A complicated case of metastatic teratoma. Growing teratoma syndrome and cerebral metastasis.
All patients presenting with metastatic teratoma should be regarded as potentially curable and this case demonstrates the multiple treatment modalities which are often needed in the management of such patients. Increasing experience with cisplatin based combination chemotherapy has led to the development of prognostic factors which are used to determine the intensity of treatment given to individual patients. Surgical intervention plays a very important role in the management of residual disease at the completion of chemotherapy. Recognition of the growing teratoma syndrome and the importance of early surgical excision is illustrated by this case. Isolated CNS relapse may occur because the CNS may act as a sanctuary site in patients receiving systemic chemotherapy, but does not preclude long term disease free survival.
Simmonds
P D
PD
CRC Wessex Medical Oncology Unit, Royal South Hants Hospital, Southampton, U.K.
Mead
G M
GM
Whitehouse
J M
JM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001761:Bleomycin / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe; D009919:Orchiectomy; D012074:Remission Induction; D018243:Teratocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000601:surgery; D013908:Thoracotomy; D014750:Vincristine / Q000008:administration & dosage
D014408:Biomarkers, Tumor; D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide