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. 2021 Mar;12(1):31-38.
doi: 10.1007/s13193-020-01224-1. Epub 2020 Sep 23.

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

Praveen S Rathod  1 , Amarinder Singh  1 , R M Punyashree  1 , V R Pallavi  1 , A Usha  2 , C R Vijay  3 , K Shoba  1 , K Rajshekar  1
Affiliations

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

Praveen S Rathod et al. Indian J Surg Oncol. 2021 Mar.

Abstract

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.

Keywords: Cytoreduction; Germ cell tumors of ovary; Growing teratoma syndrome; Gynecological oncology.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The radiological and intra-operative pictures of growing teratoma in the pararectal space
Fig. 2
Fig. 2
The intra-operative pictures revealing multiple pelvic, abdominal, and splenic lesions of growing teratoma
Fig. 3
Fig. 3
Histomicrophotograph and immunohistochemistry revealing the mature teratoma elements and stains for the neuroendocrine tumor component
Fig. 4
Fig. 4
The Kaplan-Meier overall survival curve
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