scholarly journals Growing Teratoma Syndrome: Two case reports

2021 ◽  
Author(s):  
anju shrestha ◽  
Hari Dhakal ◽  
Sirish Pandey ◽  
Kapendra Amatya ◽  
Sudip Shrestha ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Surgical Resection ◽  
Case Reports ◽  
Mature Teratoma ◽  
Immature Teratoma ◽  
Surgical Staging ◽  
Growing Teratoma Syndrome ◽  
Complete Surgical Resection

We present two cases of nine and twenty-seven years old girls with recurrence of immature teratoma after an incomplete surgical staging. In both cases, there were huge abdominopelvic masses despite decrease in tumor markers with chemotherapy. Complete surgical resection of these masses was done, and histopathology showed only mature teratoma.

Management of growing teratoma syndrome: Aachen University experience.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 385-385
Author(s):  
David J. K. P. Pfister ◽  
Daniel Porres ◽  
Andrea K. Thissen ◽  
Charlotte Piper ◽  
Axel Heidenreich
Keyword(s):  
Tumor Markers ◽  
Surgical Resection ◽  
Systemic Chemotherapy ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Vena Cava ◽  
Retroperitoneal Lymph Node Dissection ◽  
Tumor Diameter ◽  
Growing Teratoma Syndrome ◽  
Complete Surgical Resection

385 Background: Growing teratoma syndrome (GTS) is an infrequent clinical phenomenon. GTS is defined as an enlarging metastatic mass during systemic chemotherapy for advanced nonseminomatous germ cell tumors (NSGCT) despite decreasing serum tumor markers. Complete surgical resection of the mass is mandatory to achieve a favourable outcome. We report on our single center experience in the management of GTS. Methods: Between January 2000 and August 2009 postchemotherapeutic retroperitoneal lymph node dissection (PCRPLND) was performed in 162 patients (pts) with advanced NSGCT. Fourteen pts (4.9%) fulfilled the criteria of a GTS: enlarging metastatic mass in the retroperitoneum or visceral organs during systemic chemotherapy with normalized or regredient tumor markers. In all cases of GTS a complete radical bilateral PCRPLND including the resection of adjacent visceral and vascular structures was performed. Results: Median patient age was 24.5 (18 to 52) years. All patients exhibited NSGCT with a good or intermediate prognosis according to IGCCCG; in all cases the primary tumor contained predominantly (greater than 50%) mature teratoma; 10 and 4 patients presented with clinical stage IIC and III, resp. Median tumor diameter at time of surgery was 6,5 (3,0-35)cm. Tumor markers were normalized in 12 out of 14 patients and markers plateauted in 2 out of 14 patients. Tumor masses were localized in the retroperitoneum in 12 pts.; two patients had additional pulmonary metastases which were resected in a second approach. Median time from start of chemotherapy to surgery was 4.8 (1.5 to 26.5) months Median surgical time was 265 (165 to 585) minutes, and median blood loss 650 (450 to 2,000) ml. Four pts required resection of the inferior vena cava or abdominal aorta with implantation of a prosthetic graft; adjunctive nephrectomy was performed in three pts. After a median follow-up of 4.2 years two pts developed recurrent disease; the remainder are alive without evidence of disease. Conclusions: GTS is a rare phenomenom among pts with advanced NSGCT and necessitates complete surgical resection of all masses with curative intention. Surgery should be considered at time of progression to facilitate complete removal of the mass. Due to the complex surgery, treatment should be performed at specialized centers.

scholarly journals Complete Surgical Resection and Aggressive Treatment for Liver Metastasis May Be Beneficial to Adult Patients With Pancreatoblastoma: A Case Report and Review of Literature

2020 ◽  
Vol 104 (3-4) ◽  
pp. 149-154
Author(s):  
Shih-Min Yin ◽  
Yueh-Wei Liu ◽  
Fong-Fu Chou ◽  
Fang-Ying Kuo ◽  
Leung-Chit Tsang
Keyword(s):  
Liver Metastasis ◽  
Surgical Resection ◽  
Tumor Size ◽  
Case Reports ◽  
Abdominal Mass ◽  
Pancreatic Neoplasm ◽  
Pancreatic Head ◽  
Curative Treatment ◽  
Postprandial Fullness ◽  
Complete Surgical Resection

