Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Residual masses are a common finding after chemotherapy for retroperitoneal and other metastases from nonseminomatous germ cell tumors of the testis. These may contain mature teratoma, fibrotic tissue, or tumor. Mature teratoma, which is unresponsive to chemotherapy, may result from evolution of a malignant lesion during treatment, or it may represent a metastasis from a focus of mature teratoma in the primary testicular tumor. An enlarging retroperitoneal mass during the course of chemotherapy is usually due to treatment failure but rarely may be due to an enlarging mature teratoma, the so-called growing teratoma syndrome. This report concerns five patients with nonseminomatous germ cell tumors metastatic to the retroperitoneum in whom mature teratomas were found at surgery. These tumors had grown despite the administration of combination systemic chemotherapy, and the cystic component had increased in size. Three patients had evidence of urinary tract compression, three had vascular compression or displacement, and one had gastrointestinal compression. The retroperitoneal mass was excised in each patient, and all are alive 4-27 months after surgery without evidence of recurrence. Growing mature teratoma is unresponsive to chemotherapy but is cured by surgical excision. The possibility of the growing teratoma syndrome should be considered so that these lesions can be treated appropriately.
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PMID:The growing teratoma syndrome: an unusual manifestation of treated, nonseminomatous germ cell tumors of the testis. 283 69

Before the era of chemotherapy an extensively metastasized non-seminomatous testicular tumour was nearly always fatal. Only 10 cases of spontaneous regression of thoracic metastasis have been reported. With chemotherapy, a much better outlook has been achieved, however, in 10% of the cases, chemotherapy resistant thoracic masses remain after treatment. In 70 to 80% of those cases with normal tumour markers, mature teratoma is found. In this paper, three patients with non-seminomatous testicular tumour and thoracic opacities resistant to conservative treatment are reported. One patient showed a complete disappearance of 9 out of 10 thoracic opacities 6 months after a short chemotherapy course, which had seemed to be ineffective. After a short period of reduction, the remaining opacity demonstrated continued tumour growth with a significantly longer tumour doubling time. The other two patients showed enlarged thoracic opacities despite combination chemotherapy and normal tumour marker levels. At the time of thoracotomy and complete surgical resection of the tumours all patients had normal tumour marker levels. Mature teratoma without genuine malignant cells was found microscopically. At this time all patients are free of metastases, 18, 3.5 and 2 year post thoracotomy. We suggest complete extirpation of the chemotherapy resistant lesions because, mature teratoma may give rise to compression and because in the cases with notwithstanding normalization of tumour markers and active tumour histology has to be obtained to restart combination chemotherapy.
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PMID:The therapeutic approach to intrathoracic metastases of non-seminomatous testicular tumour. 652 31