Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review

Curr Oncol. 2022 Sep 4;29(9):6364-6372. doi: 10.3390/curroncol29090501.

Abstract

Coexistent growing teratoma syndrome (GTS) and gliomatosis peritonei (GP) arising during chemotherapy of ovarian immature teratoma (IMT) is extremely rare and can be misdiagnosed as recurrent or progressive disease. We present a 33-year-old woman diagnosed with GTS with synchronous GP during chemotherapy of IMT. She underwent ovarian cystectomy due to ovarian immature teratoma and chemotherapy were administered. The α-fetoprotein (AFP) concentration decreased from 28.7 ng/mL to normal after the second cycle. Four days after the third cycle of chemotherapy, ultrasound and CT revealed an 8-cm mass with negative tumor markers in the pouch of Douglas. An exploratory laparotomy was conducted, and a smooth round cystic-solid 8-cm mass was noted in the pouch of Douglas. Extensive peritoneal seeding glial nodules were also observed on the surface of the uterus, peritoneum, and omentum. The patient underwent a partial omentectomy, intact resection of the tumor, and resection of most of the glial nodules. Postoperative pathology demonstrated a pure mature cystic teratoma component in the mass, as well as diffuse GP involving the uterine serosa, peritoneum, and omentum; this diagnosis of GTS with synchorous GP should be considered in IMT patients with mass newly identified during chemotherapy while tumor markers are normal after treatment.

Keywords: gliomatosis peritonei; growing teratoma syndrome; immature teratoma; ovarian tumors; treatment.

Publication types

  • Case Reports
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers, Tumor
  • Female
  • Humans
  • Ovarian Neoplasms
  • Peritoneal Neoplasms* / drug therapy
  • Peritoneal Neoplasms* / surgery
  • Syndrome
  • Teratoma* / diagnosis
  • Teratoma* / drug therapy
  • Teratoma* / surgery
  • alpha-Fetoproteins

Substances

  • Biomarkers, Tumor
  • alpha-Fetoproteins

Supplementary concepts

  • Teratoma, Ovarian

Grants and funding

This study was funded by the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) (No. CIFMS-2017-I2M-1-002) and National High Technology Research and Development Program of China (No. 2012AA02A507).