Reproduction-preserving technique for benign cystic teratoma of the ovary

Abstract

The accepted surgical treatment of unilateral large ovarian cystic teratoma has been oophorectomy, since there seems to be no apparent residual ovarian tissue to salvage or reconstruct. However, there is no guarantee that the other ovary will remain healthy. Therefore, we attempted to preserve the ovarian tissue and reproductive potential in a reproduction-preserving technique (cystectomy) performed in seven patients whose ages ranged from 2 to 14 years. A circumferential incision was made several centimeters from the hilum; the cyst was then removed from the hilar attachment and the capsule was repaired with absorbable sutures. The weight of the resected cysts ranged from 120 to 800 g. The time required for this operation was twice that of simple oophorectomy. Although the preserved hilum did not appear to contain recognizable ovarian tissue, normal oocytes were found in biopsied specimens taken from the thin hilar attachment. Ultrasonography performed 1 year after the operation revealed a normal, round-shaped ovary. For benign cystic teratoma of the ovary, cystectomy with preservation of the hilar structure should be tried.