Growing Teratoma Syndrome A Rare Case Report

Abstract

Introduction - Growing teratoma syndrome
(GTS) refers to metastatic
masses from non-seminomatous germ
cell tumors (NSGCT) containing mature
teratoma, enlarging during or after chemotherapy.
Surgery is the only chance of
cure for these patients and is often difficult.
Early exploration optimizes the
chance of complete resection which is
necessary for long term survival. Case
report - We report a case of growing
teratoma syndrome in a 24 year old male
who had underwent orchiectomy for
NSGCT in the right undescended intraabdominal
testis in a private hospital
in january 2010 after which he received 4
cycles of BEP (Bleomycin-Etoposide-
Cisplatin) and 2 cycles of EP (Etoposide
- Cisplatin) chemotherapy. The initial
stage was stage IIIB (T1 N2 M1a S2).
After completion of chemotherapy he had
no residual disease on CT scans of chest
and abdomen and his tumour markers
were normal. But on followup CT scan
done in September 2010, he had developed
a
retroperitoneal mass with normal serum
markers. He was followed up in the same
hospital with serial CT scans and tumour
markers till June 2012. The tumour markers
were constantly normal and the mass
was growing slowly. With these findings he
presented to our department in June 2012.
He was evaluated for metastatic disease
and underwent laparatomy and excision of
the mass. The post-operative histopathology
was consistent with mature teratoma.
Conclusion - Growing teratoma syndrome
occurs in 1.9-7.6 percent of patients with
metastatic nonseminomatous germ cell tumours.
Vigilant and frequent imaging helps
in its early diagnosis. Prompt and complete
surgical resection are essential in giving
the best chance for cure, preventing local
complications and development of second
malignancies