The growing teratoma syndrome: a woman with nonseminomatous germ cell tumor of the ovary

Abstract

A 38-year-old woman underwent an incomplete surgical excision of multiple peritoneal nodules from nonseminomatous germ cell tumor of the ovary. Tumor markers normalized with combination chemotherapy but contrasted with abdominal node enlargement. Surgical resection failed to remove abdominal masses completely and histologic examination revealed mature teratoma without malignant cells. Nodules continued to grow, infiltrating the liver parenchyma and causing small bowel necrosis and urinary tract obstruction. According to the literature, this female patient presents the typical features of the growing teratoma syndrome. This syndrome was described in treated nonseminomatous germ cell tumors of the testis. Moreover, this patient had an unexpected very high CA 19-9 level. Treatment by low-dose interferon-alpha-induced a subjective improvement and a slight decrease in the size of teratomatous cysts.