The Growing Teratoma Syndrome: A Woman with Nonseminomatous Germ Cell Tumor of the Ovary

Kattan, Joseph; Droz, Jean‐Pierre; Culine, Stéphane; Duvillard, P.; Thiellet, Anne; Peillon, Christophe

doi:10.1006/gyno.1993.1147

Cited by 52 publications

(57 citation statements)

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“…6,8 Non-resectable masses could be treated with long term alpha-2 interferon but the regression is slow, incomplete and discontinuation results in progression of disease. 4,9 The prognosis after complete surgical excision in both females and males is excellent. Only few deaths are reported in literature.…”

Section: Discussionmentioning

confidence: 99%

Growing teratoma syndrome in a post laparoscopic excision of ovarian immature teratoma

Sengar

Kulkarni²

2010

J Gynecol Oncol

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A 26-year-old girl was referred to us in December 2008 with progressive pelvic mass while on chemotherapy. In May 2008, she presented with large adnexal mass and high alpha-fetoprotein (AFP, 265.7 ng/mL; normal range, 0 to 10). She underwent laparoscopic right salpingo-oophorectomy with staging. Since histology was immature teratoma grade I, FIGO stage 1 she was kept on surveillance. In September 2008, she developed recurrent pelvic mass with AFP levels of 2,400 ng/mL. Three courses of chemotherapy (bleomycin-etoposide-cisplatin) were given. Post-chemotherapy AFP normalized but tumor size increased. CT-scan (abdomen-pelvis) showed a large pelvic mass with calcification specks; infiltrating the sigmoid colon and abdominal wall. With provisional diagnosis of growing teratoma syndrome she had exploratory laparotomy with excision of pelvic mass along with sigmoid colon, excision of right pelvic and subcutaneous deposits, omentectomy and sigmoid anastomosis. Left ovary, left tube and uterus appeared normal and were preserved. Histology of all masses showed mature teratoma, no immature elements. At six months follow up she is disease free and has resumed menstruation. Growing teratoma syndrome is a clinico-pathological presentation during/post-chemotherapy in malignant ovarian germ cell tumor where mature teratoma grows and requires complete surgical excision. Our case highlights the safety and adequacy concerns of laparoscopic management of malignant ovarian tumor. Literature review suggests good prospects of resumption of menses, child bearing and five year survival in case of growing teratoma syndrome.

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Section: Discussionmentioning

confidence: 99%

Growing teratoma syndrome in a post laparoscopic excision of ovarian immature teratoma

Sengar

Kulkarni²

2010

J Gynecol Oncol

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“…4,7 The entity was first described in 1881 by Carr et al 2 In 1882, Logothetis et al 1 described six cases of this tumor, gave the current name to the syndrome, and described its characteristics. These lesions usually are located in sites where metastasis of the original NSGCT of testicular or ovarian origin 8 would present. For this reason, GTS has a greater propensity for the retroperitoneal space through the retroperitoneal lymphatic system.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for growing teratoma syndrome: Report of a case

Eghtesad

Marsh

Cacciarelli

et al. 2003

Liver Transplantation

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Liver transplantation is a well-established treatment for liver failure and for a selected group of patients with hepatic tumors. The growing teratoma syndrome refers to the phenomenon whereby germ cell tumors enlarge after chemotherapy despite complete eradication of malignant cells and normalization of serum tumor markers. We present the case of a young patient with rapidly growing teratomatous masses in his liver who was treated with liver transplantation from a live donor. We discuss his postoperative management, follow-up, and briefly review literature on the subject. (Liver Transpl 2003;9:1222-1224.)T he growing teratoma syndrome (GTS) is characterized by the enlargement of mixed nonseminomatous germ cell tumors (NSGCTs) after successful chemotherapy with normalization of tumor marker values. 1,2 This syndrome includes patients with enlarging masses in the retroperitoneum or mediastinum and, rarely, liver containing mature teratoma cells. Despite their benign nature, continuous growth of these tumors can potentially cause significant morbidity and possible mortality secondary to their encroachment on adjacent structures in the chest or abdomen. Radical surgical excision of tumors is the only curative option.Involvement of the liver by NSGCTs and transformation to GTS, although rare, has been reported. 3,4 Unfortunately, because of the diffuse involvement of the liver, in some cases, liver resection and other recent modalities for treatment of hepatic tumors are not effective. Liver transplantation (LT) may be the only option with potential for cure in these patients. We report the first case of LT for GTS. Case ReportA 22-year-old man initially presented with a right testicular mass, which he had ignored for 6 months, followed by increasing abdominal girth, right upper-quadrant fullness, and a more than 30-pound weight loss. At evaluation, he was found to have a large testicular mass, as well as multiple metastatic deposits in the liver, hydronephrosis in the right kidney, and retroperitoneal adenopathy with moderate ascites on an abdominal computed tomographic (CT) scan.At presentation serum, alpha-fetoprotein level was 18,300 ng/mL (normal, 0 to 15 ng/mL), and ␤-human chorionic gonadotropin level was 3,840 MIU/mL (normal, 0 to 5 MIU/ mL). The patient underwent a right radical orchiectomy. A pathological diagnosis of mixed germ cell tumor (embryonal carcinoma, 50%; yolk sac tumor, 30%; immature teratoma, 10%; and seminoma, 10%) was established. There was extratesticular extension of the tumor with invasion of the epididymis and focal lymphovascular invasion with negative resection margin. The patient was started on a cisplatin-based chemotherapeutic regimen. After 4 months, the patient underwent retroperitoneal lymphadenectomy, right nephrectomy, and liver biopsy. The specimens showed residual mature teratoma cells without evidence of malignant components in any resected tissue. The patient continued to undergo chemotherapy for another 4 months. Serum tumor marker levels stayed normal, but the hepatic les...

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“…Based on a few reports in the literature [9,14,20,21], we decided to treat our patient with interferon α2β and the result was satisfactory. Other authors have also reported positive results with this kind of treatment, and some patients treated in this manner benefited from stabilization and even experienced a decrease in the size of the teratoma [14,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…The growing teratoma can be located in various sites; this syndrome has been described in patients with GTS in the brain [11], mediastinum [12], and, most commonly, in the abdominal cavity [5,[13][14][15]. In the vast majority of cases, GTS consists of only benign, mature tissue [4,5,7,15] and all signs and symptoms of the tumor are due exclusively to local pressure on surrounding structures [14]. In very rare instances, the growing teratoma may contain malignant cells along with benign tissue.…”

Section: Discussionmentioning

confidence: 99%

GROWING TERATOMA SYNDROME TREATED BY INTERFERON ALPHA-2β: Case Report and Literature Review

Postovsky

Epelbaum

Itzhak

et al. 2004

Pediatric Hematology and Oncology

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The Growing Teratoma Syndrome: A Woman with Nonseminomatous Germ Cell Tumor of the Ovary

Cited by 52 publications

References 0 publications

Growing teratoma syndrome in a post laparoscopic excision of ovarian immature teratoma

Growing teratoma syndrome in a post laparoscopic excision of ovarian immature teratoma

Liver transplantation for growing teratoma syndrome: Report of a case

GROWING TERATOMA SYNDROME TREATED BY INTERFERON ALPHA-2β: Case Report and Literature Review

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