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Nonseminomatous germ cell tumors: enlarging masses despite chemotherapy

D M Panicek1, G C Toner, R T Heelan

  • 1Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center New York, NY 10021.

Radiology
|May 1, 1990
PubMed

Insights

Enlarging masses after chemotherapy for nonseminomatous germ cell tumors (NSGCT) in men with negative markers often indicate benign teratomas, not recurrent cancer. Surgical removal of these masses is typically curative and aids in identifying true residual malignancy.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Genitourinary Oncology

Background:

  • Nonseminomatous germ cell tumors (NSGCT) can present challenges in post-chemotherapy surveillance.
  • Distinguishing benign post-treatment changes from residual or recurrent malignancy is critical for patient management.

Purpose of the Study:

  • To investigate the nature of enlarging masses in men with NSGCT after chemotherapy, despite negative tumor markers.
  • To determine the diagnostic and therapeutic implications of these findings.

Main Methods:

  • Retrospective analysis of 185 men with NSGCT who underwent surgical resection of residual masses post-chemotherapy.
  • Evaluation of radiologic findings, including computed tomography (CT) scans, and histopathological results of resected masses.

Main Results:

  • Of 17 enlarging masses in 14 patients, 14 (82%) were teratomas (13 mature, 1 immature).
  • Two masses were necrotic tissue, and one was a mature teratoma with sarcomatous transformation.
  • Enlarging masses were frequently cystic and surgical resection was curative for teratomas.

Conclusions:

  • Enlarging masses in patients with negative serum tumor markers post-chemotherapy for NSGCT commonly represent mature teratomas.
  • Complete surgical resection is crucial for definitive diagnosis and treatment, and for identifying patients requiring further therapy for residual malignancy.

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