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Growing teratoma syndrome - ovarian germ cell tumor

Published:November 04, 2022DOI:https://doi.org/10.1016/j.amjms.2022.11.001
      A 28-year-old woman presented with pain and a mass in the abdomen for three months. The mass was was diagnosed as a mixed germ cell tumour (grade 3 immature teratoma and yolk sac tumour - FIGO stage IIIC). She underwent cytoreductive surgery, and three months later, she presented with a recurrent abdominal lump. Contrast-enhanced computed tomography (CECT) scan showed multiple deposits in the peritoneum, the largest measuring 23 × 17 × 12cm (Figure 1A) and elevated tumour markers (Alpha Feto Protein (AFP): 3080ng/ml). She received two lines of chemotherapy [Bleomycin, Etoposide and Cisplatin (BEP) and Vinblastine, Ifosfamide & Cisplatin (VeIP)]. Post-chemotherapy, the patient's symptoms worsened with increasing abdominal distension. CECT scan showed an increase in the size of the lesion (Figure 1B). However, the tumour markers were normal (AFP 8.34 ng/ml). She underwent a second-look laparotomy with complete cytoreduction. Pathology revealed only elements of mature teratoma with elements of all three germ cell layers (respiratory epithelium, mucinous glands, cartilage and mature glial tissue forming nodules in the peritoneum) (Figure 2A-D).
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