Growing teratoma syndrome after ovarian germ cell tumors.

OBJECTIVE

To analyze a series of occurrences of growing teratoma syndrome after ovarian germ cell tumors.

METHODS

We analyzed a database containing 103 patients affected by pure or mixed ovarian immature teratoma.

RESULTS

We report 12 patients fulfilling growing teratoma syndrome criteria (incidence 12%). The median interval between the diagnosis of ovarian immature teratoma and growing teratoma syndrome was 9 months (range 4-55). Growing teratoma syndrome was revealed by radiological examinations in nine cases (75%). In all cases but one, growing teratoma syndrome occurred in the site involved by the primary tumor. The peritoneum was the first site involved (10 cases, 83%). A complete surgical resection of the growing teratoma syndrome was done in eight cases. The median follow-up was 144 months. Four patients presented a late growing teratoma syndrome recurrence after treatment (second event), more than 5 years after the initial diagnosis, and 14 years later for one patient. All patients but one (lost to follow-up) were still alive at the end of the study.

CONCLUSION

The treatment of growing teratoma syndrome consists of the surgical resection of the tumor, as completely as possible. Because of the possibility of very late recurrence of growing teratoma syndrome, a prolonged follow-up of patients treated for ovarian immature teratoma is mandatory.