Challenges in the diagnosis of growing teratoma syndrome: two case reports

Abstract

Growing teratoma syndrome (GTS) is reported to have an incidence of 1.9–7.6% among all germ cell tumours (GCT) and is often mistaken for tumor progression. There are no absolute signs or symptoms of GTS but it can be suspected based on the following criteria: the normalization of tumour markers, the enlargement of the mass and the presence in the tumour of mature teratoma cells alone. A delayed tumor resection in GTS can result in higher surgical risks and/or the infeasibility of complete resection. In 72–83% of cases, incomplete resection leads to relapses in the form of mature teratoma growth. A repeat biopsy is recommended in all patients with suspected GTS so that to avoid chemotherapy that would be ineffective in this disease. The article reports two clinical cases of GTS illustrating challenges inherent in the diagnosis of this syndrome. In each case, the parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.