Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2020; 19: 126-132
Сложности диагностики синдрома растущей тератомы на примере двух клинических наблюдений
https://doi.org/10.24287/1726-1708-2020-19-4-126-132Аннотация
Синдром растущей тератомы (СРТ) встречается с частотой 1,9–7,6% среди всех герминогенноклеточных опухолей (ГКО) и зачастую ошибочно трактуется как прогрессия заболевания. Абсолютных признаков течения СРТ не существует, однако основными критериями являются нормализация уровня опухолевых маркеров, увеличение объема образования, а также присутствие исключительно клеток зрелой тератомы в опухоли. Несвоевременное удаление образования при СРТ приводит к повышению хирургических рисков и/или к невозможности полного удаления. При неполной резекции в 72–83% случаев возникают рецидивы, представленные ростом зрелой тератомы. Проведение повторной биопсии рекомендовано всем пациентам в случае подозрения на СРТ, это помогает избежать неэффективного химиотерапевтического лечения. В данной статье приведены 2 клинических случая с течением СРТ, которые демонстрируют сложность диагностики данного заболевания. Родители дали согласие на использование информации, в том числе фотографий детей, в научных исследованиях и публикациях.
Список литературы
1. Göbel U., Schneider D.T., Calaminus G., Haas R.J., Schmidt P., Harms D. Germcell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups. Ann Oncol 2000; 11 (3): 263–71.
2. Ries L.A., Smith M.A., Gurney J.G., Linet M., Tamra T., Young J.L., et al. Cancer incidence and survival among children and adolescents: United States SEER Program 1975–1995. Bethesda, Md: National Cancer Institute, SEER Program, 1999. NIH Pub. No. 99–4649.
3. Logothetis C.J., Samuels M.L., Trindade A., Johnson D.E. The growing teratoma syndrome. Cancer 1982; 50 (8): 1629–35.
4. Gorbatiy V. Philippe E., Pisters L. The growing teratoma syndrome: Current review of the literature. Indian J Urol 2009; 25 (2): 186–9. DOI: 10.4103/0970-1591.52910
5. Djordjevic B., Euscher E.D., Malpica A. Growing teratoma syndrome of the ovary: review of literature and first report of a carcinoid tumor arising in a growing teratoma of the ovary. Am J Surg Pathol 2007; 31 (12): 1913–8. DOI: 10.1097/PAS.0b013e318073cf44
6. O'Callaghan A.M., Katapodis O., Ellison D.W., Theaker J.M. The growing teratoma syndrome in a nongerminomatous germ cell tumor of the pineal gland: a case report and review. Cancer. 1997; 80 (5): 942–7. DOI: 10.1002/(sici)1097-0142(19970901)80:5<942::aid-cncr16>3.0.co;2-w
7. Bentivegna E., Gonthier C., Uzan C., Genestie C., Duvillard P., Morice P., Gouy S. Gliomatosis peritonei: a particular entity with specific outcomes within the growing teratoma syndrome. Int J Gynecol Cancer. 2015; 25 (2): 244–9. DOI: 10.1097/IGC.0000000000000345
8. André F., Fizazi K., Culine S., Droz J., Taupin P., Lhommé C., et al. The growing teratoma syndrome: results of therapy and long-term follow-up of 33 patients. Eur J Cancer 2000; 36 (11): 1389–94. DOI: 10.1016/s0959-8049(00)00137-4
9. Spiess P.E., Kassouf W., Brown G.A., Kamat A.M., Liu P., Gomez J.A., et al. Surgical management of growing teratoma syndrome: the M. D. Anderson cancer center experience. J Urol. 2007; 177 (4): 1330–4; discussion 1334. DOI: 10.1016/j.juro.2006.11.086
10. [Электронный ресурс]. URL: http://www.eortc.be/services/forms/1407/1407%20TigerOutline%2020140919.pdf (Дата обращения 13.11.2020).
