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abstract
Objectives: Growing teratoma syndrome (GTS) after adjuvant
chemotherapy for ovarian germ cell tumors is uncommon, with
approximately 60 cases reported in the English literature. The objective
of this study was to report clinical parameters including outcomes of
patients with a diagnosis of GTS after adjuvant chemotherapy for ovarian
immature teratoma (IT).
Methods and Materials: Patients with a condition
diagnosed as ovarian IT between 1999 and 2014 at 2 tertiary-care
academic centers were evaluated for the development of GTS. Patients'
demographics, surgical and pathology data, adjuvant treatment, tumor
markers, and survival data were collected retrospectively.
Results: Twenty-six patients were treated for ovarian IT
with a median follow-up of 69 months (9-166 months). Of the 15 patients
who received adjuvant chemotherapy, 6 developed GTS (crude incidence,
40%; 2- and 5-year cumulative actuarial rates, 40% and 50%,
respectively). The median age at diagnosis of ovarian IT was 24 years
(17-38 years). The median interval from diagnosis of IT to development
of GTS was 20 months (8-42 months). These 6 patients underwent 1 to 4
additional surgeries for management of GTS and were alive without
evidence of malignancy after a median follow-up of 90 months (range,
24-166 months).
Conclusions: The development of GTS after adjuvant
chemotherapy for ovarian IT seems to be more common than previously
reported in the literature. Clinicians need to be cognizant that the
occurrence of rapidly growing masses during or after chemotherapy for
ovarian IT raises the possibility of GTS. This highlights the importance
of prolonged follow-up with tumor markers and imaging studies in
patients with ovarian IT.
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