The growing teratoma syndrome: results of therapy and long-term follow-up of 33 patients

André, Fabrice; Fizazi, Karim; Culine, Stéphane; Droz, Jean‐Pierre; Taupin, Pierre; Lhommé, C.; Terrier‐Lacombe, Marie‐José; Théodore, Christine

doi:10.1016/s0959-8049(00)00137-4

Cited by 215 publications

(246 citation statements)

References 26 publications

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“…Our patient had tumor adherence to blood vessels and the left kidney. The fate of GTS, studied in a large French cohort includes relapse of GTS or NSGCT, or second malignancies such as sarcoma, adenocarcinoma, squamous cell carcinoma, PNET, carcinoid and leukemia [15].…”

Section: Discussionmentioning

confidence: 99%

Immature Testicular Teratoma Post-operatively Presenting as a Chemotherapy Resistant Retroperitoneal Mature Teratoma

Vijayakumar¹,

B²,

Gochait³

et al. 2016

JCR

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Abstract:Introduction: Growing teratoma syndrome (GTS), first described in 1982, presents as newly growing metastatic masses in patients previously treated for immature teratoma. Since 1994, only 13 cases have been reported in India. Case Report: A 21 year old male who had undergone orchidectomy for immature teratoma presented with retroperitoneal mass 6 months later. He received 4 cycles bleomycin-etoposide-cisplatin based chemotherapy without change in size of mass. He underwent excision of tumor and retroperitoneal lymph nodes. Histopathology revealed mature teratoma predominantly cartilage, respiratory and enteric epithelium and adipose tissue without immature elements. Conclusion: These tumors cause adjacent vascular and organ invasion causing compressive symptoms. GTS mimics tumor recurrence and patients need to be on regular follow up for detecting these tumors, for they are resistant to chemoradiotherapy and are amenable to surgical resection.

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Section: Discussionmentioning

confidence: 99%

Immature Testicular Teratoma Post-operatively Presenting as a Chemotherapy Resistant Retroperitoneal Mature Teratoma

Vijayakumar¹,

B²,

Gochait³

et al. 2016

JCR

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“…11,14,16,24) Alternatively, the destruction of malignant tumor cells by chemotherapy may facilitate the enhanced growth of resistant mature teratoma cells as cellular competition from the malignant element is removed. 1,2,6,15,21) Some factors may be predictive of growing teratoma syndrome, including the presence of mature teratoma at the primary site, the failure of chemotherapy to reduce the tumor size, and the presence of mature teratoma elements in the residual tumor after chemotherapy. 2) Repeat surgery and adjuvant therapy are now widely employed in the treatment of intracranial NGGCT.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,6,15,21) Some factors may be predictive of growing teratoma syndrome, including the presence of mature teratoma at the primary site, the failure of chemotherapy to reduce the tumor size, and the presence of mature teratoma elements in the residual tumor after chemotherapy. 2) Repeat surgery and adjuvant therapy are now widely employed in the treatment of intracranial NGGCT. Therapeutic strategies must consider the possibility of growing teratoma syndrome in patients exhibiting rapid posttherapy tumor growth to lower the risk of debilitating or fatal treatment failure.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of growing teratoma syndrome is 1.9-7.6% in patients with metastatic NGGCT. 1,2,7,13,18) Only a few cases of this syndrome have been reported in patients with intracranial germ cell tumors. 8,15,21,22) We treated a 16-year-old Japanese woman with intracranial growing teratoma syndrome associated with a NGGCT in the neurohypophysis.…”

Section: Introductionmentioning

confidence: 99%

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Growing Teratoma Syndrome in a Patient With a Non-germinomatous Germ Cell Tumor in the Neurohypophysis-Case Report-

