{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T18:25:18Z","timestamp":1773685518923,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Growing teratoma syndrome (GTS) is rare and can mimic disease recurrence in patients with a history of immature teratoma. Benign hypermetabolic lymphadenopathy found on staging and surveillance computed tomography (CT) and positron emission tomography (PET) may lead to the presumption of metastatic malignancy. We report a case of a 38 year old with mixed mature and immature teratomas who developed new peritoneal masses after adjuvant chemotherapy despite a normalization of tumor markers. In addition to low FDG uptake observed in these peritoneal masses, a PET scan showed hypermetabolic lymphadenopathy and pulmonary and spleen lesions suggesting widespread metastases. Subsequent surgical resection confirmed a mixed pathology with GTS and sarcoidosis. We reviewed the current literature evidence of GTS and sarcoidosis as a benign cause of lymphadenopathy in cancer patients. We emphasize the importance of a tissue diagnosis before instituting therapy for presumed cancer recurrence to avoid potentially fatal diagnostic traps and management errors. A multiple disciplinary team approach is imperative in managing patients with suspected recurrent immature teratomas.<\/jats:p>","DOI":"10.3390\/curroncol29060331","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T00:22:39Z","timestamp":1654820559000},"page":"4148-4154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Growing Teratoma Syndrome in the Setting of Sarcoidosis: A Case Report and Literature Review"],"prefix":"10.3390","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0043-8374","authenticated-orcid":false,"given":"Adel","family":"Shahnam","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Blacktown and Westmead Hospitals, Sydney, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Sayer","sequence":"additional","affiliation":[{"name":"Gynecological Oncology Department, Chris O\u2019Brien Lifehouse, Sydney, NSW 2050, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Unine","family":"Herbst","sequence":"additional","affiliation":[{"name":"Gynaecological Oncology Department, Westmead Hospital, Sydney, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghwa","family":"Sharma","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won-hee","family":"Yoon","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Blacktown and Westmead Hospitals, Sydney, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Dinihan","sequence":"additional","affiliation":[{"name":"Respiratory and Thoracic Medicine, Blacktown Hospital, Sydney, NSW 2148, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Gao","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Blacktown and Westmead Hospitals, Sydney, NSW 2145, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1148\/radiographics.21.2.g01mr09475","article-title":"Ovarian teratomas: Tumor types and imaging characteristics","volume":"21","author":"Outwater","year":"2001","journal-title":"Radiographics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1097\/00000478-199809000-00011","article-title":"Immature teratomas in children: Pathologic considerations: A report from the combined Pediatric Oncology Group\/Children\u2019s Cancer Group","volume":"22","author":"Heifetz","year":"1998","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2938","DOI":"10.1200\/JCO.2007.10.8738","article-title":"Management of Ovarian Germ Cell Tumors","volume":"25","author":"Gershenson","year":"2007","journal-title":"J. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1200\/JCO.1991.9.11.1950","article-title":"Chemotherapy of advanced dysgerminoma: Trials of the Gynecologic Oncology Group","volume":"9","author":"Williams","year":"1991","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/GRF.0b013e318248045b","article-title":"Treatment of ovarian cancer in young women","volume":"55","author":"Gershenson","year":"2012","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.ygyno.2017.03.022","article-title":"An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations","volume":"146","author":"Salani","year":"2017","journal-title":"Gynecol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1046\/j.1525-1438.1992.02060295.x","article-title":"Primary treatment failure in patients with malignant ovarian germ cell neoplasms","volume":"2","author":"Messing","year":"1992","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_8","first-page":"CD007584","article-title":"Chemotherapy for malignant germ cell ovarian cancer in adult patients with early stage, advanced and recurrent disease","volume":"3","author":"Li","year":"2011","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1200\/JCO.2016.69.5395","article-title":"High-Dose Chemotherapy and Autologous Peripheral-Blood Stem-Cell Transplantation for Relapsed Metastatic Germ Cell Tumors: The Indiana University Experience","volume":"35","author":"Adra","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1002\/1097-0142(19821015)50:8<1629::AID-CNCR2820500828>3.0.CO;2-1","article-title":"The growing teratoma syndrome","volume":"50","author":"Logothetis","year":"1982","journal-title":"Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.ygyno.2003.10.024","article-title":"Growing teratoma syndrome vs. chemotherapeutic retroconversion: Case report and review of the literature","volume":"92","author":"Amsalem","year":"2004","journal-title":"Gynecol. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1016\/j.juro.2006.11.086","article-title":"Surgical management of growing teratoma syndrome: The M. D. Anderson cancer center experience","volume":"1","author":"Spiess","year":"2007","journal-title":"J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ygyno.2019.12.042","article-title":"Diagnosis and management of growing teratoma syndrome after ovarian immature teratoma: A single center experience","volume":"157","author":"Wang","year":"2020","journal-title":"Gynecol. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S964","DOI":"10.1245\/s10434-015-4608-y","article-title":"Surgical Outcomes After Debulking Surgery for Intraabdominal Ovarian Growing Teratoma Syndrome: Analysis of 38 Cases","volume":"22","author":"Bentivegna","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/S0959-8049(00)00137-4","article-title":"The growing teratoma syndrome: Results of therapy and long-term follow-up of 33 patients","volume":"36","author":"Fizazi","year":"2000","journal-title":"Eur. J. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1136\/ijgc-00009577-200602001-00070","article-title":"The growing teratoma syndrome: A case report and a review of the literature","volume":"16","author":"Tangjitgamol","year":"2006","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1159\/000356563","article-title":"Growing Teratoma Syndrome of the Ovary Showing Three Patterns of Metastasis: A Case Report","volume":"6","author":"Shibata","year":"2013","journal-title":"Case Rep. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/S0009-9260(05)80570-7","article-title":"Retroconversion of immature teratoma of the ovary: CT appearances","volume":"43","author":"Moskovic","year":"1991","journal-title":"Clin. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e9171","DOI":"10.1097\/MD.0000000000009171","article-title":"The application of 18F-FDG PET\/CT in ovarian immature teratomas when pathological examination results contradict clinical observations: A case report","volume":"96","author":"Wang","year":"2017","journal-title":"Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s11307-020-01576-8","article-title":"Spectrum of [(18)F]FDG-PET\/CT] Findings in Benign Lymph Node Pathology","volume":"23","author":"Zeman","year":"2021","journal-title":"Mol. Imaging Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4605","DOI":"10.1007\/s12325-021-01832-5","article-title":"How to Tackle the Diagnosis and Treatment in the Diverse Scenarios of Extrapulmonary Sarcoidosis","volume":"38","author":"Valeyre","year":"2021","journal-title":"Adv. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/MCP.0000000000000715","article-title":"Sarcoidosis epidemiology: Recent estimates of incidence, prevalence and risk factors","volume":"26","author":"Arkema","year":"2020","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1148\/rg.241035076","article-title":"Radiologic manifestations of sarcoidosis in various organs","volume":"24","author":"Koyama","year":"2004","journal-title":"Radiographics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1164\/ajrccm.164.10.2104046","article-title":"Clinical characteristics of patients in a case control study of sarcoidosis","volume":"164","author":"Baughman","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1056\/NEJMra071714","article-title":"Sarcoidosis","volume":"357","author":"Iannuzzi","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1378\/chest.07-1178","article-title":"Results of 188 whole-body fluorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis","volume":"132","author":"Teirstein","year":"2007","journal-title":"Chest"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1097\/01.meg.0000223911.85739.38","article-title":"Natural history of hepatic sarcoidosis and its response to treatment","volume":"18","author":"Kennedy","year":"2006","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.amjsurg.2009.01.004","article-title":"Sarcoidosis as a benign cause of lymphadenopathy in cancer patients","volume":"197","author":"Hunt","year":"2009","journal-title":"Am. J. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ejim.2005.09.023","article-title":"Neoplasia in the etiology of sarcoidosis","volume":"17","author":"Reich","year":"2006","journal-title":"Eur. J. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1038\/bjc.1972.18","article-title":"Sarcoid reactions and sarcoidosis in Hodgkin\u2019s disease and other malignant lymphomata","volume":"26","author":"Brincker","year":"1972","journal-title":"Br. J. Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.3109\/10428199409056299","article-title":"Sarcoidosis following chemotherapy for Hodgkin\u2019s disease","volume":"13","author":"Merchant","year":"1994","journal-title":"Leuk Lymphoma"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1001\/archderm.141.7.865","article-title":"Sarcoidosis associated with pegylated interferon alfa and ribavirin treatment for chronic hepatitis C: A case report and review of the literature","volume":"141","author":"Hurst","year":"2005","journal-title":"Arch. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.ejca.2021.05.041","article-title":"Immune checkpoint inhibitor\u2013associated sarcoidosis: A usually benign disease that does not require immunotherapy discontinuation","volume":"158","author":"Chanson","year":"2021","journal-title":"Eur. J. Cancer"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/6\/331\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:25:25Z","timestamp":1760138725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/6\/331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,7]]},"references-count":33,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["curroncol29060331"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29060331","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,7]]}}}