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Growing teratoma syndrome.

Scavuzzo A, Santana Ríos ZA, Noverón NR, Jimenez Ríos MA - Case Rep Urol (2014)

Bottom Line: Awareness of this syndrome is necessary in order to prevent unnecessary chemotherapy and allow optimal management.Prognosis is excellent after the excision of these tumors, but surgery has to be as complete as possible.Our experience in the surgical management of these lesions is reviewed in the following work.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Instituto Nacional de Cancerología (INCan), Avenida San Fernando 22, Colonia Seccion XVI, Tlalpan, 14080 Mexico City, DF, Mexico.

ABSTRACT
Growing teratoma syndrome (GTS) is a rare clinical entity, which presents with enlarging teratomas masses of the retroperitoneum or other locations, occurring during or after systemic chemotherapy for the treatment of nonseminomatous germ cell of the testis (NSGCT), with normalised tumour markers. Awareness of this syndrome is necessary in order to prevent unnecessary chemotherapy and allow optimal management. Prognosis is excellent after the excision of these tumors, but surgery has to be as complete as possible. Surgical resection of bulky GTS lesions is technically challenging; intraoperative complications may occur; that is, why the treatment must not be delayed. Our experience in the surgical management of these lesions is reviewed in the following work.

No MeSH data available.


Related in: MedlinePlus

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Mentions: A 28-year-old man with a history of left orchiectomy for mixed NSGCT (80% teratoma and 20% embryonal carcinoma) without adjuvant therapy, six months later, started having gastrointestinal symptoms, weight loss, and lower back pain as well as abdominal mass. Workup revealed that α-fetoprotein, lactate dehydrogenase, and beta subunit of human chorionic gonadotropin levels were 2372 ng/mL, 216 IU/L, and 395 mIU/mL. The chest radiography shows metastatic lesions. Abdominal CT evidenced giant retroperitoneal tumor from the renal vessels to the left iliac vessels. The clinical stage was IIIA for cervical lymph nodes. He received three cycles of bleomycin, etoposide, and platinum chemotherapy until normalization of serum tumor markers. CT scan showed an increase in tumor size (30 cm) after five months from chemotherapy (Figure 3) and chest metastasis disappearance. Tumor was resected through transverse incision. Iliac vessels were resected in block and continuity was restored by Dacron graft without complications (Figure 4). Closed drainage system was left in the retroperitoneal space at the end of the procedure. Estimated blood loss was greater than 2,500 mL. Operative time was 6 hours. The patient required a transfusion of 2 units of packed red blood cells during surgery. He was admitted to the intensive care unit after surgery and was dismissed from the intensive care unit on postoperative day 1. A fluid diet was started on the third postoperative day and solid diet on the fifth. He was discharged home postoperatively after six days in good general condition. Abdominal drains were removed when daily output was below 100 mL. Histologic find was teratoma mature. After follow-up of 8 months, he had no recurrence.


Growing teratoma syndrome.

Scavuzzo A, Santana Ríos ZA, Noverón NR, Jimenez Ríos MA - Case Rep Urol (2014)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150507&req=5

Mentions: A 28-year-old man with a history of left orchiectomy for mixed NSGCT (80% teratoma and 20% embryonal carcinoma) without adjuvant therapy, six months later, started having gastrointestinal symptoms, weight loss, and lower back pain as well as abdominal mass. Workup revealed that α-fetoprotein, lactate dehydrogenase, and beta subunit of human chorionic gonadotropin levels were 2372 ng/mL, 216 IU/L, and 395 mIU/mL. The chest radiography shows metastatic lesions. Abdominal CT evidenced giant retroperitoneal tumor from the renal vessels to the left iliac vessels. The clinical stage was IIIA for cervical lymph nodes. He received three cycles of bleomycin, etoposide, and platinum chemotherapy until normalization of serum tumor markers. CT scan showed an increase in tumor size (30 cm) after five months from chemotherapy (Figure 3) and chest metastasis disappearance. Tumor was resected through transverse incision. Iliac vessels were resected in block and continuity was restored by Dacron graft without complications (Figure 4). Closed drainage system was left in the retroperitoneal space at the end of the procedure. Estimated blood loss was greater than 2,500 mL. Operative time was 6 hours. The patient required a transfusion of 2 units of packed red blood cells during surgery. He was admitted to the intensive care unit after surgery and was dismissed from the intensive care unit on postoperative day 1. A fluid diet was started on the third postoperative day and solid diet on the fifth. He was discharged home postoperatively after six days in good general condition. Abdominal drains were removed when daily output was below 100 mL. Histologic find was teratoma mature. After follow-up of 8 months, he had no recurrence.

Bottom Line: Awareness of this syndrome is necessary in order to prevent unnecessary chemotherapy and allow optimal management.Prognosis is excellent after the excision of these tumors, but surgery has to be as complete as possible.Our experience in the surgical management of these lesions is reviewed in the following work.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Instituto Nacional de Cancerología (INCan), Avenida San Fernando 22, Colonia Seccion XVI, Tlalpan, 14080 Mexico City, DF, Mexico.

ABSTRACT
Growing teratoma syndrome (GTS) is a rare clinical entity, which presents with enlarging teratomas masses of the retroperitoneum or other locations, occurring during or after systemic chemotherapy for the treatment of nonseminomatous germ cell of the testis (NSGCT), with normalised tumour markers. Awareness of this syndrome is necessary in order to prevent unnecessary chemotherapy and allow optimal management. Prognosis is excellent after the excision of these tumors, but surgery has to be as complete as possible. Surgical resection of bulky GTS lesions is technically challenging; intraoperative complications may occur; that is, why the treatment must not be delayed. Our experience in the surgical management of these lesions is reviewed in the following work.

No MeSH data available.


Related in: MedlinePlus