11. Nimkin K., Gupta P., McCauley R., Gilchrist B.F., Lessin M.S. The growing teratoma syndrome. Pediatr Radiol 2004; 34 (3): 259–62. DOI: 10.1007/s00247-003-1045-z
12. Cho A., Kim S.W., Choi J., Kang W., Lee J.D., Yun M. The additional value of attenuation correction CT acquired during 18F-FDG PET/CT in differentiating mature from immature teratomas. Clin Nucl Med 2014; 39 (3): e193–6. DOI: 10.1097/RLU.0b013e3182a20d5c
13. Hariprasad R., Kumar L., Janga D., Kumar S., Vijayaraghavan M. Growing teratoma syndrome of ovary. Int J Clin Oncol 2008; 13 (1): 83–7. DOI: 10.1007/s10147-007-0693-7
14. Miyasaka N., Kubota T. Unusually intense (1)F-fluorodeoxyglucose (FDG) uptake by a mature ovarian teratoma: a pitfall of FDG positron emission tomography. J Obstet Gynaecol Res 2011; 37 (6): 623–8. DOI: 10.1111/j.1447-0756.2010.01393.x
15. Yokoyama T., Takehara K., Yasuko Yamamoto Y. The usefulness of 18F-FDG-PET/CT in discriminating benign from malignant ovarian teratomas. Int J Clin Oncol 2015; 20 (5): 960–6. DOI: 10.1007/s10147-015-0800-0
16. Inaoka T., Takahashi K., Yamada T., Miyokawa N., Tokusashi Y., Yoshida M., et al. The growing teratoma syndrome secondary to immature teratoma of the ovary. Eur Radiol 2003; 13 (9): 2115–8.
17. Rustin G.J., Kaye S.B., Williams C.J., Newlands E.S., Bagshawe K.D., Toy J.L. Response of differentiated but not anaplastic teratoma to interferon. Br J Cancer 1984; 50 (5): 611–6.
18. Mego M., Recková M., Sycova-Mila Z., Obertova J., Brozmanova K., Salek T., et al. Bevacizumab in a growing teratoma syndrome. Case report. Ann Oncol 2007; 18 (5): 962–3.
19. Vaughn D.J., Flaherty K., Lal P., Gallagher M., O'Dwyer P., Wilner K., et al. Treatment of growing teratoma syndrome. N Engl J Med 2009; 360 (4): 423–4.
Pediatric Hematology/Oncology and Immunopathology. 2020; 19: 126-132
Challenges in the diagnosis of growing teratoma syndrome: two case reports
https://doi.org/10.24287/1726-1708-2020-19-4-126-132Abstract
Growing teratoma syndrome (GTS) is reported to have an incidence of 1.9–7.6% among all germ cell tumours (GCT) and is often mistaken for tumor progression. There are no absolute signs or symptoms of GTS but it can be suspected based on the following criteria: the normalization of tumour markers, the enlargement of the mass and the presence in the tumour of mature teratoma cells alone. A delayed tumor resection in GTS can result in higher surgical risks and/or the infeasibility of complete resection. In 72–83% of cases, incomplete resection leads to relapses in the form of mature teratoma growth. A repeat biopsy is recommended in all patients with suspected GTS so that to avoid chemotherapy that would be ineffective in this disease. The article reports two clinical cases of GTS illustrating challenges inherent in the diagnosis of this syndrome. In each case, the parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.
References
1. Göbel U., Schneider D.T., Calaminus G., Haas R.J., Schmidt P., Harms D. Germcell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups. Ann Oncol 2000; 11 (3): 263–71.
2. Ries L.A., Smith M.A., Gurney J.G., Linet M., Tamra T., Young J.L., et al. Cancer incidence and survival among children and adolescents: United States SEER Program 1975–1995. Bethesda, Md: National Cancer Institute, SEER Program, 1999. NIH Pub. No. 99–4649.