Introduction: Pancreatoblastoma (PB) is a rare pancreatic neoplasm that occurs most in pediatric patients. Here, we report a rare case of adult PB with liver metastasis and review the literature in order to assist clinicians in the management of the disease. Case Presentation: A 27-year-old female patient suffered from postprandial fullness, anorexia, and weight loss in the past 3 months. An abdominal ultrasound and contrast-enhanced computed tomography scans confirmed right abdominal mass with compression of major liver vessels, as well as the P-duct and biliary ducts and causing mild dilatation. Pancreatoduodenectomy was performed and pathologic findings showed typical squamoid corpuscles, which confirmed the diagnosis of PB. The patient was alive and disease-free for 1 year and 10 months until a new metastatic lesion was found. Radiofrequency ablation was arranged as a curative treatment, and no viable tumor or sign of recurrence was found until this paper was submitted. Based on a review of previous case reports, we found adult PB patients with only liver metastasis presented with a smaller tumor size (P = 0.031), more frequent pancreatic head origin (P = 0.043), and decreased 1-year mortality (P = 0.009) compared with patients with other distal metastases. Therefore, we assumed that PB with liver metastasis might present favorable outcome by complete surgical resection or other curative treatment. Conclusion: PB patients with liver metastasis are more likely to show a pancreatic head origin, smaller tumor size, and more favorable outcomes compared with other sites of metastasis. PB should be treated aggressively with surgical resection or other curative treatment as opposed to chemotherapy alone.

Growing teratoma syndrome in mixed hepatoblastoma with teratoid features

2021 ◽  
Vol 14 (3) ◽  
pp. e241197
Author(s):  
Sanjeev Khera ◽  
Vikram Singh ◽  
Badal Parikh ◽  
Karunesh Chand
Keyword(s):  
Early Recognition ◽  
Case Reports ◽  
Mature Teratoma ◽  
Germ Cell Tumour ◽  
Surgical Excision ◽  
Tumour Mass ◽  
Growing Teratoma Syndrome ◽  
Complete Surgical Excision ◽  
Histological Variant ◽  
Definitive Management

Mixed epithelial mesenchymal (MEM) hepatoblastoma with teratoid features is rare histological variant of hepatoblastoma and described in case reports. Growing teratoma syndrome (GTS) is a rare and often unrecognised phenomenon generally associated with less than 5% of germ cell tumour. It is defined by enlarging tumour mass which is generally mature teratoma with normal or significantly decreasing tumour markers during chemotherapy. The treatment outcomes in GTS are dependent on early recognition and complete surgical excision. We describe a rare case of MEM hepatoblastoma with teratoid features with GTS in an infant who had a delay in definitive management due to late diagnosis of GTS.

scholarly journals Growing teratoma syndrome: A case report

2016 ◽  
Author(s):  
Swati Gupta ◽  
Saritha Shamsunder ◽  
Roli Purwar ◽  
Vidya Jha ◽  
A. K. Yadav ◽  
...  
Keyword(s):  
Case Report ◽  
Adnexal Mass ◽  
Mature Teratoma ◽  
Pelvic Mass ◽  
Testicular Germ Cell Tumor ◽  
Conservative Surgery ◽  
Immature Teratoma ◽  
Testicular Germ Cell ◽  
Growing Teratoma Syndrome ◽  
Sporadic Cases

Introduction: Growing teratoma syndrome (GTS) or chemotherapeutic retro conversion is an extremely rare phenomenon seen in about 1.9-7.6% of patients being treated for non-seminomatous testicular germ cell tumor. It is even more rarely reported in females with only sporadic cases reported so far. It was described by logothetis et al and is described as conversion of immature teratoma to mature one after chemotherapy and presents as growing and metastasizing mass. Case Report: We report a case of 10 year old girl who underwent conservative surgery for an adnexal mass reported as immature teratoma on histopathology. Following which she was given chemotherapy for rapidly developing ascites. After four cycles of chemotherapy, the pelvic mass increased in size with metastatic deposits around the liver. Re-laparotomy and removal of the ovarian mass and metastatic deposits was carried out in stages. The histopathology showed mature teratoma. Conclusion: GTS is an extremely rare occurrence and it is important for the clinicians to know it to avoid misdiagnosis. Moreover, being a chemo-resistant tumor, early diagnosis and surgery are curative.

