Growing teratoma syndrome in children and adolescents: Prevalence and surgical outcome.
germ cell tumor
growing teratoma syndrome
pediatric germ cell tumor
teratoma with malignant transformation
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
04 Jun 2024
04 Jun 2024
Historique:
revised:
15
05
2024
received:
07
12
2023
accepted:
19
05
2024
medline:
5
6
2024
pubmed:
5
6
2024
entrez:
5
6
2024
Statut:
aheadofprint
Résumé
Patients affected by metastatic germ cell tumors may occasionally experience enlargement of masses with concurrent normalization of tumor markers during or after chemotherapy. This phenomenon is described as growing teratoma syndrome (GTS). The aim of the pre sent study is to assess the prevalence of GTS in the pediatric population and its implications in terms of surgical outcome. The clinical notes of patients diagnosed with stage III and IV malignant germ cell tumors from January 2010 until December 2020 at our Institution were retrospectively reviewed. The prevalence of GTS, treatment strategies, survival, and outcome were analyzed. Thirty-three patients with high-stage malignant germ cell tumors were diagnosed in our institution in the analyzed period. Nine patients (28%) had radiologic evidence of enlargement of persistent masses with normal markers after chemotherapy; these patients were classified as GTS patients. All nine patients underwent resection of metastatic lymph nodes, and six had surgery on visceral metastases. In six patients, radical excision of all metastatic sites was achieved; five patients are alive and in complete remission, while one died because of peri-operative complications. Out of the three patients who could not achieve radical excision of the metastases, two died of progressive disease, and one is alive with progressive disease. Patients affected by GTS have a risk of progression of chemotherapy-resistant disease and death. Radical surgical excision is essential to achieve disease control and long-term survival.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e31126Subventions
Organisme : Italian Ministry of Health
Informations de copyright
© 2024 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.
Références
Logothetis CJ, Samuels ML, Trindade A, et al. The growing teratoma syndrome. Cancer. 1982;50:1629‐1635.
André F, Fizazi K, Culine S, et al. The growing teratoma syndrome: results of therapy and long‐term follow‐up of 33 patients. Eur J Cancer. 2000;36(11):1389‐1394.
Paffenholz P, Pfister D, Matveev V, Heidenreich A. Diagnosis and management of the growing teratoma syndrome: a single‐center experience and review of the literature. Urol Oncol. 2018;36(12):529.e23‐529.e30.
Green DB, La Rosa FG, Craig PG, Khani F, Lam ET. Metastatic mature teratoma and growing teratoma syndrome in patients with testicular non‐seminomatous germ cell tumors Korean. J Radiol. 2021;22(10):1650‐1657.
Li S, Liu Z, Dong C, et al. Growing teratoma syndrome secondary to ovarian giant immature teratoma in an adolescent girl: a case report and literature review. Medicine (Baltimore). 2016;95:e2647.
Terenziani M, De Pasquale MD, Bisogno G, et al. Malignant testicular germ cell tumors in children and adolescents: the AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) protocol. Urol Oncol. 2018;36:502.e7‐502.e13. doi:10.1016/j.urolonc.2018.07.001
Terenziani M, Bisogno G, Boldrini R, et al. Malignant ovarian germ cell tumors in pediatric patients: the AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica) study. Pediatr Blood Cancer. 2017;64:e26568.
Weil BR, Billmire DF. Management of germ cell tumors in pediatric patients. Surg Oncol Clin N Am. 2021;30(2):325‐338.
Shayegan B, Carver BS, Stasi J, Motzer RJ, Bosl GJ, Sheinfeld J. Clinical outcome following post‐chemotherapy retroperitoneal lymph node dissection in men with intermediate‐ and poor‐risk nonseminomatous germ cell tumour. BJU Int. 2007;99(5):993‐997.
Kollmannsberger C, Daneshmand S, So A, et al. Management of disseminated nonseminomatous germ cell tumors with risk‐based chemotherapy followed by response‐guided postchemotherapy surgery. J Clin Oncol. 2010;28(4):537‐542.
Rogers PC, Olson TA, Cullen JW, Billmire DF, Marina N, Rescorla F. Treatment of children and adolescents with stage II testicular and stages I and II ovarian malignant germ cell tumors: a Pediatric Intergroup Study–Pediatric Oncology Group 9048 and Children's Cancer Group 8891. J Clin Oncol. 2004;22(17):3563‐3569.
