Abstract
Growing teratoma syndrome (GTS) is characterized by the enlargement of peritoneal implants containing only mature components during or after chemotherapy for malignant germ cell tumors.
We managed a case of GTS in a 19-year-old woman who was diagnosed and treated using laparoscopic surgery. At the initial laparotomy, we performed a right salpingo-oophorectomy, partial omentectomy, and biopsy of peritoneal disseminations, and the patient was diagnosed with grade3 stage2C immature teratoma, which was treated with four courses of BEP (Bleomycin, Etoposide, Cisplatin) chemotherapy.
Postoperative magnetic resonance imaging (MRI) and Positron emission tomography (PET-CT) revieled new lesions on the bilateral uterosacral ligament, whereas no tumor marker levels were elevated. We laparoscopically resected the uterosacral lesions, GTS. No recurrent disease was observed after the second operation.
It is difficult to distinguish recurrence or metastasis of malignant germ cell tumors from GTS, therefore surgery should be considered. Recurrent GTS occurs in some cases following laparoscopic surgery, thus a minimally invasive method presents a good option for possible frequent surgeries. Moreover, laparoscopy is suitable to visualize details even when the lesion is deep within the pelvis.
In conclusion, laparoscopic surgery should be considered as an alternative strategy in some GTS cases.
