Archivos espanoles de urologia · 2000
[Growing teratoma syndrome].
Сравнительное исследованиеАннотация на английскомСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Ponce de León Roca J, Villavicencio Mavrich H
Аннотация
OBJECTIVE: To review our series of patients with the growing teratoma syndrome (GTS) and to compare our results with those reported in the literature.
METHODS: We reviewed the clinical records of our series of patients with GTS for age, location of the tumor mass before and after chemotherapy, clinical stage according to the Royal Marsden Hospital Classification, histological pattern of the primary tumor, number and type of surgical procedures performed and clinical course.
RESULTS: There were 17 patients with GTS, accounting for 4.9% of the patients with nonseminomatous germ cell testicular tumors treated in our hospital. The mean age at the time of diagnosis was 23 years. The site of the lesions was the same as that of the prechemotherapy metastasis in all cases. Histological analysis of the primary tumor showed mature teratoma in 11, ectodermal sinus tumor in 8, and both histological types in 4. By stage, 11 patients were stage II and 6 were stage IV. A total of 33 surgical procedures were performed: 25 retroperitoneal lymphadenectomy (7 with retrocrural involvement), 4 thoracotomy with segmental lung resection, 2 resection of supraclavicular adenopathy, 1 resection of liver metastasis, and 1 resection of inguinal adenopathy. The 25 retroperitoneal lymphadenectomy performed due to GTS account for 16.2% of the 154 retroperitoneal lymphadenectomies that were performed during the same time period. Follow-up showed recurrence in 10 patients (58.8%); 7 had mature teratoma and 3 had malignant tumor.
CONCLUSIONS: Mature teratoma lesions can appear in different sites, the most frequent being the retroperitoneum and lung. These lesions can appear before or during chemotherapy or after a disease-free interval. The treatment of choice is resection of the mass, if possible in a single session to prevent malignant degeneration or compression of the adjacent structures. We institute treatment early since an increase in size will make surgical treatment difficult, compromise organs and favor recurrence.
METHODS: We reviewed the clinical records of our series of patients with GTS for age, location of the tumor mass before and after chemotherapy, clinical stage according to the Royal Marsden Hospital Classification, histological pattern of the primary tumor, number and type of surgical procedures performed and clinical course.
RESULTS: There were 17 patients with GTS, accounting for 4.9% of the patients with nonseminomatous germ cell testicular tumors treated in our hospital. The mean age at the time of diagnosis was 23 years. The site of the lesions was the same as that of the prechemotherapy metastasis in all cases. Histological analysis of the primary tumor showed mature teratoma in 11, ectodermal sinus tumor in 8, and both histological types in 4. By stage, 11 patients were stage II and 6 were stage IV. A total of 33 surgical procedures were performed: 25 retroperitoneal lymphadenectomy (7 with retrocrural involvement), 4 thoracotomy with segmental lung resection, 2 resection of supraclavicular adenopathy, 1 resection of liver metastasis, and 1 resection of inguinal adenopathy. The 25 retroperitoneal lymphadenectomy performed due to GTS account for 16.2% of the 154 retroperitoneal lymphadenectomies that were performed during the same time period. Follow-up showed recurrence in 10 patients (58.8%); 7 had mature teratoma and 3 had malignant tumor.
CONCLUSIONS: Mature teratoma lesions can appear in different sites, the most frequent being the retroperitoneum and lung. These lesions can appear before or during chemotherapy or after a disease-free interval. The treatment of choice is resection of the mass, if possible in a single session to prevent malignant degeneration or compression of the adjacent structures. We institute treatment early since an increase in size will make surgical treatment difficult, compromise organs and favor recurrence.