Total en bloc spondylectomy in testicular immature teratoma: Long‐term survival amidst vertebral metastasis escalated by growing teratoma syndrome

Abstract

Introduction We present a rare case of long‐term survival following metastasectomy for lumbar metastasis with growing teratoma syndrome. Case presentation An 18‐year‐old man presented with left scrotal mass and lumbago. Alpha‐fetoprotein was elevated to 648.8 ng/mL, while human chorionic gonadotropin and lactate hydrogenase were normal. Pathology of left inguinal orchiectomy revealed immature teratoma, and computed tomography confirmed a single metastasis in the second lumbar vertebra. After two courses of bleomycin, etoposide, cisplatin chemotherapy, alpha‐fetoprotein decreased, but computed tomography confirmed an enlarged lumbar metastasis. A vertebral biopsy demonstrated teratoma with a dominant mature component, and growing teratoma syndrome was suspected. Following additional etoposide, cisplatin chemotherapy, and normalization of alfa‐fetoprotein, total spondylectomy was performed. Vertebral pathology proved mature teratoma. After adjuvant chemotherapy, he has been recurrence‐free for 17 years. Conclusion Spondylectomy of a single metastatic vertebra contributed to long‐term survival in a testicular teratoma case.

Keywords

• growing teratoma syndrome
• metastasectomy
• pure teratoma
• spinal metastasis
• spondylectomy
• testicular neoplasms