Laparoscopic Excisional Surgery for Growing Teratoma Syndrome of the Ovary: Case Report and Literature Review

Shigeta, Naoya; Kobayashi, Eiji; Sawada, Kenjiro; Ueda, Yutaka; Yoshino, Kiyoshi; Hori, Yumiko; Kimura, Tadashi

doi:10.1016/j.jmig.2015.01.011

Cited by 18 publications

(16 citation statements)

References 35 publications

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“…Our cohort adds information about clinical presentation, treatment, patterns of recurrence, and outcomes of this rare syndrome that has been reported in only approximately 60 patients to date. 2 Despite our study representing one of the largest institutional reviews of ovarian IT, the limitations are evident and inherent in retrospective studies, including the small sample size, reflecting the rarity of ovarian IT.…”

Section: Discussionmentioning

confidence: 95%

“…11,13,16,23 There is also a low risk of malignant transformation, which was reported to be 3% to 5%. 2,16 Growing teratoma syndrome has been reported to have the potential to transform into sarcoma, adenocarcinoma, primitive neuroectodermal tumor, spindle cell neoplasm, and carcinoid tumors, as late as 22 years after the diagnosis of GTS. 13,24Y27 None of our patients experienced malignant transformation of GTS.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

How Common Is the Growing Teratoma Syndrome in Patients With Ovarian Immature Teratoma?

Nguyen

Bouchard-Fortier

Ferguson

et al. 2016

Int J Gynecol Cancer

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The development of GTS after adjuvant chemotherapy for ovarian IT seems to be more common than previously reported in the literature. Clinicians need to be cognizant that the occurrence of rapidly growing masses during or after chemotherapy for ovarian IT raises the possibility of GTS. This highlights the importance of prolonged follow-up with tumor markers and imaging studies in patients with ovarian IT.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

How Common Is the Growing Teratoma Syndrome in Patients With Ovarian Immature Teratoma?

Nguyen

Bouchard-Fortier

Ferguson

et al. 2016

Int J Gynecol Cancer

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“…[ 19 ] Complete resection of all GST tissue is recommended, as incomplete resection can lead to progression or malignant transformation. 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.…”

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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“…Ovarian GTS has been described in 101 published English literature cases [15, 16]. Most of the patients had abdominal symptoms, such as abdominal pain and distension when they first sought evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…GTS has a high recurrence rate between 72% and 83% with partial resection versus 0% and 12.7% in those who undergo complete resections [20, 21]. Laparoscopy can be utilized as a diagnostic and therapeutic approach in cases of questionable or limited GTS [16]. …”

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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Laparoscopic Excisional Surgery for Growing Teratoma Syndrome of the Ovary: Case Report and Literature Review

Cited by 18 publications

References 35 publications

How Common Is the Growing Teratoma Syndrome in Patients With Ovarian Immature Teratoma?

How Common Is the Growing Teratoma Syndrome in Patients With Ovarian Immature Teratoma?

Pediatric growing teratoma syndrome of the ovary

Pediatric Ovarian Growing Teratoma Syndrome

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