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This case series aims to illustrate the occurrence of growing teratoma syndrome in young patients undergoing treatment for ovarian germ cell tumors.

May 26, 2026Journal of Medical Case Reports0 citationsOpen Access

Growing teratoma syndrome of the ovary: a case series

MKMpokigwa KiputaMuhimbili University of Health and Allied Sciences TATariq AzizMuhimbili National Hospital ANAdvera NgaizaMuhimbili National Hospital

Key Points

This case series aims to illustrate the occurrence of growing teratoma syndrome in young patients undergoing treatment for ovarian germ cell tumors.
Case series involving two Black African females, aged 10 and 12 years, initially diagnosed with malignant ovarian tumors.
Treatment included chemotherapy, and tumor markers were monitored during therapy.
Surgical removal of tumors was performed to assess tumor composition post-therapy.
Both patients exhibited tumor progression during chemotherapy while experiencing declining tumor markers (AFP, B-HCG).
Histological examination post-surgery revealed mature teratomas without malignant features, indicating misclassification of tumor growth as disease progression.
These cases highlight the need for heightened awareness and monitoring of tumor markers in similar scenarios.

Abstract

Growing teratoma syndrome (GTS) is a rare clinical phenomenon characterized by an enlarging tumor during or after completion of therapy for a germ cell tumor. We report two Black African females, aged 10 and 12 years, with an initial diagnosis of malignant ovarian tumor with elevated alpha-fetoprotein (AFP) and B-human chorionic gonadotropin (B-HCG). After initiation of chemotherapy, the tumors progressed while the tumor markers continued to decline. Subsequent removal of the tumors showed mature teratoma with no malignant components. GTS is often mistaken for disease progression. High index of suspicion is required when an abdominal germ cell tumor progresses on therapy with declining tumor markers.

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