It was first described in the pediatric population with treated germ cell neoplasms, and represents enlarging masses at the site of previous tumor deposits. It is often cystic, and occurs after complete serological response to multimodality therapy.
The enlarging tumor consists of mature tissues from all three layers (endoderm, mesoderm and ectoderm) thus representing a mature teratoma, that presumably arises from differentiated cells that are refractory to chemotherapy or radiation.
The incidence systemically is estimated between 1.9 and 7.6% and is most often seen in the retroperitoneum in patients with metastatic testicular non-seminomatous germ cell tumors.
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