Editorial Comment to Advanced germ cell tumor patients undergoing post‐chemotherapy retroperitoneal lymph node dissection: Impact of residual teratoma on prognosis

Teratoma components of germ cell tumors (GCTs) are clinically challenging due to their uniform resistance toward conventional anticancer treatment; for example, chemotherapy and radiotherapy. Approximately one in three non-seminoma patients undergoing residual mass resection have teratoma specimens, whereas viable GCT can be found 10–20% secondary resection.1 Satoshi et al. reported on a series post-chemotherapy the prognostic impact contained teratoma.2 Unfortunately, reliable serum tumor markers functional imaging modalities predict presence within masses lacking. While 18F-fluorodeoxy-glucose positron emission tomography scans reliably detect tissues, this method is incapable differentiating between necrotic or fibrotic material from mature components.3 Consequently, surgical all visible lesions >1 cm size remains an integral part optimal multimodal treatment accordance with current guideline recommendations; however, means that approximately 50% undergo unnecessary interventions. An emerging marker GCTs, micro-RNA miR-371a-3p, shows tissues high specificity sensitivity, but fails teratoma.4 According al., minor remission manifestations <50% baseline might helpful surrogate and, thus, guide case complete not feasible. The results presented by underpin importance completeness teratoma-containing masses. Incomplete bears inevitable risk disease progression has detrimental effect patient survival. This possibly threat subsequent malignant transformation into phenotypes other somatic lineage, including rhabdomyosarcomas, primitive neuroectodermal adenocarcinomas. Such particularly poor chemosensitivity transformation.5 Teratomas remain enigmatic challenge disciplines involved radiologists detect, oncologists treat systemically surgeons thoroughly completely resect. Radical management at high-volume centers paramount maintain excellent outcomes through experienced surgeons. Novel diagnostic tools innovative options required unresectable incompletely resectable teratoma. Open Access funding enabled organized Projekt DEAL. None declared.