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Updated: Apr 18, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Management of bilateral malignant ovarian germ cell tumors: a MITO-9 retrospective study
Cristina Sigismondi1, Paolo Scollo, Gabriella Ferrandina
1*Department of Gynecology, IRCCS Ospedale San Raffaele, Milan; †Department of Obstetrics and Gynecology, Cannizzaro Hospital, Catania; ‡Department of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome; §Department of Gynecology, University Campus Bio-Medico of Rome, Rome; and ∥Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico Mangiagalli Regina Elena Hospital, Milan, Italy.
Objectives:
Bilaterality is rare in malignant ovarian germ cell tumors (MOGTs). The bilateral ovarian involvement represents a critical issue when diagnosed in young women desiring to preserve fertility. The aim of this study was to evaluate clinical characteristic and management of patients bilateral MOGTs.
Methods:
Patients affected by bilateral MOGT and treated at MITO group centers were reviewed.
Results:
In 145 patients with MOGTs, 5.5% were bilateral. Three patients were affected by dysgerminoma (associated with bilateral gonadoblastoma in 1), 2 by immature teratoma, 2 by mixed germ cell tumors, and 1 by embryonal carcinoma. International Federation of Gynecology and Obstetrics stage was 3 IB, 1 IC, 3 IIIC, and 1 IV. Three patients received radical surgery, and the patient with dysgerminoma associated with gonadoblastoma received bilateral adnexectomy. Four patients received fertility-sparing surgery; 2 patients received unilateral salpingo-oophorectomy and contralateral cystectomy; in 2 patients, the ovaries were completely transformed in neoplastic tissue; suspecting a contralateral dysgerminoma histology, a unilateral salpingo-oophorectomy and contralateral biopsy were performed, and the contralateral neoplastic ovary was left unresected. Six patients received adjuvant chemotherapy. Seven patients are disease free after a median follow-up of 54 months. The patient affected by embryonal carcinoma died of disease. Two patients resumed menstruation, and one had a pregnancy. A compromised ovarian function was found in 2 patients, and they were addressed to oocyte cryopreservation.
Conclusions:
Bilateral MOGTs have a good prognosis. In dysgerminoma histology, residual disease could be left to spare fertility. An oncological and reproductive function follow-up is recommended.
