Complete Resection Best for Growing Teratomas

Long-term follow-up needed due to late recurrence after removal of ovarian germ cell tumors

WEDNESDAY, Sept. 6 (HealthDay News) -- About 12 percent of patients treated for ovarian germ cell tumors will develop growing teratoma syndrome, and such patients should have a complete surgical resection to avoid long-term complications including mechanical and malignant transformations, according to a paper in the Sept. 1 issue of Obstetrics & Gynecology.

In the single-institution retrospective study, Livia Zagame, M.D., of the Institut Gustave-Roussy in Villejuif, France, and colleagues analyzed 103 patients with pure or mixed ovarian immature teratoma, including 12 who developed growing teratoma syndrome within four to 55 months (median, nine months). Eleven cases had growing teratoma syndrome on the primary tumor site, 10 of which involved the peritoneum.

Over a 22-year study period, patients with ovarian immature teratoma were treated with initial surgery for complete or partial resection of the primary tumor, followed by platinum-based chemotherapy except in stage I tumors and grade 1 or 2 pure immature teratoma. After chemotherapy, and in cases with residual masses and normalization of serum tumoral markers, the tumor was resected as completely as possible.

With an incidence of at least 12 percent, growing teratoma is not that unusual, the authors write. "Treatment of growing teratoma syndrome consisted in a surgical resection as complete as possible to avoid complications (mechanical and malignant transformations). Most of the patients are then in complete remission, and no further treatment is indicated. The medical follow-up of the patients has to be prolonged because of the possibility for very late recurrences," they conclude.

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