A Case of Many Ovarian Cystectomies

EDITORIAL COMMENT: This comment was prepared to discuss the question of whether or not a macroscopically normal ovary should be sectioned for evidence of bilaterality when the opposite ovary is found to contain a cystic teratoma. This practice is often mentioned but, in the experience of the editorial committee, seldom performed. Wedge resection of a normal ovary can result in adhesions and impairment of fertility. Readers are referred to a series of clinicopathological evaluation of286 cases of ovarian teratomas in Turkey (A). In this series bilaterality of the tumour was present in 65.9% (29 of 44) of women with bilateral adnexal masses but only in 1.1% (2 of 182) of women who had a unilateral mass and who had histological examination of a wedge resection from the macroscopically uninvolved ovary. The authors concluded that ‘as the risk of bilaterality of the tumour in the normal‐appearing contralateral ovary was so small, we no longer perform the routine ovarian wedge biopsy in patients with mature ovarian teratoma, in order not to decrease the fertility potential of the patient’. Readers can decide whether the case presented here is an exception to this rule! (A). Ayhan A, Aksu T, Develioglu O, Tuncer S, Ayhan A. Complications and Bilaterality of Mature Ovarian Teratomas. Aust NZ J Obstet Gynaecol 1991; 31: 83–85. Summary: Over a period of 6 years a young patient had 3 laparotomies resulting in the removal of 5 benign ovarian dermoid cysts and 1 ovarian mucinous cystadenoma. The occurrence of 3 dermoid cysts at I procedure and the recurrence of bilateral dermoid cysts raises questions regarding the histogenesis of these tumours. The subsequent occurrence of a mucinous cystadenoma confirms the known relationship between these benign ovarian neoplasms.