Management of bilateral malignant ovarian germ cell tumors: A MITO-9 retrospective study

Cristina Sigismondi, Paolo Scollo, Gabriella Ferrandina, Massimo Candiani, Roberto Angioli, Riccardo Viganò, Giovanna Scarfone, Giorgia Mangili

Research output: Contribution to journalArticle

Abstract

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 bilateralMOGTand treated atMITOgroup centerswere 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 resumedmenstruation, 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.

Original languageEnglish
Pages (from-to)203-207
Number of pages5
JournalInternational Journal of Gynecological Cancer
Volume25
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

Keywords

  • Bilaterality
  • Fertility-sparing surgery
  • Malignant ovarian germ cell tumors
  • PEB chemotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Medicine(all)

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