So wowɔ akisikuru bi a ɛyɛ nwonwa wɔ wo nipadua so? So ebetumi ayɛ ɔyare mmoawa nkwammoaa akisikuru? Momma yɛnkasa!

So woate ‘Germ Cell Tumor’ ho asɛm pɛn? Ebia edin no te sɛ nea ɛyɛ hu kakra, nanso mma ɛnhaw wo. Ɛnnɛ yɛbɛka ho asɛm wɔ ɔkwan tiawa bi so a wobɛtumi ate aseɛ. Efisɛ ɛho hia yiye sɛ wubehu saa nneɛma yi, titiriw esiane sɛ ɛtɔ mmere bi a ebetumi anya nkɔso wɔ mmofra nkumaa ne mpanyimfo nkumaa mu nti.

Dɛn ne saa mmoawa nkwammoaa akisikuru yi?

Sɛ yɛbɛka no tiawa a, mmoawa nkwammoaa akisikuru yɛ akisikuru a efi yɛn awo nkwammoaa mu, a wɔfrɛ no ‘mmofra nkwammoaa’. Asɛmfua "ɔyare mmoawa" kyerɛ sɛ "sɛ wofifi" anaa "sɛ wonyin." Afei, wɔ abeawa mu no, akyiri yi saa mmoawa nkwammoaa yi bɛyɛ `nkwaa'. Wɔ abarimaa mu no, eyinom bɛyɛ `sperm'. Enti, saa mmoawa nkwammoaa akisikuru yi taa nyin wɔ mmeae a wɔyɛ nkesua, a ɛne `ovaries', ne baabi a wɔyɛ mmadwoa, a ɛne `testicles'.

Nanso, ɛtɔ mmere bi a, saa akisikuru yi tumi ba nipadua no afã afoforo a ɛnyɛ mmadwoa ne mmadwoa. Sɛ nhwɛso no, wobetumi anyin wɔ mmeae te sɛ yafunu, koko, akyi, dua, ne amemene. Wɔfrɛ akisikuru a ɛba mmeae afoforo te sɛ eyi sɛ extragonadal tumors . Ɛne sɛ, akisikuru a ɛba wɔ awo ntini no akyi.

Nea ɛho hia sen biara no, wɔtaa hu saa mmoawa nkwammoaa akisikuru yi wɔ mmofra nkumaa, mmabun, ne mpanyimfo nkumaa mu .

So mmoawa nkwammoaa mu akisikuru ahorow bi wɔ hɔ?

Yiw, mmoawa nkwammoaa mu akisikuru ahorow abien na ɛwɔ hɔ. Ebinom betumi ayɛ malignant , a ɛkyerɛ sɛ wɔwɔ kokoram. Ɔkwan foforo no yɛ nea ɛnyɛ hu . Akisikuru ahorow abien no nyinaa tumi nyin kɛse. Nanso, kokoram mmoawa nkwammoaa akisikuru nkutoo na ebetumi atrɛw akɔ nipadua no afã afoforo. Sɛ wɔtrɛw (metastasized) a, ebetumi asɛe yɛn akwaa a ɛwɔ yɛn mu no na ɛyɛ den kakra sɛ yɛbɛsa.

Afei momma yɛnhwɛ nea mmoawa nkwammoaa mu akisikuru ahorow titiriw ne:

Teratoma a ɛwɔ nipadua no mu

Eyinom yɛ nnuaba soronko koraa. Ntini te sɛ sẽ, nhwi, ntini, ne dompe betumi ayɛ saa nnuaba yi. Fa no sɛ aduaba a nneɛma ahorow nyinaa ayɛ. Eyinom betumi ayɛ ‘wɔn a wɔn ho akokwaw’ anaasɛ ‘wɔn ho akokwaw’.

• Teratomas a ɛho akokwaw , a ɛtɔ mmere bi a wɔfrɛ no dermoid cysts , ne mmoawa nkwammoaa akisikuru a ɛtaa ba a ɛba wɔ awotwaa mu. Mpɛn pii no, wɔnyɛ kokoram.
• Mpɛn pii no, teratomas a ennyinii no yɛ kokoram, na enyin ntɛmntɛm.

