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Case Reports in Obstetrics and Gynecology
Volume 2013 (2013), Article ID 984524, 4 pages
http://dx.doi.org/10.1155/2013/984524
Case Report

Clinical and Radiologic Signs of Relapsed Ovarian Germ Cell Tumor: Tissue Is the Issue

1Department of Medical Oncology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
2Department of Reproductive Medicine and Gynaecology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
3Department of Pathology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands

Received 14 August 2013; Accepted 16 September 2013

Academic Editors: K. Dafopoulos, J. Herod, and S. P. Renner

Copyright © 2013 M. Y. V. Homs et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malignant ovarian germ cell tumor is a rare disease, but with current treatment strategies including surgery and platinum based chemotherapy survival is excellent. After treatment, intensive followup is indicated to encounter tumor relapse at an early stage. This case describes a 22-year-old female with a history of common variable immune deficiency (CVID) who underwent a resection of a large ovarian germ cell tumor followed by 4 cycles of cisplatin and etoposide resulting in clinical complete remission. During followup, she developed a mass at the umbilicus and ascites. Initially, the cytology of the ascites was interpreted as tumor positive, suspicious of relapse of the disease, but tumor markers remained negative. However, during laparoscopy it turned out to be a mature teratoma, which can develop after chemotherapy, the so called growing teratoma syndrome. In retrospect, the ascites was false positive. This case shows that current diagnostic tools are not sufficient to distinguish between vital tumor and mature teratoma and can be misleading. Tumor biopsy and/or laparoscopic inspection are therefore indicated.