Growing teratoma syndrome: A case report / Philippine Journal of Obstetrics and Gynecology

@#Growing teratoma syndrome is a rare phenomenon. Presented is a case of a 36 year old, G2P2 (2002) who consulted for abdominal enlargement and subsequently underwent exploratory laparotomy, peritoneal fluid cytology, left salpingooophorectomy, right oophorocystectomy, infracolic omentectomy and random peritoneal biopsy. Histopathology revealed immature teratoma of the ovary, FIGO grade III, stage IIIC. She received adjuvant chemotherapy using Bleomycin, Etoposide, Cisplatin. After the second cycle of chemotherapy, new lesions were appreciated in the right ovary and at the cul de sac for which she underwent exploratory laparotomy, peritoneal fluid cytology, total hysterectomy with right salpingooophorectomy, tumor debulking, infragastric omentectomy, random peritoneal biopsy. Histopathologic study showed mature teratoma. No further treatment was given. Presently, patient has no evidence of disease for 5 months.

Ovarygrowing teratoma syndrome of report and literature review / 临床与实验病理学杂志

Purpose To study the clinical characteristics of disease development,pathology,treatment and prognosis in ovarian growing teratoma syndrome (GTS).Methods The clinical and pathological data of 1 cases of ovarian GTS were analyzed retrospectively,and the special course of disease and pathological changes were summarized.Results Ultrasound examination revealed a mass measuring 93 mm × 72 mm in the right ovary.Grossly,the tumor was cystic and solid,and solid area was mainly cauliflower like,with soft texture and small amount of hair and grease.Histopathological examination showed there were multifocal immature primitive neural tube in the solid area.Immunohistochemical staining showed the tumor cell were positive for NSE and focal positive for Syn,S-100,CD99,and CD56.In the preoperation,AFP and CA125 were 48.7 ng/mL and 84.2 U/mL.The right ovary mass and uterus,bilateral appendages,omentum and appendix were resected by radical operation,and two courses of chemotherapy postoperative were given.After 17 months,a solid peritoneal mass mesauring 47mm ×35mm × 24mm,was found in the original position by gynecological ultrasound.Grossly,it was solid and soft with some bone tissue.Histopathological examination showed a few immature cartilage and mesenchymal tissue.Tumor markers were within the normal range,the peritoneal mass and bilateral pelvic lymph nodes were excised thoroughly.A slight elevated in CA125 one month after surgery.After successive five courses of chemotherapy,no tumor recurred for 19 months follow up.Conclusion The diagnosis of GTS requires a combination of the overall course of the disease.The pathologic diagnosis of mature teratoma on postoperative recurred tumor are important indications for the differential diagnosis of GTS.Therefore,the tumor markers and abdominal and pelvic ultrasonography should be checked regularly,and reasonable treatment should be carried out aceording to the individual condition of the patient to avoid unnecessary chemotherapy.Keeping the fertility of young patients and preventing postoperative complications is the key to ensure a good prognosis.

Growing Teratoma Syndrome of the Pineal Gland Recognized Very Early during Chemotherapy in a Child with a Non-Germinomatous Germ-Cell Tumor / 임상소아혈액종양

The growing teratoma syndrome (GTS) is defined as the development of mature low-grade elements in the absence of a recurrent non-germinomatous germ-cell tumor (NGGCT) after partial response to multimodal treatment. It is uncommon and may occur in intracranial NGGCTs. Here, we report that a 7-year-old boy with intracranial NGGCT presented with precocious puberty and developed growing teratoma syndrome only 2 weeks after the first cycle of chemotherapy.

Growing Teratoma Syndrome of the Pineal Gland Recognized Very Early during Chemotherapy in a Child with a Non-Germinomatous Germ-Cell Tumor / 임상소아혈액종양

The growing teratoma syndrome (GTS) is defined as the development of mature low-grade elements in the absence of a recurrent non-germinomatous germ-cell tumor (NGGCT) after partial response to multimodal treatment. It is uncommon and may occur in intracranial NGGCTs. Here, we report that a 7-year-old boy with intracranial NGGCT presented with precocious puberty and developed growing teratoma syndrome only 2 weeks after the first cycle of chemotherapy.

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

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.