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Introduction: Growing teratoma syndrome is defined as a chemotherapy-resistant tumor occurring after initial therapy for an immature ovarian teratoma or testicular seminoma; its histological findings are that of a mature teratoma. In past case reports, the lesions were almost always benign, and were treated surgically if the tumor exhibited enlargement and/or clinical symptoms were present. We report a case of growing teratoma syndrome, successfully treated with laparoscopic surgery.
Case presentation: The patient is a 30-year-old, nulligravida Japanese female. She had an acute abdomen with torsion of the right ovarian tumor pedicle; therefore, she underwent a laparotomy for a right salpingo-oophorectomy. The histologic diagnosis was an immature ovarian teratoma. She underwent three courses of bleomycin, etoposide, platinum (BEP) chemotherapy; complete remission was attained; however, 26 months after the resection, we discovered a tumor in the Pouch of Douglas but the AFP tumor marker was not elevated. Therefore, we suspected the tumor to be growing teratoma syndrome and resected it laparoscopically. The histology of the specimen was in accordance with preoperative diagnosis.
Conclusions: The literature does not contain any previous reports of a growing teratoma syndrome resected laparoscopically. In this case, the lesion was located deep in the pelvis; therefore, visualization by laparoscopy was very useful for attaining complete resection of the tumor. In addition, laparoscopic visualization was also beneficial for locating intraperitoneal micro-metastases.
