Growing teratoma syndrome of the ovary: a case series.
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BACKGROUND: Growing teratoma syndrome (GTS) is a rare clinical phenomenon characterized by an enlarging tumor during or after completion of therapy for a germ cell tumor. CASE PRESENTATION: We report two Black African females, aged 10 and 12 years, with an initial diagnosis of malignant ovarian tumor with elevated alpha-fetoprotein (AFP) and B-human chorionic gonadotropin (B-HCG). After initiation of chemotherapy, the tumors progressed while the tumor markers continued to decline. Subsequent removal of the tumors showed mature teratoma with no malignant components. CONCLUSION: GTS is often mistaken for disease progression. High index of suspicion is required when an abdominal germ cell tumor progresses on therapy with declining tumor markers.