Intracranial growing teratoma syndrome following radiotherapy--an unusually fulminant course.

Abstract

INTRODUCTION:

Residual radiologically progressive masses following multimodality treatment of malignant mixed intracranial germ cell tumors are described. Often these enlarge, and this is called the growing teratoma syndrome. A similar phenomenon during radiotherapy alone has not been described.

SUBJECTS AND METHODS:

A 5-year old boy presented with features of raised intracranial pressure. Imaging revealed a posterior third ventricular mass, which was biopsied endoscopically.

RESULTS:

A review of the scanty tissue was suggestive of a pineal parenchymal tumor, and hence radiation was planned. After just ten fractions, he developed rapid neurological deterioration. Repeat imaging raised a possibility of a teratomatous tumor. He underwent emergency excision. However, he had a stormy postoperative course and succumbed to deep venous infarction. Histology revealed a purely mature teratoma.

CONCLUSION:

Though a growing teratoma syndrome has been described following chemotherapy, no such report while on radiation exists. Ours could be the first such reported case. We discuss the possible mechanisms with a review of the literature.

• Authors: Aliasgar Moiyadi, Rakesh Jalali, S V Kane
• Journal: Acta neurochirurgica (Acta Neurochir (Wien)) Vol. 152 Issue 1 Pg. 137-42 (Jan 2010) ISSN: 0942-0940 [Electronic] Austria
• PMID: 19404574 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Brain Neoplasms (diagnosis, etiology, surgery)
• Child, Preschool
• Fatal Outcome
• Humans
• Magnetic Resonance Imaging
• Male
• Neoplasms, Radiation-Induced (diagnosis, surgery)
• Neurosurgical Procedures
• Pinealoma (diagnostic imaging, radiotherapy)
• Teratoma (diagnosis, etiology, surgery)
• Tomography, X-Ray Computed