Laparoscopic Excisional Surgery for Growing Teratoma Syndrome Presenting 19 Years after Initial Treatment: A Case Report

Growing teratoma syndrome (GTS) is rare. The optimum treatment strategy is complete surgical excision. We describe a 42-year-old woman with GTS who was treated with laparoscopic excisional surgery. Initially, we performed right salpingo-oophorectomy; she was diagnosed with grade 2 immature teratoma, which was treated with four courses of peplomycin, etoposide, and cisplatin chemotherapy. Postoperatively, her tumor marker (alpha-fetoprotein) was not elevated; however, 19 years later, she developed an enlarged mass in her pelvic cavity. Laparoscopic surgery revealed some of the enlarged tumors detected by preoperative magnetic resonance imaging in the pouch of Douglas. We resected the retroperitoneal tumors. The histological diagnosis was mature teratomas. We concluded that these tumors were GTS. No recurrent disease was observed 12 months thereafter. This case represents one of the longest reported interval periods before the development of GTS. Laparoscopic surgery is an effective alternative diagnostic and therapeutic approach in cases suggestive of GTS. Laparoscopic surgery might be feasible in cases of GTS, but further study will be needed, given that only a few reported cases have been managed laparoscopically.