Growing Teratoma Syndrome a Rare Clinical Entity: Two Decades Management Experience from the Regional Cancer Institute.

To study the clinical, biochemical, radiological, pathological characteristics, surgical treatment details, and follow-up of growing teratoma syndrome (GTS) patients. This is a retrospective study of GTS treated in the Department of Gynaecological Oncology at a regional cancer institute from March 2000 to March 2020. A total of 303 cases of germ cell ovarian cancers were treated, and 8 (2.6%) of 303 cases recurred as GTS during this period. The patients presenting with recurrent GTS were studied for clinical, radiological, tumor markers, surgical management, histopathology, and post-operative follow-up details that were analyzed retrospectively. The Kaplan-Meier curve was used for the survival analysis. The 8 out of 303 cases of germ cell ovarian cancers recurred as GTS and the incidence rate is 2.6% during this period. In the six (75%) of eight cases, the histopathology report was immature teratoma ovaries. The five cases (62.5%) were in advanced stage. All the eight recurrent GTS cases received optimal surgical cytoreduction. The overall disease-free survival is 85.7% and one patient has recurrence after the surgery for GTS at 23rd month of follow-up visit. All the patients are alive till date. The GTS represents a rare clinical and pathological phenomenon. Nevertheless, GTS should be considered as one of the differential diagnosis in young patients having normal tumor markers with recurrent carcinomatosis following the primary treatment germ cell tumors of ovaries. The optimal cytoreduction of recurrent GTS leads to prolonged survival and possible cure in young patients.

PCL-retaining versus PCL-substituting TKR - Outcome assessment based on the "forgotten joint score".

BACKGROUND: Posterior cruciate ligament (PCL) retention or sacrifice figures prominently among the current controversies in total knee arthroplasty (TKA). Even though biomechanical advantages and disadvantages have been claimed for each type of TKA, clinical studies have not shown significant differences in the outcomes. METHODS: In this retrospective study, the recently introduced "forgotten joint score" (FJS) was used to assess whether any differences exist between the two types of total knee replacement (TKR). FJ scores of 169 patients with PCL-retaining TKA and 178 patients with PCL sacrificing were obtained. The mean follow-up period was 3.5 years and the minimum follow-up period was 2.5 years. RESULTS: Both groups showed high FJ scores indicating that majority of the patients were oblivious to the presence of the artificial joint during daily activities. There was no statistically significant difference between the mean FJ scores of the two groups. Scores of subsets based on gender, age and unilateral and bilateral TKR also did not show significant differences. CONCLUSIONS: Since there are no clinically important differences between the two types of TKR, the choice of the TKA should be based on surgeon preferences and training and local conditions of the knee. Patient-reported outcomes appear to be similar regardless of the choice of TKA. Further prospective studies and validation of FJS outcomes with those of other questionnaires are essential to confirm the absence of differences between PCL retention and sacrifice.

A rare case of plasmacytoma of the ovary: a case report and literature review.

OBJECTIVE: Extramedullary plasmacytomas are rare. Ovarian plasmacytomas, for which treatment options vary, are more unique and even more rare. We will consider the option of optimal cytoreductive surgery followed by adjuvant chemotherapy consisting of carboplatin (AUC-2) to prevent massive ascites and pleural effusion. CASE REPORT: We report a case of ovarian plasmacytoma in a 35-year-old woman presenting with abdominal pain due to the mass. She underwent optimal cytoreductive surgery. A post-operative histopathologic diagnosis of ovarian plasmacytoma was confirmed. She was assigned stage IIC disease. She received three cycles of single agent carboplatin for rapidly refilling ascites and pleural effusion. Her response was dramatic. There is no evidence of recurrence clinically for more than 14 months. The patient is receiving follow-up care. CONCLUSION: Multimodality treatment comprising of optimal cytoreductive surgery followed by carboplatin-based chemotherapy is a novel observation and may be an option for the treatment of these rare tumours. This options needs to be further researched.