scholarly journals Challenges in the diagnosis of growing teratoma syndrome: two case reports

2020 ◽  
Vol 19 (4) ◽  
pp. 126-132
Author(s):  
K. Yu. Sinichenkova ◽  
E. S. Tyutikova ◽  
Yu. N. Likar ◽  
A. M. Mitrofanova ◽  
D. M. Konovalov ◽  
...  
Keyword(s):  
Germ Cell ◽  
Tumor Progression ◽  
Case Reports ◽  
Mature Teratoma ◽  
Tumor Resection ◽  
Complete Resection ◽  
Repeat Biopsy ◽  
Incomplete Resection ◽  
Germ Cell Tumours ◽  
Growing Teratoma Syndrome

Growing teratoma syndrome (GTS) is reported to have an incidence of 1.9–7.6% among all germ cell tumours (GCT) and is often mistaken for tumor progression. There are no absolute signs or symptoms of GTS but it can be suspected based on the following criteria: the normalization of tumour markers, the enlargement of the mass and the presence in the tumour of mature teratoma cells alone. A delayed tumor resection in GTS can result in higher surgical risks and/or the infeasibility of complete resection. In 72–83% of cases, incomplete resection leads to relapses in the form of mature teratoma growth. A repeat biopsy is recommended in all patients with suspected GTS so that to avoid chemotherapy that would be ineffective in this disease. The article reports two clinical cases of GTS illustrating challenges inherent in the diagnosis of this syndrome. In each case, the parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.

scholarly journals GCT-14. SECOND-LOOK SURGERY FOR INTRACRANIAL GERM CELL TUMORS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii330-iii330
Author(s):  
Hideki Ogiwara
Keyword(s):  
Germ Cell ◽  
Tumor Markers ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Residual Tumor ◽  
Complete Response ◽  
Immature Teratoma ◽  
Total Resection ◽  
Mixed Germ Cell Tumor ◽  
Second Look

Abstract OBJECTIVE The authors present their experiences of second-look surgery in patients with intracranial GCTs who showed less than complete response despite normalizing or decreasing tumor markers after chemotherapy. METHODS Retrospective review of 14 patients who underwent second-look surgery for an intracranial GCT was performed. RESULTS Of 40 consecutive patients with newly diagnosed intracranial GCTs treated between August 2003 and 2019, 14 patients (35%) underwent second-look surgery. The mean age was 9.2 years. The initial diagnoses were mixed germ cell tumor in 6, immature teratoma in 4, yolk sac tumor in 2, and germinoma 2. Second-look surgery was performed after 1–3 courses of chemotherapy. Magnetic resonance imaging (MRI) at the surgery demonstrated increasing residual tumor in 8 and stable residual tumor in 6. Tumor markers were normalized in 10 and nearly-normalized in 4. Gross total resection was achieved in 12 patients and near-total resection in 2. Histopatholgy at second-look surgery revealed mature teratoma in 6, immature teratoma in 3, fibrosis with atypical cells in 2, and fibrosis in 3. Eleven patients subsequently underwent additional chemo-radiation therapy according to the initial diagnosis. All patients are alive with no evidence of recurrence with a mean follow-up of 69 months. CONCLUSIONS Second-look surgery plays an important role in the treatment of intracranial GCTs. Surgery may be encouraged at a relatively early phase after chemotherapy when the residual tumor increases or does not change the size despite normalized or nearly-normalized tumor markers in order to achieve complete resection and improve the outcome.

scholarly journals Pediatric Ovarian Growing Teratoma Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Rebecca M. Rentea ◽  
Aaron Varghese ◽  
Atif Ahmed ◽  
Alexander Kats ◽  
Michelle Manalang ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Mature Teratoma ◽  
Diagnostic Algorithm ◽  
Chemotherapeutic Agents ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
Growing Teratoma Syndrome ◽  
Liver Recurrence ◽  
Management Protocol

Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation. Current treatment modality is surgical resection. We discuss a 12-year-old female who presented following resection of a pure ovarian immature teratoma (grade 3, FIGO stage IIIC). Following chemotherapy and resection of a pelvic/liver recurrence demonstrating mature teratoma, she underwent molecular genetics based chemotherapeutic treatment. No standardized management protocol has been established for the treatment of GTS. The effect of chemotherapeutic agents for decreasing the volume of and prevention of expansion is unknown. We review in detail the history, diagnostic algorithm, and previous reported pediatric cases as well as treatment options for pediatric patients with GTS.

scholarly journals Resection of primary cardiac angiosarcoma infiltrating the right atrioventricular junction and tricuspid valve: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lubna Bakr ◽  
Hussam AlKhalaf ◽  
Ahmad Takriti
Keyword(s):  
Surgical Resection ◽  
Tricuspid Valve ◽  
Right Atrium ◽  
Large Mass ◽  
Small Mass ◽  
Malignant Tumours ◽  
Atrioventricular Junction ◽  
Cardiac Angiosarcoma ◽  
Complete Surgical Resection ◽  
The Right

Abstract Background Primary cardiac tumours are extremely rare. Most of them are benign. Sarcomas account for 95% of the malignant tumours. Prognosis of primary cardiac angiosarcoma remains poor. Complete surgical resection is oftentimes hampered when there is extensive tumour involvement into important cardiac apparatus. We report a case of cardiac angiosarcoma of the right atrium and ventricle, infiltrating the right atrioventricular junction and tricuspid valve. Case presentation Initially, a 22-year-old man presented with dyspnoea. One year later, he had recurrent pericardial effusion. Afterwards, echocardiography revealed a large mass in the right atrium, expanding from the roof of the right atrium to the tricuspid valve. The mass was causing compression on the tricuspid valve, and another mass was seen in the right ventricle. Complete resection of the tumour was impossible. The mass was resected with the biggest possible margins. The right atrium was reconstructed using heterologous pericardium. The patient’s postoperative course was uneventful. Postoperative echocardiography showed a small mass remaining in the right side of the heart. Histopathology and immunohistochemistry confirmed the diagnosis of angiosarcoma. The patient underwent adjuvant chemotherapy and radiotherapy later on. He survived for 1 year and 5 days after the surgery. After a diagnosis of lung and brain metastases, he ended up on mechanical ventilation for 48 h and died. Conclusions Surgical resection combined with postoperative chemotherapy and radiotherapy is feasible even in patients with an advanced stage of cardiac angiosarcoma when it is impossible to perform complete surgical resection.

scholarly journals Treatment of tumor thrombus in the superior mesenteric vein due to advanced colon cancer with complete surgical resection and chemotherapy: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshitsugu Yanagida ◽  
Takahiro Amano ◽  
Ryuji Akai ◽  
Akira Toyoshima ◽  
Jotaro Kobayashi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Tumor Thrombus ◽  
Superior Mesenteric Vein ◽  
Tumor Resection ◽  
Term Survival ◽  
Mesenteric Vein ◽  
Advanced Colon Cancer ◽  
Complete Surgical Resection

Abstract Background Tumor thrombus in the superior mesenteric vein secondary to colon cancer is rare. We report a case of tumor thrombus in the superior mesenteric vein and liver metastasis due to advanced colon cancer that was treated with chemotherapy and complete surgical resection. Case presentation A 72-year-old man after transverse colectomy with lymph node dissection for advanced colon cancer was diagnosed with tumor thrombus in the superior mesenteric vein and liver metastasis. He underwent adjuvant chemotherapy and had complete surgical tumor resection involving tumor thrombectomy and hepatectomy. There has been no recurrence at 36 months after surgery. Conclusion Herein, we report a rare case of tumor thrombus in the superior mesenteric vein related to advanced colon cancer. The combination of chemotherapy and complete surgical tumor resection may provide long-term survival.

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