The growing teratoma syndrome: a case report and a review of the literature.

We present the case of a 5-year-old girl with ovarian immature teratoma, which recurred a few months after an incomplete surgical staging. The recurrent masses, located in the upper abdomen and lower pelvis, were accompanied by rise in levels of serum alpha-fetoprotein. The patient and her parents refused surgical resection of these recurrent masses; therefore, chemotherapy was promptly given. After multiple cycles of chemotherapy, all the masses remained stable in size despite normalization of the tumor marker. Subsequent complete resection of the masses showed only mature teratoma (MT) component without any residual malignant germ cell tumor. The patient was disease free for 2 years, when another episode of recurrence developed as a 5-cm mass in the perihepatic area. The third laparotomy revealed a tumor mass, histologically composed of only MT tissue. She is now doing well without any evidence of the disease, 24 months after the last surgery.