Successful delivery after fertility-sparing management for uterine immature teratoma : a case report and literature review

Uterine immature teratoma is an extremely rare neoplasm. No cases of successful pregnancy and delivery following fertility-sparing management have been reported in the literature. From September 2020 to January 2026, we identified a 36-year-old nulliparous woman diagnosed with uterine immature teratoma, who achieved successful pregnancy and delivery following standardized fertility-sparing management. The patient presented with a four‑month history of abnormal vaginal bleeding. Pelvic contrast‑enhanced magnetic resonance imaging (MRI) revealed a 9.5 cm × 8.5 cm × 7.5 cm mixed cystic‑solid mass in the lower middle uterine cavity. Tumor marker levels were all within normal limits. The patient underwent two surgical procedures. The first was an incomplete tumor resection; histopathological examination confirmed a grade 2 uterine immature teratoma. The second procedure achieved complete tumor resection, and pathological examination of the resected specimen showed a mature teratoma. Postoperatively, the patient received four cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy. One and a half years later, she delivered successfully and has remained recurrence‑free during five years of follow‑up. This case highlights the diagnostic and therapeutic challenges of uterine immature teratoma. For patients desiring fertility preservation, a fertility-sparing approach may be considered when the disease is confined to the endometrium, in the absence of other malignant components, with grade 1–2 histology, and provided that there is a favorable response to chemotherapy.