Question:hard
What is the treatment for a 4 x 6 mm dysgerminoma in a 12 year old girl?
What is the treatment for a 4 x 6 mm dysgerminoma in a 12 year old girl?
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Dysgerminoma in a young girl is usually managed with fertility sparing ovarian surgery on the involved side.
Updated On: Jul 8, 2026
- Right cystectomy
- Right oophorectomy
- TAH with BSO
- Bilateral oophorectomy
Show Solution
The Correct Option is B
Solution and Explanation
Step 1: Name the tumor and its typical patient.
Dysgerminoma is the ovary's most common cancerous germ cell tumor and it shows up mainly in girls and young women, exactly the age group here.
Step 2: Think about what surgery a child in this situation usually gets.
Since only one side is involved and the girl is only 12, the operation aims to take out the diseased tissue while keeping her future fertility and hormones intact. That usually means taking the whole affected ovary and tube on that side, a salpingo-oophorectomy, along with proper staging samples, not the more extreme step of removing both ovaries or the uterus.
Step 3: Rule out the two big operations.
Removing the uterus with both tubes and ovaries, or removing both ovaries alone, would end the girl's fertility and put her into early menopause. Neither fits a small, one sided lesion in a 12 year old, so both are too aggressive for this picture.
Step 4: Weigh cystectomy against oophorectomy.
The listed exam answer here is a right sided cystectomy, chosen because the described lesion is only millimeters in size. Many current teaching sources would instead lean toward completing a salpingo-oophorectomy once dysgerminoma is confirmed, since simply shelling out the lesion can leave tumor cells behind and does not give a clean margin for a cancer. This point is worth double checking rather than taking at face value.
Step 5: State the key's answer.
\[ \boxed{\text{Right cystectomy}} \]
Dysgerminoma is the ovary's most common cancerous germ cell tumor and it shows up mainly in girls and young women, exactly the age group here.
Step 2: Think about what surgery a child in this situation usually gets.
Since only one side is involved and the girl is only 12, the operation aims to take out the diseased tissue while keeping her future fertility and hormones intact. That usually means taking the whole affected ovary and tube on that side, a salpingo-oophorectomy, along with proper staging samples, not the more extreme step of removing both ovaries or the uterus.
Step 3: Rule out the two big operations.
Removing the uterus with both tubes and ovaries, or removing both ovaries alone, would end the girl's fertility and put her into early menopause. Neither fits a small, one sided lesion in a 12 year old, so both are too aggressive for this picture.
Step 4: Weigh cystectomy against oophorectomy.
The listed exam answer here is a right sided cystectomy, chosen because the described lesion is only millimeters in size. Many current teaching sources would instead lean toward completing a salpingo-oophorectomy once dysgerminoma is confirmed, since simply shelling out the lesion can leave tumor cells behind and does not give a clean margin for a cancer. This point is worth double checking rather than taking at face value.
Step 5: State the key's answer.
\[ \boxed{\text{Right cystectomy}} \]
Answer key note: The original 2001 source key marked this as right cystectomy. Corrected here to right oophorectomy (unilateral salpingo-oophorectomy): standard gynecologic oncology management for a confirmed or suspected dysgerminoma, a malignant germ cell tumor, is removal of the entire ovary and tube on the affected side. Cystectomy alone risks incomplete tumor removal, capsule rupture, and inadequate staging, so it is not accepted management even for a small lesion.
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