Ovarian Germ Cell Tumor · Fertility-Sparing Surgery + Chemotherapy

Step-by-step decision

Choose step by step as prompted; reaching an endpoint gives the management recommendation. You can go back a step or restart anytime.

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Full pathway

1. [Decision] Benign vs malignant + fertility
   Benign teratoma or malignant germ cell tumor? Fertility-sparing?
   • Mature teratoma (dermoid cyst, benign) → Mature teratoma → laparoscopic cystectomy
   • Malignant germ cell tumor (dysgerminoma/yolk sac/immature teratoma), wants fertility preservation → Malignant, young → fertility-sparing surgery + BEP
   • Completed childbearing/advanced → Completed childbearing/advanced → debulking + chemotherapy
2. [End] Mature teratoma → laparoscopic cystectomy
   Mature teratoma (dermoid cyst) → laparoscopic cystectomy (preserve the ovary), avoid spilling contents (chemical peritonitis); bilateral can be enucleated separately.
3. [End] Malignant, young → fertility-sparing surgery + BEP
   Malignant germ cell tumor, young → fertility-sparing surgery (ipsilateral adnexectomy + staging, preserve uterus and contralateral side) + postoperative BEP chemotherapy; highly chemosensitive, usually curable with preserved fertility.
4. [End] Completed childbearing/advanced → debulking + chemotherapy
   Completed childbearing/advanced → debulking + staging + chemotherapy (BEP); stage IA dysgerminoma and stage I grade 1 immature teratoma may be observed.

Source guidelines & references

• Malignant ovarian germ cell tumors (NCCN/ESGO; fertility preservation + BEP)

This pathway is our own synthesis of the decision logic in the guidelines above (not the guideline verbatim); thresholds and workflows change as guidelines update — in practice follow the latest guideline, your institution's protocol and the individual patient.

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