Rentea Rebecca M, Varghese Aaron, Ahmed Atif, Kats Alexander, Manalang Michelle, Dowlut-McElroy Tazim, Hendrickson Richard J
Department of Surgery, Children's Mercy Hospital, Kansas City, MO, USA.
Department of Obstetrics and Gynecology, University of Missouri, Kansas City, Kansas City, MO, USA.
Case Rep Surg. 2017;2017:3074240. doi: 10.1155/2017/3074240. Epub 2017 Jun 1.
Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation. Current treatment modality is surgical resection. We discuss a 12-year-old female who presented following resection of a pure ovarian immature teratoma (grade 3, FIGO stage IIIC). Following chemotherapy and resection of a pelvic/liver recurrence demonstrating mature teratoma, she underwent molecular genetics based chemotherapeutic treatment. No standardized management protocol has been established for the treatment of GTS. The effect of chemotherapeutic agents for decreasing the volume of and prevention of expansion is unknown. We review in detail the history, diagnostic algorithm, and previous reported pediatric cases as well as treatment options for pediatric patients with GTS.
卵巢未成熟畸胎瘤是一种生殖细胞肿瘤，占卵巢癌的比例不到1%，根据分期采用手术减瘤和化疗进行治疗。生长性畸胎瘤综合征（GTS）是指在治疗恶性生殖细胞肿瘤的化疗期间或之后，成熟畸胎瘤成分在肿瘤标志物正常的情况下生长的现象。这些肿瘤由于侵袭性和压迫性生长以及恶性转化的可能性，会导致显著的发病率和死亡率。目前的治疗方式是手术切除。我们讨论一名12岁女性，她在切除纯卵巢未成熟畸胎瘤（3级，国际妇产科联盟（FIGO）IIIC期）后前来就诊。在化疗以及切除显示为成熟畸胎瘤的盆腔/肝脏复发病灶后，她接受了基于分子遗传学的化疗。目前尚未建立针对GTS治疗的标准化管理方案。化疗药物对于减小肿瘤体积和预防肿瘤扩大的效果尚不清楚。我们详细回顾了病史、诊断算法、既往报道的儿科病例以及GTS儿科患者的治疗选择。
