Growing Teratoma Syndrome of the Ovary Showing Three Patterns of Metastasis: A Case Report

Shibata, Kiyosumi; Kajiyama, Hiroaki; Kikkawa, Fumitaka

doi:10.1159/000356563

Cited by 19 publications

(16 citation statements)

References 10 publications

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“…Several case reports suggest that patients who have received chemotherapy for germ cell tumors may later present with growing teratoma syndrome. [188][189][190][191] Residual or Recurrent Disease: For patients having radiographic evidence of residual tumor (after surgery and chemotherapy) but with normal AFP and beta-hCG, consider surgical resection of the tumor; observation with monitoring is also an option. Clinical judgment should be used regarding the frequency of imaging.…”

Section: Malignant Germ Cell Tumorsmentioning

confidence: 99%

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Morgan

Armstrong

Alvarez

et al. 2016

J Natl Compr Canc Netw

294

243

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Section: Malignant Germ Cell Tumorsmentioning

confidence: 99%

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Morgan

Armstrong

Alvarez

et al. 2016

J Natl Compr Canc Netw

294

243

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“…For example, Shigeta et al reviewed 55 cases of ovarian GTS and reported that GTS recurred in 12.7% of cases (7/55) and underwent malignant transformation in 5.4% of cases (3/55), [ 22 ] which can result in sarcoma, adenocarcinoma, or a primitive neuroectodermal tumor and carcinoid. [ 23 ] Thus, if the residual teratoma components are caused by chemotherapeutic retroconversion, it appears logical that they would retain a high level of histopathological genetic aneuploidy and their malignant potential. [ 24 – 26 ] Therefore, complete surgical resection is a highly desirable treatment, [ 27 ] although recurrence or malignant transformation have not been reported in children.…”

Section: Discussionmentioning

confidence: 99%

Pediatric growing teratoma syndrome of the ovary

Oyama¹,

Noda²,

Washio

et al. 2020

Medicine

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Rationale: Growing teratoma syndrome is defined as an increase in tumor size during or after systemic chemotherapy for germ cell tumors. These cases involve normal tumor maker levels and histological features of only mature teratoma. We report a rare case of an ovarian immature teratoma in a Japanese child that was diagnosed as growing teratoma syndrome. Patient concerns: A 12-year-old girl presented a painful abdominal mass. She underwent left salpingo-oophorectomy for grade 1 immature teratoma in the left ovary. She did not undergo additional chemotherapy or radiotherapy. Four months later, she presented with grade 3 immature teratoma disseminated into the abdomen and pelvis. Chemotherapy resulted in the tumor maker levels returning to their normal ranges, although the tumors had grown slightly. Diagnosis: The specimens resected by laparotomy after the chemotherapy consisted of mature tissue predominantly, although primitive neuroepithelium was observed in a small part of the specimen. The pathological diagnosis was grade 1 immature teratoma, notwithstanding the clinical diagnosis was growing teratoma syndrome based on the clinical features and pathogenesis. Interventions: Laparotomy was performed at 7 months after the first operation, with resection of various tumors as well as the rectum, sigmoid colon, residual left fallopian duct, and a small part of the ileum and omentum. Some small tumors at the parietal peritoneum were ablated, although many tiny tumors around the uterus were left untreated. Outcomes: The patient has been free from recurrence for 5 years. Lessons: Growing teratoma syndrome can develop in children, and their tumor size is comparable to that in adolescents and adults. Furthermore, development of growing teratoma syndrome from a primary germ cell tumor is presumably faster in children than in adolescents and adults. Complete resection of all growing teratoma tissue is recommended, although fertility-sparing surgery should be considered when possible.

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“…The median age for the diagnosis of primary immature teratoma was 22 years (range 4–48 years, n = 56) [15]. Many cases of GTS metastasis spread in the peritoneal cavity and tend to occur in the pelvis, peritoneum, or retroperitoneum but have been located in other places such as the liver, pineal gland, and mediastinal/cervical lymph nodes [7, 14, 17, 18]. A single case report described spread via both the lymphogenous and hematogenous route in the same patient [18].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Ovarian Growing Teratoma Syndrome

Rentea

Varghese

Ahmed

et al. 2017

Case Reports in Surgery

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Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation. Current treatment modality is surgical resection. We discuss a 12-year-old female who presented following resection of a pure ovarian immature teratoma (grade 3, FIGO stage IIIC). Following chemotherapy and resection of a pelvic/liver recurrence demonstrating mature teratoma, she underwent molecular genetics based chemotherapeutic treatment. No standardized management protocol has been established for the treatment of GTS. The effect of chemotherapeutic agents for decreasing the volume of and prevention of expansion is unknown. We review in detail the history, diagnostic algorithm, and previous reported pediatric cases as well as treatment options for pediatric patients with GTS.

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Growing Teratoma Syndrome of the Ovary Showing Three Patterns of Metastasis: A Case Report

Cited by 19 publications

References 10 publications

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Pediatric growing teratoma syndrome of the ovary

Pediatric Ovarian Growing Teratoma Syndrome

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