Gliomatosis peritonei (GP) is a rare clinical condition characterized by presence of mature glial cells in the peritoneum. Growing teratoma syndrome (GTS) is described as an uncommon phenomenon which could be related to the incidence of non-seminomatous germ cell tumors. We report a case of a patient treated for immature ovarian teratoma, where both GP and GTS have been observed, an association to date scarcely described in literature. A 15-year-old female presented in the emergency department with severe pain in lower abdomen and right lumbar region. Upon admission concentration of alpha-fetoprotein (AFP) was 1500 ng/ml, beta human chorionic gonadotropin (beta b-hCG) – below 2 ng/ml. Computed tomography (CT) scan of the abdominal cavity and pelvis confirmed the presence of anomalous mass in the abdominal cavity and pelvis. Initial surgery was performed. Histopathology revealed the presence of immature teratoma with epithelial elements. Normalization of AFP was obtained within 8 weeks. Five months after surgery, progressive growth of AFP was noted. Magnetic resonance imaging (MRI) and CT scans of pelvis minor showed local relapse. Evaluation of the remission after 2 blocks of preoperative chemotherapy revealed a presence of a large tumor mass in pelvis minor despite normalization of AFP concentration. After opening the abdominal walls, numerous abnormal white-colored nodules were observed in the peritoneum. Histopathology revealed the presence of mature glial tissue (gliomatosis peritonei). The remaining tumor mass was removed – histopathology confirmed existence of mature teratoma (growing teratoma syndrome). Postoperative chemotherapy was continued. To date the patient remains under clinical and laboratory remission. Concomitant incidence of GP and GTS, although rare, should always be taken into consideration in pediatric patients with diagnosis of either condition.
Copyright © 2021. Published by Elsevier Inc.

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