Testicular teratomas: a growing problem?

Michalski, Wojciech; Jońska-Gmyrek, Joanna; Poniatowska, Grażyna; Kucharz, Jakub; Stelmasiak, Pawel; Nietupski, Karol; Sadowska, Małgorzata; Demkow, Tomasz; Wiechno, Paweł

doi:10.1007/s12032-018-1215-3

Cited by 8 publications

(9 citation statements)

References 52 publications

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“…The reported rate of developing GTS is low (1.9–7.6%) among male NSGCTs patients. [ 8 , 11 , 12 ] However, a higher incidence of GTS has been reported in female patients (12%–40%) with GCTs. [ 5 , 7 , 13 ] The management of GTS and relapse of IOTs is different, despite similar clinical findings.…”

Section: Discussionmentioning

confidence: 99%

Pelvic masses after surgery for immature ovarian teratoma: A 10-year experience of Western China

Xie

Jia

et al. 2022

Medicine

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There are debates on the management of immature ovarian teratoma and its recurrence. This study aimed to report the incidence of pelvic masses after surgery for immature ovarian teratoma and to identify prognostic factors of disease-free survival after surgery, discussing aspects of primary treatment and postoperative management.Data on the diagnosis and treatment of patients with immature teratomas were collected. Follow-up data were acquired from clinic visits and telephone interviews. Disease-free survival was defined as the time interval between the initial surgery for immature ovarian teratoma and the diagnosis of a new pelvic mass. Survival curves were drawn using the Kaplan-Meire method, and multivariate analysis was performed using the Cox proportional hazard regression model using PASW statistics software.The estimated 5-year disease-free survival and overall survival were 74.3% (95%CI 63.9%-84.7%) and 96.5% (95%CI 91.6%-100.0%), respectively. The incidence of growing teratoma syndrome and immature teratoma relapse at a median follow-up of 46 months were 20.0% and 7.7%, respectively. Two patients died of repeated relapses or repeated growing teratoma syndrome. Rupture of initial lesions (RR 4.010, 95%CI 1.035-5.531), lymph node dissection (RR 0.212, 95%CI 0.051-0.887) and adjuvant chemotherapy (RR 0.143, 95%CI 0.024-0.845) were independent prognostic factors for disease-free survival.The development of growing teratoma syndrome is more prevalent than relapse after treatment of immature ovarian teratomas. Lymph node dissection and chemotherapy are recommended to reduce recurrence. Close surveillance and active surgical intervention are important for the diagnosis and appropriate management of new pelvic masses.

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Section: Discussionmentioning

confidence: 99%

Pelvic masses after surgery for immature ovarian teratoma: A 10-year experience of Western China

Xie

Jia

et al. 2022

Medicine

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“…Adjuvant chemotherapy is not recommended in testicular teratomas or pediatric teratomas of any stage because these tumors are considered chemoresistant. The risk of malignant somatic transformation is about 3%-6% in patients with testicular non-seminoma GCTs [55][56][57]. Most common are primitive neuroectodermal tumors (30.8%), followed by sarcoma (23.3%), mixed histologies (16.7%), and adenocarcinoma (15.7%) [55].…”

Section: Testicular Teratomasmentioning

confidence: 99%

“…The risk of malignant somatic transformation is about 3%-6% in patients with testicular non-seminoma GCTs [55][56][57]. Most common are primitive neuroectodermal tumors (30.8%), followed by sarcoma (23.3%), mixed histologies (16.7%), and adenocarcinoma (15.7%) [55].…”

Section: Testicular Teratomasmentioning

confidence: 99%

“…In testicular GCTs, the incidence of growing teratoma syndrome ranges from 2% to 8%. The incidence rate is unclear in ovarian GCTs [55] but has been reported to be as high as 20% in IT patients [58]. The recommended treatment approach is to perform as complete surgery as possible because it might otherwise cause severe local problems.…”

Section: Clinical and Histological Classificationmentioning

confidence: 99%

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Malignant ovarian and testicular germ cell tumors: Common characteristics but different prognoses

