A 25-year-old woman undergoes left salpingo-oophorectomy for a 6 cm ovarian mass. Histopathology reveals a dysgerminoma confined to the left ovary with no capsular rupture and negative peritoneal cytology. Contralateral ovary and uterus are normal. The MOST appropriate next management step is:
- A Completion surgery (hysterectomy and right oophorectomy)
- B BEP (bleomycin, etoposide, cisplatin) chemotherapy regardless of stage
- C Surveillance only, with tumour markers (LDH, AFP, beta-hCG) ✓
- D Pelvic radiotherapy
Correct answer: C. Surveillance only, with tumour markers (LDH, AFP, beta-hCG)
Explanation
Dysgerminoma is a highly chemosensitive and radiosensitive germ cell tumour. Stage IA dysgerminoma (confined to one ovary, capsule intact) has an excellent prognosis with unilateral salpingo-oophorectomy alone, followed by surveillance. Surveillance includes serial measurement of LDH (the primary marker for dysgerminoma), beta-hCG, and AFP. BEP chemotherapy is reserved for Stage IC or higher. Fertility-sparing surgery is the standard approach in young women with Stage I disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.