Growing teratoma syndrome vs. chemotherapeutic retroconversion Case report and review of the literature

Amsalem, Hagai; Nadjari, M.; Prus, Diana; Hiller, Nurith; Benshushan, Abraham

doi:10.1016/j.ygyno.2003.10.024

Cited by 65 publications

(68 citation statements)

References 12 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

300

233

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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

300

233

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“…Two possible mechanisms have been proposed: selective devastation of the malignant cells leaving mature teratoma components (the components resistant to chemotherapy persist and grow alone as GTS) or malignant cell differentiation into mature teratoma (chemotherapeutic retroconversion) with chemotherapy. Recently, these hypotheses have been considered to be synonymous [2] , and direct metastasis of the mature teratoma is also regarded as a possible mechanism to cause GTS [3] . The retroperitoneum is the single most common site for GTS followed by the chest [4,5] , and GTS tends to appear at the site involved by tumor at the initial surgery [3,5] .…”

Section: Resultsmentioning

confidence: 99%

Growing Teratoma Syndrome of the Ovary after Fertility-Sparing Surgery and Successful Pregnancy

Matsushita¹,

Arai

Fukase

et al. 2010

Gynecol Obstet Invest

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Background: Growing teratoma syndrome (GTS) is rare and is defined as an enlarging mature teratoma that arises during or after chemotherapy for a malignant germ cell tumor, with normalization of previously elevated serum tumor markers. Case: A 30-year-old nulliparous Japanese woman was diagnosed as having a stage IIIa immature teratoma. After fertility-sparing surgery, she received 4 cycles of chemotherapy consisting of cisplatin, etoposide and bleomycin. Thereafter, she successfully gave birth twice. Eight years after the initial surgery, a mass mimicking an adrenal tumor was resected laparoscopically. Surgical specimens revealed a mature teratoma, and she was diagnosed as having GTS postoperatively. Conclusion: Clinicians should consider that GTS may present late, even after pregnancy. Therefore, long-term follow-up of patients treated for ovarian immature teratoma should be mandatory.

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“…This rare syndrome was originally defined by Logothetis et al (5), who described six cases of nonseminomatous GCT (NSGT) of the testis with metastases. Other authors have recommended three criteria: 1) clinical or radiologic enlargement of the primary tumor or finding a new tumor mass during or after chemotherapy; 2) normalisation of previously elevated serum tumor markers (AFP or b-hCG); and 3) metastases consisting of pure mature teratoma without malignant cells on histological examination (4,7). The syndrome appears in 1.9%-7.6% of patients after treatment for testicular NSGT.…”

Section: Discussionmentioning

confidence: 99%

“…The histology of the metastasis is a mature teratoma without any malignant component (4). The present case report describes a case of immature malignant teratoma of the ovary in a 20-year-old woman, who was treated by unilateral salpingo-oophorectomy (SOE) followed by chemotherapy.…”

mentioning

confidence: 98%