A rare case of Growing Teratoma Syndrome ; third recurrence after 13 years with liver metastases ; a case report and review of the literature

Öz

Objective: The growing teratoma syndrome (GTS) defined as the growth of a benign tumor after removal of a germ cell tumor or after chemotherapy. There is no reached consensus managing GTS. Case: A patient had undergone surgery for an adnexial mass at the age of 14 and diagnosed with immature teratoma. 13 years after the last operation she underwent a fourth time tumor free fertility sparing operation with partial resection of the right liver lobe, partial resection of the peritoneum of diaphragm and cyst removal from right ovary. Pathology result was compatible with mature teratoma having no immature characteristics. To our knowledge, this is the first case reported in the literature that reoccured such a long time after the last GTS surgery such as 13 years and having benign features on histopathological examination. Conclusion: GTS has an unpredictable behavior and could reoccur even after a very long time and several surgeries.

Anahtar Kelimeler

• Immature Teratoma
• Growing Teratoma Syndrome
• Germ Cell Tumor
• Delbulking Surgery
• Fertility Sparing Surgery

Nadir bir Growing Teratom Sendromu olgusu; 13 yıl sonra karaciğer metastazı ile üçüncü nüksü; bir olgu sunumu ve literatürün gözden geçirilmesi

Öz

Amaç: Büyüyen teratom sendromu (BTS) germ hücreli tümor için gerçekleştirilen ameliyat ya da kemoterapi sonrasında benign karakterde tümöral büyüme olarak tanımlanmıştır. BTS tedavisi için bir uzlaşı bulunmamaktadır. Vaka: 14 yaşında kız hasta adneksiyel kitle nedeni ile opere olup immatür teratom tanısı almıştır. Bu operasyondan 13 yıl sonra gerçekleşen dordüncü operasyonda hastaya batında tümör bırakılmadan sağ karaciğer lobunun parsiyel rezeksiyonu, diafram peritonunun parsiyel rezeksiyonu ve sağ over kist eksizyonu fertilite koruyucu yaklaşımla gerçekleştirlmiştir. Patoloji sonucu immatür karakterde tümör içermeyen matür teratom olarak gelmiştir. İlk operasyondan 13 yıl sonra ve benign natürde nüks eden hasta, literatürde bu denli uzun süre sonra iyi huylu olarak nüks gerçekleşen ilk BTS hastası niteliğindedir. Sonuç: BTS prognozunu öngörmek oldukça zordur, uzun zaman ve tekrarlayan cerrahiler sonrasında dahi nüksler görülebilir.

Anahtar Kelimeler

• İmmatür Teratom
• Büyüyen Teratom Sendromu
• Germ Hücreli Tümör
• Sitoredüktif Cerrahi

Kaynakça

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