Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2023; 22: 144-150
Клинический случай синдрома растущей тератомы у подростка с герминогенной опухолью яичка
https://doi.org/10.24287/1726-1708-2023-22-4-144-150Аннотация
Синдром растущей тератомы (СРТ) – состояние, характеризующееся парадоксальным увеличением размеров опухоли на фоне или после химиотерапевтического и/или хирургического лечения по поводу герминогенноклеточных опухолей. СРТ ввиду своей относительной редкости может ошибочно интерпретироваться как прогрессирование заболевания. Однако снижение уровня онкомаркеров альфа-фетопротеина (a-ФП) и хорионического гонадотропина человека (ХГЧ) в крови, парадоксальное увеличение размеров опухоли на фоне полихимиотерапии и верифицированный гистологический диагноз зрелой тератомы после удаления опухоли подтверждают СРТ. Приводим описание клинического наблюдения пациента, у которого наблюдается снижение уровня онкомаркеров a-ФП и ХГЧ в крови на фоне лечения, парадоксальное увеличение размеров опухоли спустя 5 мес после завершения полихимиотерапии при нормальных уровнях a-ФП, ХГЧ при гистологически подтвержденном диагнозе, что демонстрирует СРТ. Родители пациента дали согласие на использование информации, в том числе фотографий ребенка, в научных исследованиях и публикациях.
Список литературы
1. [Электронный ресурс] Экстракраниальные герминогенно-клеточные опухоли. Клинические рекомендации. Национальное общество детских гематологов и онкологов. М.; 2020. URL: http://nodgo.org/sites/default/files/КР экстракраниальные герминогенно-клеточные опухоли дети 2020.pdf. (дата обращения 20.11.2023).
2. Logothetis C.J., Samuels M.I., Trindade A., Johnson D.E. The growing teratome syndrome. Cancer 1982; 8 (50): 1629–35.
3. Tangjtgamol S., Manusirivithaya S., Leelahakom S., Thawaramara T., Suekwatana P., Sheanakul C. The growing teratoma syndrome: a case report and a review of literature. Int J Gynecol Cancer 2006; (16): 384–90.
4. Hariprasad R., Kumar L., Janga D., Kumar S., Vijayaraghavan M. Growing teratoma syndrome of ovary. Int J Clin Oncol 2008; (13): 83–7.
5. Zagame L., Pautier P., Duvillard P. Castaigne D., Patte C., Lhommé C. Growing teratoma syndrome after ovarian germ cell tumors. Obstet Gynecol 2006; (108): 509–14. DOI: 10.1097/01.AOG.0000231686.94924.41
6. Chua T.C., Yan T.D., Saxena A., Morris D.L. Should the treatment of peritoneal carcinomatosis by cytoreductive surgery and hypertermic intraperitoneal chemotherapy still be regarded as highly morbid procedure? A systemic review of morbidity and mortality. Ann Surg 2009; (249): 900–7. DOI: 10/1097/SLA.0b013e3181a45d86
7. Smithers D.W. Maturation in human tumors. Lancet 1969; 7627 (294): 949–52.
8. Bentivegna E., Azais H., Uzan C., Leary A., Pautier P., Gonthier C., et al. Surgical outcome after debulking surgery for intraabdominal ovarian growing teratoma syndrome: analysis of 38 cases. Ann Surg Oncol 2015; 3 (22): 964–70.
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; 4 (177): 1330–4.
10. Zheludkova O.G., Shishkina L.V., Konovalov A.N., Ryzhova M.V., Kislyakov A.N., Ozerov S.S., et al. Growing teratoma syndrome in a patient with intracranial germ cell tumor. Zh Vopr Neirokhir Im N N Burdenko 2015; 79 (3): 69–74.
11. Kellie S.J., Boyce H., Dunkel I.J. Primary chemotherapy for intracranial nongerminomatous germ cell tumors: results of the second international CNS germ cell study group protocol. J Clin Oncol 2004; 22: 846–53.
12. Matsutani M., Sano K., Takakura K., Fujimaki T., Nakamura O., Funata T., Seto T. Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 1997; 86: 446–55.
13. Gorbatiy V., Spiess P.E., Pisters L.L. The growing teratoma syndrome: current review of the literature. Indian J Urol 2009; 25: 186–9. DOI: 10.4103/0970-1591.52910
14. Kim C.Y., Choi J.W., Lee J.Y., Kim S.K., Wang K.C., Park S.H., et al. Intracranial growing teratoma syndrome: clinical characteristics and treatment strategy. J Neurooncol 2011; 101: 109–15.
