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.
© 2024 The Author(s). IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.