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Imaging Features of Growing Teratoma Syndrome Following a Malignant Ovarian Germ Cell Tumor

Han, Na Yeon MD, PhD*; Sung, Deuk Jae MD, PhD*; Park, Beom Jin MD, PhD*; Kim, Min Ju MD, PhD*; Cho, Sung Bum MD, PhD*; Kim, Kyeong Ah MD, PhD; Song, Jae Yun MD, PhD

Journal of Computer Assisted Tomography: July/August 2014 - Volume 38 - Issue 4 - p 551–557
doi: 10.1097/RCT.0000000000000073
Abdominal Imaging

Objective To access imaging findings of growing teratoma syndrome (GTS), which is a rare complication of malignant ovarian germ cell tumor (GCT) after chemotherapy.

Methods Five patients met the criteria for GTS. Computed tomography and magnetic resonance images were retrospectively reviewed by 2 radiologists in consensus for margin, attenuation, and the presence of gross fat or calcification of GTS lesions, which were compared with primary GCTs regarding tumor composition.

Results Growing teratoma syndrome lesions were characterized as follows: poorly circumscribed, diffuse peritoneal masses in 2 patients; well-circumscribed, localized peritoneal masses in 1 patient, and ovarian masses in 2 patients. Features more noticeable in GTS lesions were more prominent fatty components in 4 patients and purely cystic lesion in 1 patient.

Conclusions Growing teratoma syndrome can be manifested as intraperitoneal masses with an increased fatty or cystic component. Radiologists should consider GTS when there are such masses on follow-up imaging studies in patients with malignant ovarian GCT.

From the *Department of Radiology, College of Medicine, Korea University, Anam Hospital, Seoul, Republic of Korea; †Department of Radiology, College of Medicine, Korea University Guro Hospital, Seoul, Republic of Korea; and ‡Department of Obstetrics and Gynecology, College of Medicine, Korea University, Anam Hospital, Seoul, Republic of Korea.

Received for publication November 26, 2013; accepted January 8, 2014.

Reprints: Deuk Jae Sung, MD, PhD, Department of Radiology, College of Medicine, Korea University, Anam Hospital, 126–1 5-Ka, Anam-Dong, Sungbuk-ku, Seoul 136–705, Republic of Korea (e-mail:

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins