Growing Teratoma Syndrome Presenting as Skin Nodules: A Rare Entity

Growing teratoma syndrome (GTS) an extremely rare phenomenon complicatingmalignant ovarian germ cell tumours. Till date very few have been reported. Growing teratoma syndrome (GTS) is characterised by increase in the size of a tumour occurringduring or after chemotherapy for mixed germ cell tumour. Complete surgical resection not only confirms the diagnosis, revealing mature teratoma component, but also is most effective therapy offering cure. GTS commonly occurs in previously diseased sites such as retro peritoneum, chest, while uncommon sites include supraclavicular lymph nodes, lung, mediastinum, inguinal lymph nodes, mesentery and liver. To the best of our knowledge (GTS) involving the skin has not been reported in the past. We hereby report a rare case of paediatric mixed ovarian germ cell tumour with skin metastasis, along with its review of literature. A 12-year-old female presented who had abdominal distension and skin nodules, on the anterior abdominal wall and right lower posterior chest wall. She had previously undergone ovarian cystectomy else were, followedby cisplatin and etoposide based chemotherapy for a left ovarian immature teratoma one year back. Recent Imaging showed solid and cystic mass in pelvic and abdominal cavity with calcification and widespread diffuse peritoneal deposits. As tumour markers(AFP,LDH, betaHCG) were within the normal range, a clinicaldiagnosis of GTS was made. She underwent complete cytoreductive surgery and wedge resection of skin nodules. Histopathology of all sample revealed mature cystic teratoma.