Successful pregnancy outcome in a woman with malignant bilateral ovarian germ cell tumor

Abstract

Malignant ovarian germ cell tumors (MOGCT) are rare, accounting for 5% of all ovarian malignancies. In the first two decades of life, almost 70% of ovarian tumors are germ cell tumors and of these one-third are malignant. Bilateral involvement in MOGCT is very rare. This case presented a unique challenge of fertility-sparing surgery in the case of MOGCT. Although fertility-sparing surgery is recommended even in advanced stages if fertility is desired, the bilaterality of disease precluded the option in the index case. Neoadjuvant chemotherapy has been attempted in patients with malignant ovarian germ cell tumors with extensive intra-abdominal disease. Current chemotherapy for GCT has more than 80% chances of menstruation, more than 70% pregnancy rates with no increase in risk of teratogenicity, and less than 10% risk of premature ovarian failure. In our case not only the patient had a successful debulking surgery post NACT without any signs of recurrence, but also had a spontaneous conception with a successful pregnancy outcome with no complications pertaining to prior treatment given.