3. Logothetis C.J., Samuels M.L., Trindade A., Johnson D.E. The growing teratoma syndrome. Cancer 1982; 50 (8): 1629–35.
4. Gorbatiy V. Philippe E., Pisters L. The growing teratoma syndrome: Current review of the literature. Indian J Urol 2009; 25 (2): 186–9. DOI: 10.4103/0970-1591.52910
5. Djordjevic B., Euscher E.D., Malpica A. Growing teratoma syndrome of the ovary: review of literature and first report of a carcinoid tumor arising in a growing teratoma of the ovary. Am J Surg Pathol 2007; 31 (12): 1913–8. DOI: 10.1097/PAS.0b013e318073cf44
6. O'Callaghan A.M., Katapodis O., Ellison D.W., Theaker J.M. The growing teratoma syndrome in a nongerminomatous germ cell tumor of the pineal gland: a case report and review. Cancer. 1997; 80 (5): 942–7. DOI: 10.1002/(sici)1097-0142(19970901)80:5<942::aid-cncr16>3.0.co;2-w
7. Bentivegna E., Gonthier C., Uzan C., Genestie C., Duvillard P., Morice P., Gouy S. Gliomatosis peritonei: a particular entity with specific outcomes within the growing teratoma syndrome. Int J Gynecol Cancer. 2015; 25 (2): 244–9. DOI: 10.1097/IGC.0000000000000345
8. André F., Fizazi K., Culine S., Droz J., Taupin P., Lhommé C., et al. The growing teratoma syndrome: results of therapy and long-term follow-up of 33 patients. Eur J Cancer 2000; 36 (11): 1389–94. DOI: 10.1016/s0959-8049(00)00137-4
9. Spiess P.E., Kassouf W., Brown G.A., Kamat A.M., Liu P., Gomez J.A., et al. Surgical management of growing teratoma syndrome: the M. D. Anderson cancer center experience. J Urol. 2007; 177 (4): 1330–4; discussion 1334. DOI: 10.1016/j.juro.2006.11.086
10. [Elektronnyi resurs]. URL: http://www.eortc.be/services/forms/1407/1407%20TigerOutline%2020140919.pdf (Data obrashcheniya 13.11.2020).
11. Nimkin K., Gupta P., McCauley R., Gilchrist B.F., Lessin M.S. The growing teratoma syndrome. Pediatr Radiol 2004; 34 (3): 259–62. DOI: 10.1007/s00247-003-1045-z
12. Cho A., Kim S.W., Choi J., Kang W., Lee J.D., Yun M. The additional value of attenuation correction CT acquired during 18F-FDG PET/CT in differentiating mature from immature teratomas. Clin Nucl Med 2014; 39 (3): e193–6. DOI: 10.1097/RLU.0b013e3182a20d5c
13. Hariprasad R., Kumar L., Janga D., Kumar S., Vijayaraghavan M. Growing teratoma syndrome of ovary. Int J Clin Oncol 2008; 13 (1): 83–7. DOI: 10.1007/s10147-007-0693-7
14. Miyasaka N., Kubota T. Unusually intense (1)F-fluorodeoxyglucose (FDG) uptake by a mature ovarian teratoma: a pitfall of FDG positron emission tomography. J Obstet Gynaecol Res 2011; 37 (6): 623–8. DOI: 10.1111/j.1447-0756.2010.01393.x
15. Yokoyama T., Takehara K., Yasuko Yamamoto Y. The usefulness of 18F-FDG-PET/CT in discriminating benign from malignant ovarian teratomas. Int J Clin Oncol 2015; 20 (5): 960–6. DOI: 10.1007/s10147-015-0800-0
16. Inaoka T., Takahashi K., Yamada T., Miyokawa N., Tokusashi Y., Yoshida M., et al. The growing teratoma syndrome secondary to immature teratoma of the ovary. Eur Radiol 2003; 13 (9): 2115–8.
17. Rustin G.J., Kaye S.B., Williams C.J., Newlands E.S., Bagshawe K.D., Toy J.L. Response of differentiated but not anaplastic teratoma to interferon. Br J Cancer 1984; 50 (5): 611–6.
18. Mego M., Recková M., Sycova-Mila Z., Obertova J., Brozmanova K., Salek T., et al. Bevacizumab in a growing teratoma syndrome. Case report. Ann Oncol 2007; 18 (5): 962–3.
19. Vaughn D.J., Flaherty K., Lal P., Gallagher M., O'Dwyer P., Wilner K., et al. Treatment of growing teratoma syndrome. N Engl J Med 2009; 360 (4): 423–4.
