Differentiated Surgical Approach With Oophorectomy and Ovarian Cystectomy for Fertility Preservation in a Young Patient With Bilateral Ovarian Teratomas: A Case Report

Mature cystic teratomas are the most common benign ovarian germ cell tumors in women of reproductive age.Bilateral involvement is uncommon and presents a surgical challenge when preservation of ovarian function is desired.We report a case of bilateral ovarian mature teratomas managed with a differentiated surgical approach.A 28-year-old nulliparous woman presented with acute right iliac fossa pain and nausea.Contrast-enhanced computed tomography revealed a heterogeneous right ovarian mass measuring 11.2 × 16.5 × 17.5 cm, containing calcifications and fatty components, associated with bilateral pelvicalyceal dilatation secondary to extrinsic compression.Exploratory laparotomy identified a 15-cm mixed solid and cystic right ovarian mass and a 6-cm mixed lesion in the left ovary.Given the differences in tumor size and ovarian parenchymal involvement, right oophorectomy and left oophoroplasty were performed.The postoperative course was uneventful, and histopathological examination confirmed bilateral mature ovarian teratomas.Individualized surgical management based on tumor characteristics may allow complete treatment while preserving functional ovarian tissue in selected young patients with bilateral ovarian teratomas.Long-term surveillance of the preserved ovary remains essential.