Sköld,

Jansson,

Glimelius

2024

J Intern Med

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Both ovarian and testicular germ cell tumors (GCTs) arise from the primordial germ cell and share many similarities. Both malignancies affect mainly young patients, show remarkable responsiveness to cisplatin‐based therapy, and have an excellent prognosis, which also highlights the importance of minimizing long‐term side effects. However, certain differences can be noted: The spreading of the disease differs, and the staging system and treatment recommendations are dissimilar. Moreover, the prognosis for ovarian GCTs is significantly inferior to that for testicular cancer, as exemplified in this review comparing the survival in Swedish patients diagnosed with testicular (1995–2022) and ovarian (1990–2018) GCTs. The 5‐year overall survival in ovarian GCTs was 85.2%, versus 98.2% for testicular GCTs. How can this be explained? One reason may be the difference in knowledge, experience, and evidence because the incidence rate of testicular cancer is more than 15 times that of ovarian GCTs. Given the rarity of the disease in women and the lack of established guidelines, a comprehensive understanding of the disease and treatment decisions is challenging. The main objective of this review is to derive insights from testicular GCTs (seminoma and non‐seminoma) by reviewing etiological, tumor biological, and clinical knowledge, and to thereafter suggest actions for ovarian GCTs based on this. We hypothesize that by adopting specific treatment strategies from testicular GCTs—including de‐escalating adjuvant chemotherapy for low‐risk patients and implementing more standardized and intensive treatment protocols in cases of relapse—we can improve the prognosis and minimize long‐term side effects in ovarian GCT patients.

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“…GTS is a potentially life-threatening condition that is clinically and therapeutically challenging [ 162 ]. It was recognized by Logothetis in 1982 [ 163 ], and it is clinically defined as a growing GCT after chemotherapy accompanied by a decrease of the classical serum tumor markers [ 164 , 165 ]. The biopathology of this phenomenon is still a matter of debate, but one theory is that embryonal carcinoma cells are induced to differentiate during treatment, assuming the form of teratoma-forming transit-amplifying cells.…”

Section: Differentiation-dependent Cisplatin Resistance: Specificimentioning

confidence: 99%

Cisplatin Resistance in Testicular Germ Cell Tumors: Current Challenges from Various Perspectives

Lobo

Jerónimo

Henrique

2020

Cancers

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Testicular germ cell tumors share a marked sensitivity to cisplatin, contributing to their overall good prognosis. However, a subset of patients develop resistance to platinum-based treatments, by still-elusive mechanisms, experiencing poor quality of life due to multiple (often ineffective) interventions and, eventually, dying from disease. Currently, there is a lack of defined treatment opportunities for these patients that tackle the mechanism(s) underlying the emergence of resistance. Herein, we aim to provide a multifaceted overview of cisplatin resistance in testicular germ cell tumors, from the clinical perspective, to the pathobiology (including mechanisms contributing to induction of the resistant phenotype), to experimental models available for studying this occurrence. We provide a systematic summary of pre-target, on-target, post-target, and off-target mechanisms putatively involved in cisplatin resistance, providing data from preclinical studies and from those attempting validation in clinical samples, including those exploring specific alterations as therapeutic targets, some of them included in ongoing clinical trials. We briefly discuss the specificities of resistance related to teratoma (differentiated) phenotype, including the phenomena of growing teratoma syndrome and development of somatic-type malignancy. Cisplatin resistance is most likely multifactorial, and a combination of therapeutic strategies will most likely produce the best clinical benefit.

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Testicular teratomas: a growing problem?

Cited by 8 publications

References 52 publications

Pelvic masses after surgery for immature ovarian teratoma: A 10-year experience of Western China

Pelvic masses after surgery for immature ovarian teratoma: A 10-year experience of Western China

Malignant ovarian and testicular germ cell tumors: Common characteristics but different prognoses

Cisplatin Resistance in Testicular Germ Cell Tumors: Current Challenges from Various Perspectives

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