15. [Electronic resource] https://www.skion.nl/workspace/uploads/E_final_15062011.pdf (accessed 20.11.2023)
16. Guo C.C., Punar M., Contreras A.L., Tu S.M., Pisters L., Tamboli P., et al. Testicular germ cell tumors with sarcomatous components: an analysis of 33 cases. Am J Surg Pathol 2009; 33: 1173–8. DOI: 10.1097/PAS.0b013e3181adb9d7
Pediatric Hematology/Oncology and Immunopathology. 2023; 22: 144-150
Growing teratoma syndrome in an adolescent with a testicular germ cell tumor: a case report
https://doi.org/10.24287/1726-1708-2023-22-4-144-150Abstract
Growing teratoma syndrome (GTS) is a condition characterized by a paradoxical increase in tumor size during or after chemotherapy and/or surgical treatment for germ cell tumors. Due to its relative rarity, GTS may be misinterpreted as disease progression. However, a decrease in tumor markers (alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG)) in the blood, a paradoxical increase in tumor size during chemotherapy, and a verified histological diagnosis of mature teratoma after the tumor removal confirm GTS. Here we report a clinical case of a patient in whom we observed a decrease in tumor markers (AFP and hCG) in the blood during treatment, a paradoxical increase in the tumor size and normal AFP and hCG levels 5 months after the end of chemotherapy and a histologically verified diagnosis. These clinical features are consistent with the diagnostic criteria of GTS. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.
References
1. [Elektronnyi resurs] Ekstrakranial'nye germinogenno-kletochnye opukholi. Klinicheskie rekomendatsii. Natsional'noe obshchestvo detskikh gematologov i onkologov. M.; 2020. URL: http://nodgo.org/sites/default/files/KR ekstrakranial'nye germinogenno-kletochnye opukholi deti 2020.pdf. (data obrashcheniya 20.11.2023).
2. Logothetis C.J., Samuels M.I., Trindade A., Johnson D.E. The growing teratome syndrome. Cancer 1982; 8 (50): 1629–35.
3. Tangjtgamol S., Manusirivithaya S., Leelahakom S., Thawaramara T., Suekwatana P., Sheanakul C. The growing teratoma syndrome: a case report and a review of literature. Int J Gynecol Cancer 2006; (16): 384–90.
4. Hariprasad R., Kumar L., Janga D., Kumar S., Vijayaraghavan M. Growing teratoma syndrome of ovary. Int J Clin Oncol 2008; (13): 83–7.
5. Zagame L., Pautier P., Duvillard P. Castaigne D., Patte C., Lhommé C. Growing teratoma syndrome after ovarian germ cell tumors. Obstet Gynecol 2006; (108): 509–14. DOI: 10.1097/01.AOG.0000231686.94924.41
6. Chua T.C., Yan T.D., Saxena A., Morris D.L. Should the treatment of peritoneal carcinomatosis by cytoreductive surgery and hypertermic intraperitoneal chemotherapy still be regarded as highly morbid procedure? A systemic review of morbidity and mortality. Ann Surg 2009; (249): 900–7. DOI: 10/1097/SLA.0b013e3181a45d86
7. Smithers D.W. Maturation in human tumors. Lancet 1969; 7627 (294): 949–52.
8. Bentivegna E., Azais H., Uzan C., Leary A., Pautier P., Gonthier C., et al. Surgical outcome after debulking surgery for intraabdominal ovarian growing teratoma syndrome: analysis of 38 cases. Ann Surg Oncol 2015; 3 (22): 964–70.
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; 4 (177): 1330–4.
10. Zheludkova O.G., Shishkina L.V., Konovalov A.N., Ryzhova M.V., Kislyakov A.N., Ozerov S.S., et al. Growing teratoma syndrome in a patient with intracranial germ cell tumor. Zh Vopr Neirokhir Im N N Burdenko 2015; 79 (3): 69–74.
11. Kellie S.J., Boyce H., Dunkel I.J. Primary chemotherapy for intracranial nongerminomatous germ cell tumors: results of the second international CNS germ cell study group protocol. J Clin Oncol 2004; 22: 846–53.
12. Matsutani M., Sano K., Takakura K., Fujimaki T., Nakamura O., Funata T., Seto T. Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 1997; 86: 446–55.
13. Gorbatiy V., Spiess P.E., Pisters L.L. The growing teratoma syndrome: current review of the literature. Indian J Urol 2009; 25: 186–9. DOI: 10.4103/0970-1591.52910
14. Kim C.Y., Choi J.W., Lee J.Y., Kim S.K., Wang K.C., Park S.H., et al. Intracranial growing teratoma syndrome: clinical characteristics and treatment strategy. J Neurooncol 2011; 101: 109–15.
15. [Electronic resource] https://www.skion.nl/workspace/uploads/E_final_15062011.pdf (accessed 20.11.2023)
16. Guo C.C., Punar M., Contreras A.L., Tu S.M., Pisters L., Tamboli P., et al. Testicular germ cell tumors with sarcomatous components: an analysis of 33 cases. Am J Surg Pathol 2009; 33: 1173–8. DOI: 10.1097/PAS.0b013e3181adb9d7
