Departments of Obstetrics and Gynecology, Tsuruoka Municipal Shonai Hospital, Tsuruoka-City, Japan.
Gynecol Obstet Invest. 2010;69(4):221-223. doi: 10.1159/000273205. Epub 2010 Jan 6.
Growing teratoma syndrome (GTS) is rare and is defined as an enlarging mature teratoma that arises during or after chemotherapy for a malignant germ cell tumor, with normalization of previously elevated serum tumor markers.
A 30-year-old nulliparous Japanese woman was diagnosed as having a stage IIIa immature teratoma. After fertility-sparing surgery, she received 4 cycles of chemotherapy consisting of cisplatin, etoposide and bleomycin. Thereafter, she successfully gave birth twice. Eight years after the initial surgery, a mass mimicking an adrenal tumor was resected laparoscopically. Surgical specimens revealed a mature teratoma, and she was diagnosed as having GTS postoperatively.
Clinicians should consider that GTS may present late, even after pregnancy. Therefore, long-term follow-up of patients treated for ovarian immature teratoma should be mandatory.
生长性畸胎瘤综合征(GTS)较为罕见,其定义为在恶性生殖细胞瘤的化疗过程中或之后出现的增大的成熟畸胎瘤,同时先前升高的血清肿瘤标志物恢复正常。
一位 30 岁的未育日本女性被诊断为 IIIa 期未成熟畸胎瘤。行保留生育功能的手术后,她接受了 4 个周期的化疗,方案为顺铂、依托泊苷和博来霉素。此后,她成功生育了 2 次。初始手术后 8 年,她接受了腹腔镜下的肾上腺肿瘤切除术。手术标本显示为成熟畸胎瘤,术后诊断为 GTS。
临床医生应考虑到 GTS 可能会延迟出现,甚至在妊娠后出现。因此,对于接受卵巢未成熟畸胎瘤治疗的患者,必须进行长期随访。