Yolk Sac Tumors anaa Endodermal Sinus Akisikuru

Nkwammoaa a ɛte sɛ nkwammoaa a ɛwɔ awotwaa a ɛrenyin mu pɛpɛɛpɛ wɔ aba yi mu.Eyinom yɛ ɔyare bɔne na ebetumi atrɛw ntɛmntɛm yiye akɔ ntini a ɛma mogya tu ne akwaa afoforo mu. Yolk sac tumors ne kokoram mmoawa nkwammoaa akisikuru a abu so sen biara wɔ mmofra nkumaa mu.

Nkwammoaa a wɔfrɛ no Germinoma

Eyi nso yɛ kokoram akisikuru bi. Ebetumi ayɛ kɛse wɔ awotwaa anaa awotwaa mu. Nanso, ɛtaa hu wɔ amemene ne akyi berɛmo (central nervous system) mu. Sɛ ɛba awotwaa mu a, wɔfrɛ no dysgerminoma , na sɛ ɛba awotwaa mu a, wɔfrɛ no seminoma .

Nkwammoaa mu Nkwammoaa mu Kokoram

Eyi yɛ ɔyare mmoawa nkwammoaa akisikuru a wɔntaa nhu, a ɛyɛ kokoram. Ɛtɔ mmere bi a, ɛno nkutoo betumi aba, nanso mpɛn pii no wohu sɛ ɛne akisikuru ahorow afoforo ka ho, na ɛyɛ akisikuru a ɛyɛ mmoawa nkwammoaa a wɔadi afra .

Polyembryoma a ɛma obi nya ɔyare mmoawa

Saa akisikuru yi wɔ afã horow a ɛte sɛ nkwaboaa. Eyi nso yɛ kokoram akisikuru a ɛntaa nsi koraa na enyin ntɛmntɛm. Mpɛn pii no, saa akisikuru yi ne mmoawa nkwammoaa akisikuru afoforo bom ba.

Choriocarcinoma a ɛma obi nya kokoram

Saa akisikuru yi fi nkwammoaa a ɛyɛ awotwaa no bere a wɔyem no mu. Sɛnea ebia wunim no, awotwaa no ne akwaa a ɛboa ɛna no ne akokoaa no ma wɔsesa aduannuru. Choriocarcinoma nso yɛ ɔyare mmoawa nkwammoaa akisikuru a ɛntaa nsi, a ɛyɛ kokoram. Ɛwom sɛ ebetumi aba wɔ awotwaa anaa mmadwoa mu de, nanso ɛtaa ba wɔ awotwaa mu. Nea ɛyɛ soronko wɔ ho ne sɛ etumi trɛw kɔ akokoaa ne ɛna no nyinaa mu.

Nkwammoaa Nkwammoaa a Wɔadi Afra

Eyinom yɛ akisikuru a ɛba bere a kokoram mmoawa nkwammoaa akisikuru ahorow abien anaa nea ɛboro saa abom no. Nokwarem no, mmoawa nkwammoaa mu akisikuru pii fra bom saa.

Nsonsonoe bɛn na ɛda seminoma ne akisikuru a ɛnyɛ seminoma ntam?

Wɔakyekyɛ mmoawa nkwammoaa mu akisikuru a ɛwɔ mmarima mu, titiriw awotwaa mu kokoram mu abien: seminomas ne non-seminomas . Wɔn baanu nyinaa yɛ kokoram akisikuru.

• Seminomas: Eyinom taa nyin na ɛtrɛw nkakrankakra sen nea ɛnyɛ seminomas.
• Non-seminomas: Eyinom nyin na ɛtrɛw ntɛmntɛm sen seminomas. Yolk kotoku mu akisikuru, nkwaboaa mu nkwammoaa mu kokoram, choriocarcinomas, ne teratomas ka saa kuw a ɛnyɛ seminomas yi ho.

Saa mmoawa nkwammoaa akisikuru yi abu so dɛn?

Mmoawa nkwammoaa mu akisikuru ho yɛ na ankasa wɔ mmofra nkumaa mu. Wɔn na wɔyɛ kokoram a ɛwɔ mmofra mu nyinaa mu bɛyɛ 3.5%. Nanso, wɔtaa hu wɔ mmabun ne mmerante ne mmabaa a wɔadu mpanyin afe so mu. Wɔn na wɔyɛ kokoram a ɛwɔ nnipa a wɔadi fi mfe 15 kosi 19 mu nyinaa mu bɛyɛ 13.9%.

Hena na tebea yi ka no kɛse?

