And Staging considerations

When an adnexal mass is found to be a mature cystic teratoma, areas of squamous differentiation and small nodules in the wall of the cyst should be evaluated specifically for the presence of malignant elements. If present, the tumor should be treated as a malignant GCT and complete surgical staging attempted. Likewise, if immature elements, typically neural elements, are identified, the tumor is classified and treated as a malignant GCT. If, however, no malignant elements are identified, the neoplasm is benign and can be treated with an ovarian cystectomy alone. The contralateral ovary should be evaluated, as 12% of cases are bilateral. A contralateral cystectomy should be performed in this case, with preservation of as much normal ovarian tissue as possible [44, 45].

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