A patient treated for a nonseminatomous germ cell tumor may develop the Growing Teratoma Syndrome (GTS). Presumably chemoradiation has eradicated the anaplastic tumor elements, leaving only mature teratoid elements.
Features of the Growing Teratoma Syndrome:
(1) The patient has a history of therapy for a nonseminatous germ cell tumor, often of the testis.
(2) There is evidence of a solitary stable or enlarging mass, often in the retroperitoneum or lung, which is a mature teratoma.
(3) Serum levels of tumor markers (alpha-fetoprotein or AFP, human chorionic gonadotropin or HCG, others) are normal.
(4) Many of the tumors can be recognized based on imaging characteristics.
These tumors are treated surgically if possible since they tend to be resistant to radiation and/or chemotherapy.
Vaughn et al report success treating inoperable lesions with targeted therapy against cyclin-dependent kinase 4/6. This kinase affects expression of retinoblastoma protein (pRB), which is expressed in high levels in these tumors.
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