Growing teratoma syndrome in ovarian germ cell tumours - a diagnostic challenge, two case reports

Growing teratoma syndrome (GTS) is a rare complication of ovarian germ cell tumours and occurs in young age group. It is characterized by clinical or radiological increase in tumour size during or after chemotherapy, with normalization of tumour marker levels. Histopathological tissue growth post chemotherapy is a mature teratoma without any malignant component. Mainstay of treatment is surgical excision of the disease to prevent progression of tumour as mature teratomas are resistant to both chemotherapy and radiotherapy. Diagnosis is a challenge as disease recurrence or chemo-resistance can be difficult to distinguish. Benign nature of this disease entity is essential to avoid overzealous chemotherapy or radical surgery.