Ɛwom sɛ obiara betumi anya ɔyare mmoawa nkwammoaa mu akisikuru de, nanso .Nkokoaa, mmofra a wɔretu mmirika, mmabun, ne mpanyimfo nkumaa na wɔyɛ mmerɛw kɛse. Ɛsono sɛnea ɔhaw ahorow yi abu so wɔ mfe a obi adi mu. Sɛ nhwɛso no, ɛtaa ba fi mmofraase kosi bɛyɛ mfe 4, afei ɛso tew kakra, na afei ɛsan kɔ soro wɔ mmerantebere ne mmabaabere mu.

• Ovarian germ cell tumors: Eyinom taa ba mmeawa a wɔadi fi mfe 10 kosi 14. Nanso, ebetumi aba nnipa a wɔadi mfe 20 kosi 30 nso mu. Teratoma a ɛho akokwaw (a mpɛn pii no ɛnyɛ kokoram) ne ɔyare mmoawa nkwammoaa akisikuru a wɔtaa hu.
• Testicular germ cell tumors: Saa ɔkwan yi na ɛma awotwaa mu kokoram 75% wɔ mmofra mu, ne 90% wɔ awotwaa mu kokoram nyinaa mu. Wɔtaa ba mmofra a wonnii mfe 4 ne mmarima a wɔadi fi mfe 15 kosi 35 mu.
• Extragonadal germ cell tumors: Saa akisikuru yi yɛ 40% kosi 50% wɔ germ cell tumors a wohu wɔ mmofra a wonnii mfe 4 mu nyinaa mu. Nanso, ebetumi aba mmofra ne mmabun nso mu. Wɔ nkokoaa ne mmofra nkumaa mu no, wɔtaa hu wɔn wɔ sacrum anaa coccyx mu. Wɔ mmabun ne mmerante ne mmabaa a wɔadu mpanyin afe so mu no, wɔtaa hu wɔn wɔ mediastinum mu.
• Amemene mu mmoawa nkwammoaa akisikuru: Ɛwom sɛ eyinom ho yɛ na de, nanso wɔtaa hu wɔ nnipa a wɔadi fi mfe 11 kosi 30 mu.

Dɛn ne ɔyare mmoawa nkwammoaa akisikuru ho sɛnkyerɛnne?

Ɛsono sɛnea akisikuru yi ho sɛnkyerɛnne te, na egyina sɛnea akisikuru no kɛse te ne beae a ɛwɔ wɔ nipadua no so no so.

Nsɛnkyerɛnne a ɛkyerɛ sɛ ovarian cysts

Ɛnyɛ bere nyinaa na mmoawa nkwammoaa akisikuru a ɛba wɔ awotwaa mu no ma wonya yare no ho sɛnkyerɛnne. Sɛ nhwɛso no, ebia teratoma a ɛho akokwaw rennya yare no ho sɛnkyerɛnne biara kosi sɛ ɛbɛyɛ kɛse a ɛbɛma yafunu ayɛ no yaw. Wɔtaa hu wɔn bere a wɔreyɛ ultrasound scan de ahwehwɛ nea ɛde yafunu ase yaw ba no.

Ebia yare no ho sɛnkyerɛnne te sɛ eyi:

• Yafunu no ase a ɛnyɛ dɛ anaasɛ ɛyaw.
• Sɛ wote akisikuru a ɛyɛ yaw nka wɔ awotwaa no mu.
• Bloating, ɔfe a ɛho ahonhon.
• Yafunu mu yaw (te sɛ appendicitis ).
• Mogya a ɛba ɔbea no awotwaa mu a ɛnkɔ so daa.
• Abofono.

Nsɛnkyerɛnne a ɛkyerɛ sɛ awotwaa mu akisikuru

Nsɛnkyerɛnne a ɛwɔ mmoawa nkwammoaa akisikuru a ɛba wɔ awotwaa mu no te sɛ nea ɛwɔ awotwaa mu kokoram no.

Su ahorow no te sɛ nea edidi so yi:

• Akuru a ɛyɛ den na ɛyɛ den wɔ awotwaa mu a ɛyɛ kɛse nkakrankakra (ebia ɛbɛyɛ yaw anaasɛ ɛrenyɛ yaw).
• Ɛyaw anaa emu duru a wɔte nka wɔ awotwaa mu.
• Yafunu mu yaw anaa akyi berɛmo mu yaw.
• Nsɛso a ɛnyɛ ne kwan so a ɛwɔ awotwaa no mu.
• Akyi yaw.

Nsɛnkyerɛnne a ɛkyerɛ sɛ akisikuru a ɛba mmeae afoforo (extragonadal) .