Persano G, Crocoli A, De Pasquale MD, et al. Burned‐out testicular tumors in adolescents: clinical aspects and outcome. Front Pediatr. 2021;9:688021.
Hiester A, Nettersheim D, Nini A, Lusch A, Albers P. Management, treatment, and molecular background of the growing teratoma syndrome. Urol Clin North Am. 2019;46(3):419‐427.
Hsieh MY, Chen HH, Lee CY, et al. A case series and literature review on 98 pediatric patients of germ cell tumor developing growing teratoma syndrome. Cancer Med. 2023;12(12):13256‐13269.
Djordjevic B, Euscher ED, Malpica A. Growing teratoma syndrome of the ovary: review of literature and first report of a carcinoid tumor arising in a growing teratoma of the ovary. Am J Surg Pathol. 2007;31(12):1913‐1918.
Gorbatiy V, Spiess PE, Pisters LL. The growing teratoma syndrome: current review of the literature. Indian J Urol. 2009;25(2):186‐189.
Shahnam A, Sayer R, Herbst U, et al. Growing teratoma syndrome in the setting of sarcoidosis: a case report and literature review. Curr Oncol. 2022;29(6):4148‐4154.
Bentivegna E, Azaïs H, Uzan C, et al. Surgical outcomes after debulking surgery for intraabdominal ovarian growing teratoma syndrome: analysis of 38 cases. Ann Surg Oncol. 2015;22(Suppl. 3):S964‐S970.
Spiess PE, Kassouf W, Brown GA, et al. Surgical management of growing teratoma syndrome: the M. D. Anderson cancer center experience. J Urol. 2007;177(4):1330‐1334.
O'Carrigan B, Grimison P. Current chemotherapeutic approaches for recurrent or refractory germ cell tumors. Urol Oncol. 2015;33(8):343‐354.
Vaughn DJ, Hwang WT, Lal P, Rosen MA, Gallagher M, O'Dwyer PJ. Phase 2 trial of the cyclin‐dependent kinase 4/6 inhibitor palbociclib in patients with retinoblastoma protein‐expressing germ cell tumors. Cancer. 2015;121:1463‐1468.
Narayan V, Hwang WT, Lal P, et al. Cyclin‐dependent kinase 4/6 inhibition for the treatment of unresectable mature teratoma: long‐term follow‐up of a phase II study. Clin Genitourin Cancer. 2016;14(6):504‐510.
Carver BS, Shayegan B, Serio A, Motzer RJ, Bosl GJ, Sheinfeld J. Long‐term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma. J Clin Oncol. 2007;25(9):1033‐1037.
Stella M, Gandini A, Meeus P, et al. Retroperitoneal vascular surgery for the treatment of giant growing teratoma syndrome. Urology. 2012;79(2):365‐370.
Giannatempo P, Pond GR, Sonpavde G, et al. Treatment and clinical outcomes of patients with teratoma with somatic‐type malignant transformation: an international collaboration. J Urol. 2016;196(1):95‐100.
Spiess PE, Pisters LL, Liu P, et al. Malignant transformation of testicular teratoma: a chemoresistant phenotype. Urol Oncol. 2008;26(6):595‐599.
Lee DJ, Djaladat H, Tadros NN, et al. Growing teratoma syndrome: clinical and radiographic characteristics. Int J Urol. 2014;21(9):905‐908.
Kesler KA, Patel JB, Kruter LE, et al. The “growing teratoma syndrome” in primary mediastinal nonseminomatous germ cell tumors: criteria based on current practice. J Thorac Cardiovasc Surg. 2012;144(2):438‐443.
Dusaud M, Malavaud B, Bayoud Y, et al. Post‐chemotherapy retroperitoneal teratoma in nonseminomatous germ cell tumors: do predictive factors exist? Results from a national multicenter study. J Surg Oncol. 2016;114(8):992‐996.
Cornejo KM, Frazier L, Lee RS, Kozakewich HP, Young RH. Yolk sac tumor of the testis in infants and children: a clinicopathologic analysis of 33 cases. Am J Surg Pathol. 2015;39(8):1121‐1131.
Foster RS, Hermans B, Bihrle R, Donohue JP. Clinical stage I pure yolk sac tumor of the testis in adults has different clinical behavior than juvenile yolk sac tumor. J Urol. 2000;164(6):1943‐1944.
Lee SD, Korean Society of Pediatric Urology. Epidemiological and clinical behavior of prepubertal testicular tumors in Korea. J Urol. 2004;172(2):674‐678.