Growing teratoma syndrome of mediastinal nonseminomatous germ cell tumor

Diong, Nguk Chai; Dharmaraj, Benedict; Joseph, Cindy Thomas; Sathiamurthy, Narasimman

doi:10.4103/atm.atm_296_19

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Cohen et al in his mediastinal tumor series with mean tumor size of 7.64 cm reported an overall morbidity of 20.4% and 4 mortalities out of 230 patients (19). There were 2 (16.7%) recorded death after 30 days surgery due to pericardial decompression syndrome (20,21) and pulmonary embolism, respectively. This data demonstrated that the morbidity and mortality rate in these series were small, supporting surgical resection as the therapy of choice for these lesions after appropriately worked up.…”

Section: Discussionmentioning

confidence: 97%

Surgery in large anterior mediastinal mass: case series of Hospital Kuala Lumpur

Ahmad¹,

Sathiamurthy²,

Dharmaraj³

et al. 2021

Curr Chall Thorac Surg

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Background: Mediastinal masses comprise of a wide variety of tumors and accounts for about 3% of tumors within the chest. Very few studies have been produced so far on large anterior mediastinal masses, as this pathology is infrequently encountered in clinical practice and tend to be asymptomatic until compression symptoms occur, which leads to mediastinal mass syndrome (MMS). The aim of this writing is to assess the surgical feasibility, approach, safety of resection and outcome in large anterior mediastinal masses.Methods: A retrospective review was conducted on patients referred for mediastinal mass to the Thoracic Surgery Unit, Hospital Kuala Lumpur from October 2017 until March 2020 (30 months). Patients with evidence of primary anterior mediastinal mass measuring >6 cm on contrast-enhanced computed tomography (CECT) of thorax and had undergone treatment in our centre were included. Data were analysed by proportions, means and standard deviations. Categorical data were expressed as percentage, whereas interquartile range was used to describe continuous variables.Results: Out of 63 patients with anterior mediastinal mass, 16 (25.4%) patients had anterior mediastinal mass larger than 6 cm and was included in the analysis. The average tumor size was 11.9 cm. Five patients (31.3%) had MMS. Twelve out of 16 patients were operated with 75% rate of clear tumor margin. There was no postoperative mortality recorded within 30 days of surgery.Conclusions: Positive outcome of definitive surgery in this series suggests clinical feasibility with acceptable short-term safety. Multidisciplinary approach with adequate preoperative assessment, intraoperative preparation and short-and long-term postoperative care were key features to successful treatment of this disease.

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Section: Discussionmentioning

confidence: 97%

Surgery in large anterior mediastinal mass: case series of Hospital Kuala Lumpur

Ahmad¹,

Sathiamurthy²,

Dharmaraj³

et al. 2021

Curr Chall Thorac Surg

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“…Significant elevations in serum AFP or β-HCG, each suggesting a significant component of a yolk sac tumor or choriocarcinoma, exclude the diagnosis of a pure mature teratoma or seminoma. During the diagnosis and follow-up of mediastinal teratoma, it is necessary to monitor serum AFP and β-HCG levels [5] , [14] .…”

Section: Discussionmentioning

confidence: 99%

Ruptured mediastinal mature teratoma with shigellosis empyema: A case report

Ashuri

Wati

Febriani

et al. 2023

International Journal of Surgery Case Reports

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“…GTS is a rare clinical entity, occurring during or after systemic chemotherapy for immature teratoma or mixed malignant germ cell tumors, which presents as enlarged mass with normal serum tumor markers [ 8 – 11 ]. There are 3 main criteria to diagnose GTS [ 10 , 28 ]. Firstly, the serum AFP and β-HCG levels should decrease or even return to normal after chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Primary immature teratoma in the liver with growing teratoma syndrome and gliomatosis peritonei: a rare case report

et al. 2022

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Background Primary liver immature teratoma is extremely rare and only 4 cases have been reported, let alone with growing teratoma syndrome (GTS) and/or gliomatosis peritonei (GP). Case presentation Here, we report a case of a 44-year-old female presenting with progressive abdominal distension and elevated serum alpha fetal protein (AFP) level. CT/MRI scans revealed a large cystic-solid mass in the right lobe of the liver, accompanied with implant or metastasis in the abdominal cavity. Pathologic examination at biopsy suggested immature teratoma. After 4 cycles of chemotherapy, an MRI showed a slight increase in tumor size. Therefore, surgical resection of the right lobe of the liver was performed. The final histological diagnosis was a mature teratoma (tumor size 28 cm × 14 cm × 13 cm), with no residual immature component, and the diagnosis of GTS was considered. The patient continued to receive 2 courses of postoperative chemotherapy. An abdominal CT scan revealed innumerable miliary nodules in bilateral adnexal areas 2 months after surgery. Histologically, large numbers of mature glia were observed, supporting the diagnosis of GP. Conclusions We report for the first time a case of primary liver immature teratoma with GTS and GP in an adult. Longer follow-up is needed to assess definitive efficacy.

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Growing teratoma syndrome of mediastinal nonseminomatous germ cell tumor

Cited by 5 publications

References 7 publications

Surgery in large anterior mediastinal mass: case series of Hospital Kuala Lumpur

Surgery in large anterior mediastinal mass: case series of Hospital Kuala Lumpur

Ruptured mediastinal mature teratoma with shigellosis empyema: A case report

Primary immature teratoma in the liver with growing teratoma syndrome and gliomatosis peritonei: a rare case report

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