Akuru bi a ɛwɔ wo ba no akyi anaa ne moma so mfinimfiniSɛ ɛwɔ hɔ a, ebetumi ayɛ teratoma. Nsɛnkyerɛnne afoforo gu ahorow gyina faako a akisikuru no wɔ so.

• Ɔhome a ɛyɛ den (sɛ ɛfa ahurututu ho a).
• Mmerewa a ɛba nan no mu (sɛ ɛwɔ akyi a ɛwɔ fam a).
• Ɛyɛ den sɛ wobɛtow nsu na wobɛtow nsu (sɛ ɔhaw no fa akyi berɛmo no ho a).
• Abofra no ho ahonhon na ɔte ɛyaw a emu yɛ den anaasɛ ɛyɛ mmerɛw wɔ ne yafunu mu.

Mmoawa nkwammoaa akisikuru bi ma awo mu nkwaadɔm fi nipadua mu. Eyi betumi ama mmofra ada wɔn mpanyin afe so ho sɛnkyerɛnne adi ntɛm anaasɛ wɔanya nna mu nkɔso a ɛnteɛ. Mmabaa betumi anya nufu, awotwaa mu nhwi, ne brayɛ ntɛm. Mmarimaa betumi anya nufu (gynecomastia).

Dɛn na ɛde saa mmoawa nkwammoaa akisikuru yi ba?

Mpɛn pii no, wɔhyehyɛ saa mmoawa nkwammoaa yi bere a onipa awotwaa nyin no. Afei saa nkwammoaa yi tu kɔ awotwaa no mmadwoa anaa mmadwoa mu, na ɛhɔ bɛyɛ nkesua nkwammoaa anaa mmadwoa nkwammoaa.

Nanso, wɔ mmoawa nkwammoaa akisikuru mu no, saa nkwammoaa yi nnyin koraa nkɔyɛ nkesua anaa mmadwoa. Mmom no, saa mmoawa nkwammoaa yi mu paapae wɔ ɔkwan a ɛnteɛ so na ɛyɛ akisikuru wɔ awotwaa anaa awotwaa mu. Wɔ 'extragonadal tumors' a yɛadi kan aka ho asɛm no mu no, saa mmoawa nkwammoaa yi kɔ mmeae a ɛyɛ nwonwa wɔ nipadua no mu - mmeae te sɛ koko, amemene, yafunu, akyi ase, akyi - na wɔyɛ akisikuru wɔ hɔ.

Nokwarem no, nhwehwɛmufo nnya nhuu nea enti a saa mmoawa nkwammoaa yi yɛ wɔn ade saa no ankasa.

Dɛn ne nneɛma a ɛde asiane ba?

Ebia ɛbɛyɛ mmerɛw sɛ wubenya ɔyare mmoawa nkwammoaa akisikuru sɛ obi a ɔwɔ w’abusua mu anya bi pɛn, anaasɛ wowɔ ayaresa tebea horow bi a.

Eyinom yɛ tebea horow te sɛ eyi:

• Sɛ wowɔ mmadwoa a wɔansa no yare a ɛnsiane ( cryptorchidism ).
• Tebea bi a wɔfrɛ no Turner syndrome .
• Tebea bi a wɔfrɛ no Klinefelter syndrome .

Eyinom yɛ awosu anaa nkɔso tebea horow a nnuruyɛfo hu.

Ɔkwan bɛn so na wohu sɛ ɔyare mmoawa nkwammoaa mu akisikuru wɔ hɔ? (Nyare a Wɔahu) .

Wo duruyɛfo bedi kan ayɛ wo nipadua mu nhwehwɛmu na wabisa wo sɛnkyerɛnne ahorow no ho asɛm. Afei, ebia wɔbɛyɛ nhwehwɛmu a edidi so yi mu biako anaa nea ɛboro saa de ahu sɛ wowɔ ɔyare mmoawa nkwammoaa mu akisikuru anaa:

