Management, Treatment, and Molecular Background of the Growing Teratoma Syndrome

Urol Clin North Am. 2019 Aug;46(3):419-427. doi: 10.1016/j.ucl.2019.04.008. Epub 2019 May 29.


Growing teratoma syndrome (GTS) is a rare clinical phenomenon in patients with nonseminomatous germ cell cancer defined by growing metastatic mass during ongoing or directly after completed chemotherapy with timely decreasing tumor markers and postpubertal teratoma exclusively after resection. GTS was first described in 1982, and few reports have been published. The limited number of studies and the resulting lack of exact knowledge about development, differentiation, and treatment of GTS leaves several clinical problems regarding treatment and follow-up unsolved. This review provides an overview of clinical diagnosis and disease management and an approach to explain the molecular development of GTS.

Keywords: Growing teratoma syndrome; Molecular development of growing teratoma syndrome; Nonseminomatous germ cell cancer; Residual tumor resection; Retroperitoneal tumor.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Disease Progression
  • Humans
  • Lymphatic Metastasis
  • Male
  • Neoplasm Staging
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / therapy
  • Prognosis
  • Retroperitoneal Neoplasms / secondary
  • Retroperitoneal Neoplasms / therapy
  • Syndrome
  • Teratoma / pathology*
  • Teratoma / therapy*
  • Testicular Neoplasms / pathology*
  • Testicular Neoplasms / therapy*


  • Biomarkers, Tumor