Fertility-Sparing Treatment for Ovarian Immature Teratoma in a Young Woman

What happened, in summary

In 2021, a previously healthy woman in her early 20s developed 3 days of generalized abdominal pain and abdominal swelling. Ultrasound found an 18 × 10 cm solid-cystic ovarian mass with free fluid. Emergency surgery revealed a ruptured right ovarian tumor measuring about 15 × 12 × 7 cm and a 6 × 4 × 3 cm cyst in the left ovary. Surgeons performed right salpingo-oophorectomy, left ovarian cystectomy, and omentectomy. The diagnosis was Stage 1 ovarian immature teratoma. Four chemotherapy cycles were planned, but severe side effects limited treatment to 3 cycles. She was monitored with blood tests for 7 months. A later left-sided pelvic mass raised concern for recurrence, and another doctor recommended removing the remaining ovary and uterus. Because she hoped to preserve fertility, she sought a second opinion and chose keyhole surgery. The operation removed a 4 × 4 cm broad-ligament mass and sampled multiple deposits smaller than 0.5 cm from pelvic and abdominal surfaces. Histology showed mature neural tissue without malignancy, supporting growing teratoma syndrome and gliomatosis peritonei rather than recurrent malignant disease. She remained disease-free under regular surveillance. The fertility-sparing approach allowed natural conception 7 months after marriage, followed by a healthy full-term pregnancy and delivery.