SUCCESSFUL LIVE BIRTH IN A CASE OF GERM CELL TUMOR OF THE OVARY, TREATED BY FERTILITY SPARING SURGERY AND ADJUVANT CHEMOTHERAPY: CASE REPORT

25 year-old female G2P1L1, with 11 weeks of pregnancy, was diagnosed with ovarian mass on antenatal ultrasound which revealed 12x 12 x9 cm (rt) sided abdominopelvic lobulated solid cystic mass with internal vascularity (Figure1,2). Differential of teratoma or dermoid was made radiologically. The tumor markers were within normal limit (CA 125: 43, AFP: 24, CEA: 0.3) except a grossly elevated b-HCG (90,876) attributed to 11 weeks of pregnancy. The patient was keen for pregnancy and fertility preservation. In view of this patient underwent unilateral salpingo-oophorectomy, with collection of peritoneal lavage and omental biopsy. On postoperative histopathology, a solid cystic tumor was identified which was 16x 11.5x 1.8 cm in size, externally bosselated and encapsulated. On microscopy diagnosis of immature teratoma, Grade 2, was made, the capsule was intact, right fallopian tube and omentum was free of tumor. Peritoneal cytology was negative for malignant cells.