Yagi

Kageji

Saijo

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 16-year-old woman presented with a non-germinomatous germ cell tumor in the neurohypophysis manifesting as progressive visual disturbance, amenorrhea, hydrodipsia, and polyuria. Her serum a-fetoprotein and human chorionic gonadotropin levels were elevated. She experienced sudden, rapid visual deterioration and underwent emergency partial tumor removal to decompress the optic nerves. Her vision subsequently improved. Histological examination of the surgical specimens confirmed immature teratoma. She received chemotherapy (ifosphamide 900 mg/m 2 , cisplatin 20 mg/m 2 , etoposide 60 mg/m 2 ) for 5 consecutive days. Although the tumor marker levels decreased remarkably, her vision again declined rapidly due to enlargement of the tumor after the first course of chemotherapy. A second radical operation resulted in vision improvement. The tumor specimen showed only mature teratoma elements. This phenomenon, called the growing teratoma syndrome, is very rare in intracranial non-germinomatous germ cell tumors.

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“…All other responses were considered incomplete responses. Progressive disease (PD) was defined as rising tumour marker levels confirmed at least twice or the appearance of new lesions, except when pathologic evidence of a growing teratoma syndrome (Logothetis et al, 1982;André et al, 2000) was provided. Before response assessment, patients with tumour markers on plateau were subjected to either surgical resection of residual masses or follow-up of tumour markers.…”

Section: Assessment Of Responsementioning

confidence: 99%

Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours

Fizazi

Prow

et al. 2002

Br J Cancer

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Only about half of patients with a poor-prognosis non-seminomatous germ-cell tumours can achieve a cure. The aim of this phase II study was to assess the efficacy and toxicity of a dose-dense alternating chemotherapy regimen in this subset of patients. High volume non-seminomatous germ-cell tumours was defined as follows: at least two sites of non pulmonary metastases, an extragonadal primary tumour, a serum human chorionic gonadotropin level higher than 10 000 mIU ml 71 , or a alpha-foetoprotein level higher than 2000 mIU ml 71. Patients who fulfilled these criteria were treated with the so-called BOP-CISCA-POMB-ACE regimen (bleomycin, vincristine, and cisplatin; cisplatin, cyclophosphamide, and doxorubicin; cisplatin, vincristine, methotrexate, and bleomycin; etoposide, dactinomycin, and cyclophosphamide) plus granulocyte colony-stimulating factor. A total of 58 patients were enrolled. Patients were retrospectively classified according to the International Germ-Cell Cancer Consensus Group classification; 38 patients (66%) had poor-prognosis disease and 19 patients (33%) had intermediate-prognosis. Patients received a median of 2.5 courses (range 0.25 to five courses) of the BOP-CISCA-POMB-ACE regimen. Forty-two patients (72.4%) had a complete response to therapy. With a median follow-up time of 31 months, the 3-year progression-free survival rate was 71% (95% confidence interval, 60 to 84%) and the 3-year overall survival rate was 73% (95% confidence interval: 62 to 86%). The 3-year PFS rates were 83% (95% confidence interval: 68 to 100%) in the intermediate-prognosis group and 65% (95% confidence interval: 51 to 82%) in the poor-prognosis group. Early side effects included mainly grade 4 haematologic toxicity (neutropaenia in 79% of patients, thrombocytopaenia in 69%, anaemia in 22%), grade 4 stomatitis (19%), and four early deaths (7% of patients), at least partially related to toxicity. The dose-dense BOP-CISCA-POMB-ACE regimen is highly active in patients with non-seminomatous germ-cell tumours classified as intermediateprognosis or poor-prognosis according to the International Germ-Cell Cancer Consensus Group. Because outcomes with this regimen compare favourably with outcome after standard therapy, dose-dense chemotherapy should be further investigated in this subset of patients.

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The growing teratoma syndrome: results of therapy and long-term follow-up of 33 patients

Cited by 215 publications

References 26 publications

Immature Testicular Teratoma Post-operatively Presenting as a Chemotherapy Resistant Retroperitoneal Mature Teratoma

Immature Testicular Teratoma Post-operatively Presenting as a Chemotherapy Resistant Retroperitoneal Mature Teratoma

Growing Teratoma Syndrome in a Patient With a Non-germinomatous Germ Cell Tumor in the Neurohypophysis-Case Report-

Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours

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