Growing teratoma syndrome

Growing teratoma syndrome is a rare entity that can occur in women who have been treated for ovarian immature teratoma or mixed germ cell tumors. While our case is certainly a dramatic example, this patient demonstrates a number of important risk factors and clinical characteristics of this disease. She was relatively old at time of diagnosis for ovarian germ cell tumor (33 years old), had intraoperative rupture of her tumor at her initial surgery, received adjuvant chemotherapy, and had normalization of her germ call tumor markers (beta hCG and AFP). Biopsy to rule out persistent or recurrent immature teratoma is important, as those patients often require further systemic therapy. Surgery is the cornerstone of treatment for growing teratoma syndrome, and the goal of surgery should be complete gross resection. In patients with a large burden of disease, a multi-disciplinary team may be necessary, and should be engaged if it maximizes the chance of complete gross resection.