency of the
reproductive cells from which this group of tumors originate likely
contributes to their complexity and anatomical diversity [2]. Clin-
ical routine for the classification of GCT’s is based on histology
regardless of location but a classification based on also genetics
and site of origin has been put forward [1,2].
The earliest known description of the condition in human is
dated to Ancient time and the notion of teratoma reflecting embry-
onic events can be traced back several hundred years ago [3].
The first description based on more modern principles of devel-
opmental biology was reported 1926 by Budde; claiming that
teratomas ‘probably represented misdirection of the action of a pri-
mary embryonic organizer’, and that ‘the tumors originated in cells
*
Corresponding author at: Department of Women’s and Children’s Health,
Karolinska University Hospital, Cancer Center Karolinska, R8:00, 17176 Stockholm,
Sweden. Tel.: +46 08 51773450; fax: +46 08 51773184.
E-mail address: lars.ahrlund@ki.se (L. Ährlund-Richter).
released from normal developmental control at the stage of the
primitive streak (as cited by Pierce and Dixon in their publication
‘Testicular teratomas’ 1959 [4]).
Much has since been written on the history and characteristics
of teratoma. Following the pioneering work of Leroy Stevens on the
mouse strain 129, an array of elegant experiments on experimen-
tal teratoma has paved the way, uncovering embryonal carcinoma
(EC) and embryonic stem cells (ESC), till today’s concepts of cellular
reprogramming into pluripotency and stemness (see [5] for a time
lined review).
2. Pluripotency in normal and abnormal development
Cellular pluripotency is defined as a capacity to develop progeny
with the potential to reconstitute an entire organism given the
adequate support from extra embryonic tissues. This strict crite-
rion is for ethical reasons not applicable when testing human stem
cells. However, a more limited capacity to derive progeny repre-
senting all three germ layers is possible to test for. With either of
these two demarcations, pluripotency is fundamental for building
complex multicellular organisms and transiently effective in early
phases of ontogeny. Stemness appearing later in life, renowned as
http://dx.doi.org/10.1016/j.semcancer.2014.08.005
1044-579X/© 2014 Published by Elsevier Ltd.
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