Theres a Hair in my Egg: Exploring the Possibility of Fertility after Dramatic Bilateral Mature Cystic Teratoma Cystectomy

Abstract

Mature cystic teratomas (MCTs) are the most common benign germ cell neoplasm in reproductive aged females that contributes to 40-50% of all benign ovarian neoplasms overall. MTCs often grow in multiples within an ovary, and 15% of cases grow within both ovaries, and can become severely large causing mass effects within the pelvis, as well as essentially replacing the functional ovarian parenchyma. Because the majority of women with mature cystic teratomas are of childbearing age, cystectomy is preferred over oophorectomy for the preservation of fertility. Techniques during cystectomy have been shown to play a role in ovarian reserve, and spillage of cystic contents has been linked to adhesion formation. However, as per Mecke et al. it is unlikely that those who experienced spilling of cystic contents to acquire serious complications. Thus, patients who undergo cystectomy due to MTCs can go on to have successful pregnancies. Our case follows a 22 year old G0 female referred to the gynecologic-oncology clinic for bilateral pelvic masses discovered via transvaginal ultrasound, with subsequent removal, and confirmation from pathology of several MCTs.