Short-term and long-term outcomes after resection of thoracic growing teratoma syndrome

World J Urol. 2021 Jul;39(7):2579-2585. doi: 10.1007/s00345-020-03503-6. Epub 2020 Oct 31.

Abstract

Purpose: Thoracic growing teratoma syndrome (TGTS) is a rare disease in patients with germ cell tumors. Other than a few case reports and a limited number of case series, studies of this topic are not available.

Methods: We retrospectively analyzed the data from our patients who received surgery for TGTS between 1999 and 2016. Descriptive statistical analyses were performed to analyze the characteristics of the patients, tumors, and short-term outcomes. Furthermore, the long-term outcomes and survival curves were analyzed using the Kaplan-Meier method.

Results: Twenty-nine patients underwent surgery for TGTS. The median age was 32 years (range: 19-50 years). All patients received cisplatin-based chemotherapy. Many of the patients had multilocalized TGTS (n = 10). The median tumor size was 64.5 mm (range 10-210 mm). In all cases, R0 resection was achieved. The minor morbidity, major morbidity, and mortality rates were 3.4%, 6.9%, and 0%, respectively. Altogether, 28 patients were included in the long-term follow-up analysis, with a median follow-up time of 94 months (13-237 months). The 5-, 10-, and 15-year survival rates were 93%, 93%, and 84%, respectively.

Conclusions: TGTS may occur in multiple localizations and grow to a large tumor size. The resection of TGTS can be performed with low morbidity and mortality rates and is associated with good overall survival after complete resection. Important are an early detection and knowledge of the systemic treatment options by the oncologist and urologist, as well as a thoracic surgeon with a large experience in extended thoracic resections.

Keywords: Germ cell cancer; Growing teratoma; Lung metastases; Mediastinum; Testis cance.

MeSH terms

  • Adult
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Syndrome
  • Teratoma / pathology
  • Teratoma / surgery*
  • Thoracic Neoplasms / pathology
  • Thoracic Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome
  • Young Adult