A case of growing teratoma syndrome of the lung secondary to non-seminomatous germ cell tumor of the testis

Abstract

We sometimes see germ cell tumors which grow larger with the normal range of serum AFP after chemotherapy. And if only mature teratoma components are seen in the specimen of the resected tumor, they are called growing teratoma syndrome. The patient was a 25-year-old man. He had undergone resection of a testicular tumor for non-seminomatous germ cell tumor of the right testis. After the operation, left lung metastasis and peritoneal dissemination were found and BEP therapy (BLM+VP-16+CDDP) and TIP therapy (PTX+IFM+CDDP) were performed.
The serum AFP level was normalized, but the lung tumor became larger. Positron emission tomography with F-fluorodeoxyglucose showed little accumulation, which suggested growing teratoma syndrome. He consulted us for operation. Chest CT scan showed a tumor 103×82mm in diameter with smooth surface at a left lung hilar region and it looked larger than that after chemotherapy. CT scan also showed peritoneal dissemination 26×17mm in diameter. Extraction of the left lung and resection of the retroperitoneal tumor were performed. No recurrence has been observed for 24 months after the operation. We should remember the possibility of growing teratoma syndrome in following up a patient with non-seminomatous germ cell tumor, and when it is suspected, surgical treatment should be considered.