{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:31:44Z","timestamp":1760866304577,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,4]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Mixed epithelial mesenchymal (MEM) hepatoblastoma with teratoid features is rare histological variant of hepatoblastoma and described in case reports. Growing teratoma syndrome (GTS) is a rare and often unrecognised phenomenon generally associated with less than 5% of germ cell tumour. It is defined by enlarging tumour mass which is generally mature teratoma with normal or significantly decreasing tumour markers during chemotherapy. The treatment outcomes in GTS are dependent on early recognition and complete surgical excision. We describe a rare case of MEM hepatoblastoma with teratoid features with GTS in an infant who had a delay in definitive management due to late diagnosis of GTS.<\/jats:p>","DOI":"10.1136\/bcr-2020-241197","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T12:21:39Z","timestamp":1615983699000},"page":"e241197","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Growing teratoma syndrome in mixed hepatoblastoma with teratoid features"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"first","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Singh","sequence":"additional","affiliation":[{"name":"Pathology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4348-3490","authenticated-orcid":false,"given":"Badal","family":"Parikh","sequence":"additional","affiliation":[{"name":"Anaesthesiology & Critical Care, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karunesh","family":"Chand","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Army Hospital Research and Referral, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"2025082622562039000_14.3.e241197.1","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1002\/cncr.11585","article-title":"Where do we stand with hepatoblastoma? A review","volume":"98","author":"Schnater","year":"2003","journal-title":"Cancer"},{"key":"2025082622562039000_14.3.e241197.2","doi-asserted-by":"crossref","first-page":"520","DOI":"10.5858\/2007-131-520-PFTEOS","article-title":"Protocol for the examination of specimens from pediatric patients with hepatoblastoma","volume":"131","author":"Finegold","year":"2007","journal-title":"Arch Pathol Lab Med"},{"key":"2025082622562039000_14.3.e241197.3","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19931115)72:10<2910::AID-CNCR2820721009>3.0.CO;2-4"},{"key":"2025082622562039000_14.3.e241197.4","doi-asserted-by":"crossref","first-page":"431","DOI":"10.3349\/ymj.2001.42.4.431","article-title":"Teratoid hepatoblastoma: multidirectional differentiation of stem cell of the liver","volume":"42","author":"Kim","year":"2001","journal-title":"Yonsei Med J"},{"key":"2025082622562039000_14.3.e241197.5","doi-asserted-by":"crossref","DOI":"10.1186\/1746-1596-4-37","article-title":"Mixed hepatoblastoma and teratoma of the liver in a 3-year-old child: a unique combination and clinical challenge","volume":"4","author":"Moll","year":"2009","journal-title":"Diagn Pathol"},{"key":"2025082622562039000_14.3.e241197.6","doi-asserted-by":"crossref","unstructured":"Sarin YK . Mixed epithelial and mesenchymal hepatoblastoma with teratoid Features-A diagnostic dilemma. RPN 2018;2 http:\/\/crimsonpublishers.com\/rpn\/fulltext\/RPN.000527.php doi:10.31031\/RPN.2018.02.000527","DOI":"10.31031\/RPN.2018.02.000527"},{"key":"2025082622562039000_14.3.e241197.7","doi-asserted-by":"publisher","DOI":"10.4103\/0970-1591.52910"},{"key":"2025082622562039000_14.3.e241197.8","unstructured":"SIOPEL guidelines for the treatment of hepatoblastoma | SIOPEL: Childhood Liver Tumours Study Group [Internet]. Available: http:\/\/www.siopel.org\/?q=node\/173 [Accessed cited 2020 Nov 29]."},{"key":"2025082622562039000_14.3.e241197.9","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-013-0624-8"},{"key":"2025082622562039000_14.3.e241197.10","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1002\/1097-0142(19860601)57:11<2168::AID-CNCR2820571115>3.0.CO;2-M","article-title":"Teratoid hepatoblastoma. The nosologic dilemma of solid embryonic neoplasms of childhood","volume":"57","author":"Manivel","year":"1986","journal-title":"Cancer"},{"key":"2025082622562039000_14.3.e241197.11","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0140-6736(75)92411-3","article-title":"Letter: benign transformation of testicular carcinoma by chemotherapy","volume":"1","author":"Merrin","year":"1975","journal-title":"Lancet"},{"key":"2025082622562039000_14.3.e241197.12","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197712)40:6<2987::AID-CNCR2820400634>3.0.CO;2-A"},{"key":"2025082622562039000_14.3.e241197.13","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0022-5347(17)54375-X","article-title":"The variable transformation in metastases from testicular germ cell tumors: the need for selective biopsy","volume":"126","author":"Carr","year":"1981","journal-title":"J Urol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-241197","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:56:30Z","timestamp":1756274190000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-241197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,17]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-241197"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-241197","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}