title: Intracranial growing teratoma syndrome following radiotherapy--an unusually fulminant course.
abstract: BACKGROUND
  Residual radiologically progressive masses following multimodality treatment of malignant mixed intracranial germ cell tumors are described. Often these enlarge, and this is called the growing teratoma syndrome. A similar phenomenon during radiotherapy alone has not been described.
  
  
  METHODS
  A 5-year old boy presented with features of raised intracranial pressure. Imaging revealed a posterior third ventricular mass, which was biopsied endoscopically.
  
  
  RESULTS
  A review of the scanty tissue was suggestive of a pineal parenchymal tumor, and hence radiation was planned. After just ten fractions, he developed rapid neurological deterioration. Repeat imaging raised a possibility of a teratomatous tumor. He underwent emergency excision. However, he had a stormy postoperative course and succumbed to deep venous infarction. Histology revealed a purely mature teratoma.
  
  
  CONCLUSIONS
  Though a growing teratoma syndrome has been described following chemotherapy, no such report while on radiation exists. Ours could be the first such reported case. We discuss the possible mechanisms with a review of the literature.
authors.affiliation: Department of Surgical Oncology, Tata Memorial Centre, Parel, Mumbai, India. aliasgar.moiyadi@gmail.com
authors.forename: Aliasgar
authors.initials: A
authors.lastname: Moiyadi
authors.forename: Rakesh
authors.initials: R
authors.lastname: Jalali
authors.forename: S V
authors.initials: SV
authors.lastname: Kane
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D002675:Child, Preschool; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000601:surgery; D019635:Neurosurgical Procedures; D010871:Pinealoma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D013724:Teratoma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed