Medical Oncology Department, Blacktown and Westmead Hospitals, Sydney, NSW 2145, Australia.
Gynecological Oncology Department, Chris O'Brien Lifehouse, Sydney, NSW 2050, Australia.
Curr Oncol. 2022 Jun 7;29(6):4148-4154. doi: 10.3390/curroncol29060331.
Growing teratoma syndrome (GTS) is rare and can mimic disease recurrence in patients with a history of immature teratoma. Benign hypermetabolic lymphadenopathy found on staging and surveillance computed tomography (CT) and positron emission tomography (PET) may lead to the presumption of metastatic malignancy. We report a case of a 38 year old with mixed mature and immature teratomas who developed new peritoneal masses after adjuvant chemotherapy despite a normalization of tumor markers. In addition to low FDG uptake observed in these peritoneal masses, a PET scan showed hypermetabolic lymphadenopathy and pulmonary and spleen lesions suggesting widespread metastases. Subsequent surgical resection confirmed a mixed pathology with GTS and sarcoidosis. We reviewed the current literature evidence of GTS and sarcoidosis as a benign cause of lymphadenopathy in cancer patients. We emphasize the importance of a tissue diagnosis before instituting therapy for presumed cancer recurrence to avoid potentially fatal diagnostic traps and management errors. A multiple disciplinary team approach is imperative in managing patients with suspected recurrent immature teratomas.
种植性畸胎瘤综合征（GTS）较为罕见，在有未成熟畸胎瘤病史的患者中可能会模拟疾病复发。分期和监测用计算机断层扫描（CT）和正电子发射断层扫描（PET）发现的良性高代谢性淋巴结病可能会导致转移性恶性肿瘤的推测。我们报告了 1 例 38 岁混合性成熟和未成熟畸胎瘤患者的病例，尽管肿瘤标志物正常，但在辅助化疗后出现新的腹膜肿块。除了这些腹膜肿块中观察到的 FDG 摄取减少外，PET 扫描还显示高代谢性淋巴结病以及肺部和脾脏病变，提示广泛转移。随后的手术切除证实存在 GTS 和结节病的混合病理学。我们回顾了目前关于 GTS 和结节病作为癌症患者淋巴结病良性原因的文献证据。我们强调，在对疑似癌症复发进行治疗之前，进行组织诊断的重要性，以避免潜在的致命诊断陷阱和管理错误。对于疑似复发性未成熟畸胎瘤的患者，多学科团队的方法至关重要。
