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Case Reports in Surgery
Volume 2017, Article ID 3074240, 8 pages
https://doi.org/10.1155/2017/3074240
Case Report

Pediatric Ovarian Growing Teratoma Syndrome

1Department of Surgery, Children’s Mercy Hospital, Kansas City, MO, USA
2Department of Obstetrics and Gynecology, University of Missouri, Kansas City, Kansas City, MO, USA
3Department of Pathology, Children’s Mercy Hospital, Kansas City, MO, USA
4Department of Hematology, Oncology, and Bone Marrow Transplantation, Children’s Mercy Hospital, Kansas City, MO, USA

Correspondence should be addressed to Rebecca M. Rentea; ude.hmc@aetnerr

Received 6 December 2016; Revised 3 April 2017; Accepted 3 May 2017; Published 1 June 2017

Academic Editor: Menelaos Zafrakas

Copyright © 2017 Rebecca M. Rentea 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

Ovarian immature teratoma is a germ cell tumor that comprises less than 1% of ovarian cancers and is treated with surgical debulking and chemotherapy depending on stage. Growing teratoma syndrome (GTS) is the phenomenon of the growth of mature teratoma elements with normal tumor markers during or following chemotherapy for treatment of a malignant germ cell tumor. These tumors are associated with significant morbidity and mortality due to invasive and compressive growth as well as potential for malignant transformation. Current treatment modality is surgical resection. We discuss a 12-year-old female who presented following resection of a pure ovarian immature teratoma (grade 3, FIGO stage IIIC). Following chemotherapy and resection of a pelvic/liver recurrence demonstrating mature teratoma, she underwent molecular genetics based chemotherapeutic treatment. No standardized management protocol has been established for the treatment of GTS. The effect of chemotherapeutic agents for decreasing the volume of and prevention of expansion is unknown. We review in detail the history, diagnostic algorithm, and previous reported pediatric cases as well as treatment options for pediatric patients with GTS.