What happened, in summary

A 31-year-old woman sought care for left lower abdominal pain and a palpable pelvic mass. Imaging showed a complex left ovarian lesion measuring almost 10 cm. A laparoscopic cystectomy was performed for what appeared to be a benign dermoid cyst, but pathology unexpectedly showed a grade 1 immature ovarian teratoma. The cyst had ruptured during surgery, and she was referred for specialist care.

She underwent fertility-sparing robotic restaging surgery. The operation removed the left ovary and fallopian tube and resected visible pelvic lesions while preserving the uterus and right ovary. Pathology found teratomatous disease in the left ovary and several pelvic biopsy sites. Her ovarian cancer was Stage I.

Her multidisciplinary team recommended 3 cycles of BEP chemotherapy, but she declined chemotherapy and chose observation. She later conceived spontaneously and had a normal vaginal delivery in March 2011. At 19 months of follow-up, she had no evidence of disease.