The Growing Teratoma Syndrome

Jeffery, G. Mark; Theaker, J.M.; Lee, A. H. S.; Blaquière, R. M.; Smart, C. J.; Mead, G. M.

doi:10.1111/j.1464-410x.1991.tb15109.x

Cited by 97 publications

(73 citation statements)

References 23 publications

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“…"Growing teratoma syndrome" is a term applied to an enlarging tumor mass despite normalization of tumor markers during or after chemotherapy and histologically containing mature teratoma at resection. Growing teratoma syndrome occurs in approximately 2-7% of NSGCT (1)(2)(3)(4). However, only a few cases of growing teratoma syndrome have been reported in primary mediastinal NSGCT (5-7).…”

Section: Introductionmentioning

confidence: 99%

Mediastinal Growing Teratoma Syndrome Succesfully Treated by Multiple Modality Therapies

et al. 2011

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A 43-year-old-man was diagnosed as having primary mediastinal nonseminomatous germ cell tumor based on pericutaneous biopsy and an elevated serum concentration of alpha-fetoprotein (AFP). Although AFP decreased after chemotherapy, the mass size grew and developed tracheal compression by the tumor. The patient was treated with mechanical ventilation and subsequent stent implantation for keeping airway patency. After three cycles of chemotherapy and normalization of AFP, the increased mass was successfully resected and the pathological examination demonstrated a mature teratoma. This case showed a rare clinical manifestation of mediastinal growing teratoma syndrome and successful outcome by multimodal therapies.

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Section: Introductionmentioning

confidence: 99%

Mediastinal Growing Teratoma Syndrome Succesfully Treated by Multiple Modality Therapies

et al. 2011

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“…It accounts for 4% to 8% of patients with NSGCT in reported series. 4,7 The entity was first described in 1881 by Carr et al 2 In 1882, Logothetis et al 1 described six cases of this tumor, gave the current name to the syndrome, and described its characteristics. These lesions usually are located in sites where metastasis of the original NSGCT of testicular or ovarian origin 8 would present.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for growing teratoma syndrome: Report of a case

Eghtesad

Marsh

Cacciarelli

et al. 2003

Liver Transplantation

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Liver transplantation is a well-established treatment for liver failure and for a selected group of patients with hepatic tumors. The growing teratoma syndrome refers to the phenomenon whereby germ cell tumors enlarge after chemotherapy despite complete eradication of malignant cells and normalization of serum tumor markers. We present the case of a young patient with rapidly growing teratomatous masses in his liver who was treated with liver transplantation from a live donor. We discuss his postoperative management, follow-up, and briefly review literature on the subject. (Liver Transpl 2003;9:1222-1224.)T he growing teratoma syndrome (GTS) is characterized by the enlargement of mixed nonseminomatous germ cell tumors (NSGCTs) after successful chemotherapy with normalization of tumor marker values. 1,2 This syndrome includes patients with enlarging masses in the retroperitoneum or mediastinum and, rarely, liver containing mature teratoma cells. Despite their benign nature, continuous growth of these tumors can potentially cause significant morbidity and possible mortality secondary to their encroachment on adjacent structures in the chest or abdomen. Radical surgical excision of tumors is the only curative option.Involvement of the liver by NSGCTs and transformation to GTS, although rare, has been reported. 3,4 Unfortunately, because of the diffuse involvement of the liver, in some cases, liver resection and other recent modalities for treatment of hepatic tumors are not effective. Liver transplantation (LT) may be the only option with potential for cure in these patients. We report the first case of LT for GTS. Case ReportA 22-year-old man initially presented with a right testicular mass, which he had ignored for 6 months, followed by increasing abdominal girth, right upper-quadrant fullness, and a more than 30-pound weight loss. At evaluation, he was found to have a large testicular mass, as well as multiple metastatic deposits in the liver, hydronephrosis in the right kidney, and retroperitoneal adenopathy with moderate ascites on an abdominal computed tomographic (CT) scan.At presentation serum, alpha-fetoprotein level was 18,300 ng/mL (normal, 0 to 15 ng/mL), and ␤-human chorionic gonadotropin level was 3,840 MIU/mL (normal, 0 to 5 MIU/ mL). The patient underwent a right radical orchiectomy. A pathological diagnosis of mixed germ cell tumor (embryonal carcinoma, 50%; yolk sac tumor, 30%; immature teratoma, 10%; and seminoma, 10%) was established. There was extratesticular extension of the tumor with invasion of the epididymis and focal lymphovascular invasion with negative resection margin. The patient was started on a cisplatin-based chemotherapeutic regimen. After 4 months, the patient underwent retroperitoneal lymphadenectomy, right nephrectomy, and liver biopsy. The specimens showed residual mature teratoma cells without evidence of malignant components in any resected tissue. The patient continued to undergo chemotherapy for another 4 months. Serum tumor marker levels stayed normal, but the hepatic les...

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“…Only one patient had viable tumor visible on pathologic examination of the resected specimen; the remainder had either mature teratoma or necrosis. One patient developed growing teratoma syndrome 16 in a residual retroperitoneal mass, but this individual did not have direct IVC involvement, either on CT scans or at surgery.…”

Section: Surgical Findingsmentioning

confidence: 99%