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Clinical and radiologic signs of relapsed ovarian germ cell tumor: tissue is the issue.

Homs MY, Schreuder HW, Jonges GN, Witteveen PO - Case Rep Obstet Gynecol (2013)

Bottom Line: In retrospect, the ascites was false positive.This case shows that current diagnostic tools are not sufficient to distinguish between vital tumor and mature teratoma and can be misleading.Tumor biopsy and/or laparoscopic inspection are therefore indicated.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.

ABSTRACT
Malignant ovarian germ cell tumor is a rare disease, but with current treatment strategies including surgery and platinum based chemotherapy survival is excellent. After treatment, intensive followup is indicated to encounter tumor relapse at an early stage. This case describes a 22-year-old female with a history of common variable immune deficiency (CVID) who underwent a resection of a large ovarian germ cell tumor followed by 4 cycles of cisplatin and etoposide resulting in clinical complete remission. During followup, she developed a mass at the umbilicus and ascites. Initially, the cytology of the ascites was interpreted as tumor positive, suspicious of relapse of the disease, but tumor markers remained negative. However, during laparoscopy it turned out to be a mature teratoma, which can develop after chemotherapy, the so called growing teratoma syndrome. In retrospect, the ascites was false positive. This case shows that current diagnostic tools are not sufficient to distinguish between vital tumor and mature teratoma and can be misleading. Tumor biopsy and/or laparoscopic inspection are therefore indicated.

No MeSH data available.


Related in: MedlinePlus

Mature teratoma.
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fig4: Mature teratoma.

Mentions: It was decided to perform a diagnostic open laparoscopy. A small fascia defect was detected, with an umbilical hernia (Figure 3(a)). Multiple defects in the peritoneum were seen, which might have caused the ascites (Figure 3(b)). A brown colored mass of 10 mm was removed from the left side of the vesicouterine plica (Figure 4). After complete resection of the brown colored lesion, full inspection of the abdomen showed no further suspected abnormalities, and several biopsies were taken. Histological examination of the brown colored lesion showed a mature teratoma with no signs of immature elements (Figure 5) and no signs of malignancy in the other materials or ascites. Six months after surgery, the patient is clinically fit with no signs of ascites or residual disease and persisting normal tumor markers.


Clinical and radiologic signs of relapsed ovarian germ cell tumor: tissue is the issue.

Homs MY, Schreuder HW, Jonges GN, Witteveen PO - Case Rep Obstet Gynecol (2013)

Mature teratoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814044&req=5

fig4: Mature teratoma.
Mentions: It was decided to perform a diagnostic open laparoscopy. A small fascia defect was detected, with an umbilical hernia (Figure 3(a)). Multiple defects in the peritoneum were seen, which might have caused the ascites (Figure 3(b)). A brown colored mass of 10 mm was removed from the left side of the vesicouterine plica (Figure 4). After complete resection of the brown colored lesion, full inspection of the abdomen showed no further suspected abnormalities, and several biopsies were taken. Histological examination of the brown colored lesion showed a mature teratoma with no signs of immature elements (Figure 5) and no signs of malignancy in the other materials or ascites. Six months after surgery, the patient is clinically fit with no signs of ascites or residual disease and persisting normal tumor markers.

Bottom Line: In retrospect, the ascites was false positive.This case shows that current diagnostic tools are not sufficient to distinguish between vital tumor and mature teratoma and can be misleading.Tumor biopsy and/or laparoscopic inspection are therefore indicated.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.

ABSTRACT
Malignant ovarian germ cell tumor is a rare disease, but with current treatment strategies including surgery and platinum based chemotherapy survival is excellent. After treatment, intensive followup is indicated to encounter tumor relapse at an early stage. This case describes a 22-year-old female with a history of common variable immune deficiency (CVID) who underwent a resection of a large ovarian germ cell tumor followed by 4 cycles of cisplatin and etoposide resulting in clinical complete remission. During followup, she developed a mass at the umbilicus and ascites. Initially, the cytology of the ascites was interpreted as tumor positive, suspicious of relapse of the disease, but tumor markers remained negative. However, during laparoscopy it turned out to be a mature teratoma, which can develop after chemotherapy, the so called growing teratoma syndrome. In retrospect, the ascites was false positive. This case shows that current diagnostic tools are not sufficient to distinguish between vital tumor and mature teratoma and can be misleading. Tumor biopsy and/or laparoscopic inspection are therefore indicated.

No MeSH data available.


Related in: MedlinePlus