Surgical Outcomes After Debulking Surgery for Intraabdominal Ovarian Growing Teratoma Syndrome: Analysis of 38 Cases

Bentivegna, Enrica; Azaïs, Henri; Uzan, Catherine; Leary, Alexandra; Pautier, Patricia; Gonthier, Clémentine; Genestie, Catherine; Balleyguier, Corinne; Lhommé, C.; Duvillard, P.; Morice, Philippe; Gouy, Sébastien

doi:10.1245/s10434-015-4608-y

Cited by 46 publications

(65 citation statements)

References 31 publications

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“…nádory semenníkov -teratóm -chirurgická liečba -prognóza alent [7]. The prevalence of GTS in metastatic nonseminomatous GCT accord ing to the published data is between 2-7.6% whereas occasionally, it may originate in pure seminoma [5].…”

Section: Kľúčové Slovámentioning

confidence: 87%

See 1 more Smart Citation

Clinical Management and Outcome in Extreme Retroperitoneal Grow ing Teratoma Syndrome of Testicular Origin – Clinical Management and Effect of the Treatment

Huľová¹,

Aziri²,

Chovanec³

et al. 2019

Klin Onkol

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Background: Grow ing teratoma syndrome (GTS) is an uncommon clinical find ing in patients treated for testicular cancer. It is dia gnosed dur ing or after chemother apy as an expand ing tumour mass not respond ing to the treatment while the serum tumour markers are within the normal range. Pathological evaluation of resected tissue confirms the structures of benign mature teratoma. Case: Authors report a case of metastatic germ cell testicular cancer treated with 2 lines of chemother apy and everolimus, that had finally been subjected for the resection of voluminous metastatic masses. We give a brief overview of current records concern ing clinical management of GTS, and support the major role of surgical treatment in GTS. Results: Patient with metastatic mixed germ cell tumour of testis underwent a radical orchiectomy and completed the 1 st line treatment with BEP (bleomycin, etoposide, cisplatin) regimen. Radiographic restag ing showed considerable dis ease progression to the retroperitoneum and supraclavicular lymph nodes. Second-line treatment with VIP (etoposide, ifosfamide, cisplatin) did not reverse the progression and the patient was consulted at our institute. Follow ing the enrolment to the clinical study with everolimus, the patient exhibited continual metastatic growth in contrast to serum markers decrease. GTS was confirmed after resection of enormous retroperitoneal tumour mass, as well as from the specimen obtained from the subsequent supraclavicular and hepatal metastasectomy. The patient attained complete remission and has been closely observed over the last 31 months since the last surgery. Conclusion: GTS is resistant to chemother apy and radiation and complete surgical resection results in excellent dis ease control. Clinicians should be aware of this infrequent presentation of testicular tumours, to ensure the timely dia gnosis and the appropriate surgical removal without any delay. Despite the great extent and vital vasculature encasement, surgery may be feasible and successful, as we report in our case, consistently with the published data.

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Section: Kľúčové Slovámentioning

confidence: 87%

“…[15]. An atypical clinical find ing in ovary-associated GTS was described as gliomatosis peritonei, a condition characterised by the presence of mature glial tissue in the peritoneum [7].…”

Section: Discussionmentioning

confidence: 99%

Clinical Management and Outcome in Extreme Retroperitoneal Grow ing Teratoma Syndrome of Testicular Origin – Clinical Management and Effect of the Treatment

Huľová¹,

Aziri²,

Chovanec³

et al. 2019

Klin Onkol

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“…The incidence of GTS in non-seminomatous germ cell tumors of the testis is 1.9% to 7.6%. [ 1 , 6 ] In contrast, the incidence of ovarian GTS in ovarian immature teratomas is 12% to 19%, [ 7 , 8 ] with the GTS originating from the right ovary in 57% of cases and the left ovary in 43% of cases. The median primary tumor size was reportedly 18.7 cm (range: 6–45 cm) and median subsequent tumor size was 8.6 cm (range: 1–25 cm).…”

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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“…Germ cell tumours are rare in females and the immature teratoma, defined by the presence of immature cancerous tissue, most often immature neural tissue, typically is managed by chemotherapy after initial surgery. Two conditions described in the literature on germ cell tumours are the "growing teratoma syndrome" and "chemotherapeutic retroconversion" are generally considered to be the same as histologically the tissue found is mature teratoma [91]. In the former, after successful chemotherapy, there is recurrent disease but of mature not immature teratoma; in the latter, chemotherapy given to immature teratoma resulted in subsequent mature elements only.…”

Section: Recurrent Non-epithelial Ovarian Cancermentioning

confidence: 99%

Surgery for Recurrent Ovarian Cancer

Barton¹

2018

Ovarian Cancer - From Pathogenesis to Treatment

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Most patients with ovarian cancer (OC) have the epithelial subtype (EOC) and present with advanced stage disease. Despite improved surgical and medical management of primary disease, the majority of patients will develop recurrence and ultimately die of disease. The current surgical goal in primary EOC is complete surgical cytoreduction (CSC) as this significantly improves disease-specific survival and overall survival. CSC is a major independent prognostic factor in primary EOC. Recurrent ovarian cancer (ROC) can be diagnosed in the symptomatic or in the asymptomatic patient on clinical evidence, tumour marker results and/or imaging. There are data from cases series and retrospective series on the role of surgery in ROC but there is not yet level I evidence of secondary surgical cytoreduction improving overall survival. The published data emphasise that, as with primary disease, the surgical goal is CSC. In selecting patients for secondary cytoreductive surgery a number of predictive models have been proposed and tested. Patients with ROC who have undergone CSC have a better prognosis than those treated with chemotherapy alone or those in whom the surgical goal was not achieved. The counter-argument is that there is bias in the surgical reports-those patients not operated on chemotherapy alone, or who had incomplete cytoreduction and/or who had chemotherapy had less favourable diseaseassociated and patient-associated factors than those who had CSC. To address these concerns, there are currently three ongoing randomised controlled trials on surgery for ROC.

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Surgical Outcomes After Debulking Surgery for Intraabdominal Ovarian Growing Teratoma Syndrome: Analysis of 38 Cases

Cited by 46 publications

References 31 publications

Clinical Management and Outcome in Extreme Retroperitoneal Grow ing Teratoma Syndrome of Testicular Origin – Clinical Management and Effect of the Treatment

Clinical Management and Outcome in Extreme Retroperitoneal Grow ing Teratoma Syndrome of Testicular Origin – Clinical Management and Effect of the Treatment

Pediatric growing teratoma syndrome of the ovary

Surgery for Recurrent Ovarian Cancer

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