• CT scan: Eyi hwehwɛ sɛ wotwa wo nipadua no mu X-ray mfonini pii na wode kɔmputa yɛ nnompe ne ntini a ɛyɛ mmerɛw no mfonini a ɛwɔ afã abiɛsa (`3D`). CT scan a wɔyɛ wɔ koko, yafunu, anaa akyi berɛmo mu no betumi aboa ma wɔahu baabi a akisikuru no wɔ.
• MRI: Eyi de magnet ne radio asorɔkye yɛ kɔmputa so mfonini a ɛkyerɛ nipadua no nnompe ne ntini a ɛyɛ mmerɛw. Te sɛ CT scan no, MRI tumi kyerɛ baabi a akisikuru no wɔ.
• Ultrasound a wɔde yɛ nneɛma:Eyi de nnyigyei asorɔkye di dwuma de yɛ nipadua no mu mfonini. Ultrasound kyerɛ sɛnea akisikuru no mu dodow yɛ den ne dodow a ɛyɛ nsu (`cystic`). Saa nsɛm yi boa ma wohu sɛ ebia akisikuru yɛ mmoawa nkwammoaa akisikuru anaasɛ nsu (`cyst`) ara kwa.
• PET scan: Eyi de nnuru titiriw bi (a `tracer`) di dwuma de hwehwɛ mmeae a kokoram nkwammoaa wɔ nipadua no mu. PET scan nso betumi ahu sɛ kokoram no atrɛw anaa.
• Nnompe mu nhwehwɛmu: Nea ɛka eyi ho ne sɛ wɔde aduru soronko bi bɛhyɛ nipadua no mu, na wɔama atumi akɔ nnompe no mu, na afei wɔatwa X-ray mfonini. Saa aduru yi boa ma wohu nneɛma a ɛnteɛ na ebetumi aboa ma wɔahu sɛ ebia akisikuru bi atrɛw akɔ nnompe no mu anaa.
• Mogya mu nhwehwɛmu: Ebia wo duruyɛfo bɛfa mogya de ahwɛ sɛnea enzymes, protein, anaa hormone ahorow bi wɔ wo mogya mu. Nneɛma te sɛ human chorionic gonadotropin (hCG) , alpha-fetoprotein (AFP) , ne lactate dehydrogenase a ɛdɔɔso betumi ayɛ mmoawa nkwammoaa akisikuru ahorow bi ho sɛnkyerɛnne.
• Biopsy: Nea ɛka eyi ho ne sɛ wobeyi ntini ketewaa bi afi akisikuru no mu na wɔde akɔ lab ma wɔayɛ ho nhwehwɛmu. Ɔyare ho ɔbenfo , oduruyɛfo a ne ho akokwaw wɔ ntini mu nhwehwɛmu mu, bɛhwehwɛ nhwɛsode no mu wɔ afiri a wɔde hwɛ nneɛma nketenkete mu ahwɛ sɛ ɛyɛ mmoawa nkwammoaa mu akisikuru anaa.

Nea ɛho hia: Sɛ ɛda adi sɛ wo kurukuruwa no bɛyɛ kokoram a, ebia wo duruyɛfo besi gyinae sɛ obeyi akwaa no nyinaa afi hɔ. Sɛ nhwɛso no, ɔkwan a wɔtaa fa so hu awotwaa mu kokoram ne sɛ wobeyi awotwaa no nyinaa ( radical inguinal orchiectomy ). Sɛ woyi awotwaa no fi hɔ a, ɛma wo duruyɛfo tumi hwehwɛ ntini no mu na ɔyɛ oprehyɛn sɛ ayaresa.

Ɔkwan bɛn so na wɔsa mmoawa nkwammoaa akisikuru?

Ayaresa ahorow pii wɔ hɔ a wobetumi apaw. Wo duruyɛfo no begyina akisikuru no su, ne kɛse, beae a ɛwɔ, ne w’akwahosan nyinaa so akyerɛ ayaresa a eye sen biara.

• Oprehyɛn: Oprehyɛn ne aduru titiriw a wɔde sa mmoawa nkwammoaa akisikuru. Wɔ awotwaa mu akisikuru fam no, wobetumi ayi akisikuru no nkutoo afi hɔ ( ovarian cystectomy ), anaasɛ wobetumi ayi awotwaa ne awotwaa no nyinaa afi hɔ ( salpingo-oophorectomy ). Wɔ awotwaa mu kokoram fam no, woyi awotwaa a akisikuru no wom no.
• Nnuru a wɔde sa yare: Nea ɛka eyi ho ne sɛ wɔma wo nnuru a ekum kokoram nkwammoaa anaasɛ ɛmma ɛnkyɛ. Sɛ wo duruyɛfo ntumi nyi akisikuru no mfi hɔ dwoodwoo, anaasɛ atrɛw akɔ wo nipadua no afã afoforo a, wobetumi ama wo nnuru a wɔde sa yare. Wɔ oprehyɛn akyi no, wɔde nnuru a wɔde sa yare nso ma de kum kokoram nkwammoaa biara a ebetumi aka akyi, sɛ wɔanhu wɔ scan mu mpo a. Wɔde nnuru a wɔde sa yare di dwuma ma mmoawa nkwammoaa akisikuru ahorow dodow no ara.Ɔkwan a wɔfa so sa yare a edi mu yiye.
• Mframa a wɔde sa yare: Nea ɛka eyi ho ne sɛ wɔde X-ray a ahoɔden wom kɛse bedi dwuma de asɛe kokoram nkwammoaa. Mmoawa nkwammoaa akisikuru ahorow bi yɛ wɔn ade yiye wɔ mframa a wɔde sa yare no ho.

