日本産科婦人科内視鏡学会雑誌
Online ISSN : 1884-5746
Print ISSN : 1884-9938
症例報告
卵巣未熟奇形腫化学療法後腹腔鏡手術にて診断しえたGrowing teratoma syndromeの一例
安堂 有希子川島 直逸徳重 悠池田 亜貴子高松 史朗邨田 裕子吉水 美嶺野々垣 多加史吉岡 信也
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ジャーナル フリー

2015 年 31 巻 1 号 p. 232-237

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  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.
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