Diagnosis and management of growing teratoma syndrome after ovarian immature teratoma: A single center experience

Gynecol Oncol. 2020 Apr;157(1):94-100. doi: 10.1016/j.ygyno.2019.12.042. Epub 2020 Jan 15.


Objectives: To evaluate the diagnostic, surgical, and oncological outcomes of patients with growing teratoma syndrome (GTS).

Methods: Patients diagnosed with ovarian immature teratoma (IMT) between 1980 and 2018 at Peking Union Medical College Hospital (PUMCH) were evaluated for the development of GTS. Their clinical characteristics, surgical and pathological data, and oncological outcomes were collected.

Results: Between 1980 and 2018, 175 cases of IMT were referred to PUMCH. Thirty-five patients subsequently developed GTS with a crude rate of approximately 20%. The median interval between the initial diagnosis of IMT and the first occurrence of GTS was 18.5 months (range, 6-78 months). Residual disease (P < 0.001) and gliomatosis peritonei (GP) at initial surgery (P = 0.023) were independent risk factors for GTS development. Fertility-sparing surgery for GTS was performed in 27 patients and four patients achieved five singleton pregnancies. The median follow-up time was 73 months (range, 11-401 months). Eleven patients developed at least one recurrence. Residual disease after GTS surgery was associated with GTS recurrence (P = 0.001). By the end of follow-up, 27 patients were alive without disease and the other eight patients were alive with disease.

Conclusion: The presence of residual disease and GP at initial surgery are risk factors for GTS. Complete surgical resection is the cornerstone for treatment of GTS. The presence of residual disease after surgery for GTS is a risk factor for GTS recurrence. Fertility-sparing surgery should be performed because spontaneous pregnancy is possible. The overall prognosis of GTS is excellent.

Keywords: Adjuvant chemotherapy; Growing teratoma syndrome; Immature teratoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Fertility Preservation / methods
  • Humans
  • Neoplasm Staging
  • Neoplasm, Residual / pathology
  • Organ Sparing Treatments / methods
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Prognosis
  • Syndrome
  • Teratoma / diagnosis*
  • Teratoma / pathology
  • Teratoma / surgery*
  • Treatment Outcome
  • Young Adult

Supplementary concepts

  • Teratoma, Ovarian