So wobetumi asa ɔyare mmoawa nkwammoaa mu akisikuru koraa?

Nkɔmhyɛ, anaa anidaso sɛ wɔbɛsa, wɔ mmoawa nkwammoaa mu akisikuru dodow no ara ho no ye yiye. Mpɛn pii no, sɛ woyi akisikuru no fi hɔ koraa a, wɔsa yare no. Sɛ nhwɛso no, awotwaa mu kokoram nya nkwa 95% wɔ ayaresa akyi. Ovarian germ cell tumors no nya nkwa 93%. Germ cell tumors a ɛwɔ mmofra mu no sa yareɛ yɛ 82% kɔsi 90%.

Nanso, nea efi mu ba yi gyina nneɛma pii a ɛfa wo ho pɔtee so. Eyinom bi ne:

• wo mfe a woadi.
• Mmoawa nkwammoaa mu akisikuru no su.
• Beae a akisikuru no wɔ ne ne kɛse.
• Ɔkwan tenten a kokoram no atrɛw.
• Sɛnea akisikuru no yɛ n’ade wɔ ayaresa ho.

Enti, ɛho hia yiye sɛ wo ne wo duruyɛfo kasa fa sɛnea wo yare no bɛka nea ebefi mu aba no ho.

Nsɛmmisa a ɛho hia a ɛsɛ sɛ wubisa wo duruyɛfo

Wubetumi abisa nsɛm yi na ama woate wo yare no ase yiye:

• So me akisikuru no yɛ kokoram (ɛyɛ bɔne)?
• Me akisikuru no nyin ntɛmntɛm (a ɛyɛ basabasa) dɛn?
• So kokoram no atrɛw?
• Ayaresa ahorow bɛn na wokamfo kyerɛ?
• Dɛn ne nneɛma bɔne a ebetumi afi ayaresa mu aba?
• Dɛn ne nea ebetumi afi mu aba a ɛbata ayaresa biara a wɔpaw ho?
• Sɔhwɛ ahorow bɛn na ɛsɛ sɛ meyɛ de hwɛ sɛnea ayaresa no tu mpɔn?
• Mpɛn ahe na ɛho behia sɛ meba bɛhwɛ bere a wɔadi akyi de ahwɛ me tumor/mmuae wɔ ayaresa ho?

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Mmoawa nkwammoaa akisikuru yɛ akisikuru a efi awo nkwammoaa mu ba. Wo duruyɛfo betumi akyerɛkyerɛ sɛnea saa yare a wɔahu yi bɛka wo anaa wo ba no mu akyerɛ wo. Mmoawa nkwammoaa mu akisikuru yɛ nea ɛyɛ den kakra. Wo sɛnkyerɛnne ne wo nkɔmhyɛ gyina nneɛma pii so, na wo duruyɛfo no ne wo bɛbɔ ne nyinaa ho nkɔmmɔ.

Asɛmpa no ne sɛ mmoawa nkwammoaa mu akisikuru dodow no ara yɛ wɔn ade yiye wɔ ayaresa ho. Sɛnea ɛte wɔ akisikuru biara ho (titiriw kokoram akisikuru) no, dodow a wuhu ntɛm na wufi ase sa yare no, dodow no ara na nea ebefi mu aba no bɛyɛ papa. Enti, sɛ wowɔ akisikuru, wo hohoro, anaa ɛyaw bi a ɛyɛ soronko a, nyansa wom sɛ wobɛhwehwɛ aduruyɛfo afotu mmom sen sɛ wubebu w’ani agu so.

` Mmoawa nkwammoaa akisikuru, kokoram, teratoma, yolk sac akisikuru, germinoma, awotwaa mu kokoram, awotwaa mu kokoram