Stage I Immature Ovarian Teratoma With a Benign Teratoma in the Other Ovary

What happened, in summary

A 30-year-old woman was evaluated for mild lower abdominal pain and a suspected pelvic tumor. CT showed a large left ovarian lesion containing fat and calcifications and a smaller lesion in the right ovary. Her AFP level was elevated at 90 ng/mL, while CA-125 was normal. Surgery removed the left adnexal tumor, which measured up to 16 cm. Intraoperative assessment suggested an immature teratoma, leading to additional removal of the right adnexal tumor, uterus, and part of the omentum. Final pathology confirmed a grade 3 immature teratoma in the left ovary and a small mature, non-malignant teratoma in the right ovary. No metastases were found, and the malignant tumor was classified as FIGO IA, normalized here to Stage I. She later received BEP chemotherapy with cisplatin, etoposide, and bleomycin. Treatment was stopped early after she developed hearing loss and balance problems. Follow-up CT showed no recurrence in the pelvis or abdomen, and control tumor markers were within normal ranges. Despite the shortened chemotherapy course, she remained in good health with no documented recurrence and continued regular oncologic follow-up. The benign right-sided mature teratoma is kept separate from the malignant left ovarian diagnosis rather than treated as a second cancer.