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15.04.2020 | Clinical Study

Intracranial growing teratoma syndrome (iGTS): an international case series and review of the literature

verfasst von: George Michaiel, Douglas Strother, Nicholas Gottardo, Ute Bartels, Hallie Coltin, Juliette Hukin, Beverly Wilson, Shayna Zelcer, Jordan R. Hansford, Timothy Hassall, Mohamed S. AbdelBaki, Kristina A. Cole, Lindsey Hoffman, Natasha P. Smiley, Amy Smith, Anna Vinitsky, Nicholas A. Vitanza, Avery Wright, Kee K. Yeo, Lionel M. L. Chow, Magimairajan I. Vanan, Girish Dhall, Eric Bouffet, Lucie Lafay-Cousin

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2020

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Abstract

Purpose

Intracranial growing teratoma syndrome (iGTS) is a rare phenomenon of paradoxical growth of a germ cell tumor (GCT) during treatment despite normalization of tumor markers. We sought to evaluate the frequency, clinical characteristics and outcome of iGTS in Western countries.

Methods

Pediatric patients from 22 North American and Australian institutions diagnosed with iGTS between 2000 and 2017 were retrospectively evaluated.

Results

From a total of 777 cases of central nervous system (CNS) GCT, 39 cases of iGTS were identified for an overall frequency of 5%. Pineal region was a more frequent location for iGTS as compared to cases of GCT without iGTS (p < 0.00001). In patients with an initial tissue diagnosis of GCT, immature teratoma was present in 50%. Serum AFP or ßhCG was detectable in 87% of patients (median values 66 ng/mL and 44 IU/L, respectively). iGTS occurred at a median of 2 months (range 0.5–32) from diagnosis, in the majority of patients. All patients underwent surgical resection, leading to gross total resection in 79%. Following surgery, all patients resumed adjuvant therapy or post treatment follow-up for GCT. At a median follow-up of 5.3 years (range 0.2–11.8), 37 (95%) of patients are alive, including 5 with stable residual mass.

Conclusion

iGTS occurs in 5% of patients with GCT in Western countries. Tumors of the pineal region and GCT containing immature teratoma appear to be associated with a higher risk of developing iGTS. Complete surgical resection is the mainstay of treatment. Overall survival of patients developing iGTS remains favorable.
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Metadaten
Titel
Intracranial growing teratoma syndrome (iGTS): an international case series and review of the literature
verfasst von
George Michaiel
Douglas Strother
Nicholas Gottardo
Ute Bartels
Hallie Coltin
Juliette Hukin
Beverly Wilson
Shayna Zelcer
Jordan R. Hansford
Timothy Hassall
Mohamed S. AbdelBaki
Kristina A. Cole
Lindsey Hoffman
Natasha P. Smiley
Amy Smith
Anna Vinitsky
Nicholas A. Vitanza
Avery Wright
Kee K. Yeo
Lionel M. L. Chow
Magimairajan I. Vanan
Girish Dhall
Eric Bouffet
Lucie Lafay-Cousin
Publikationsdatum
15.04.2020
Verlag
Springer US
Erschienen in
Journal of Neuro-Oncology / Ausgabe 3/2020
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-020-03486-9

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