A 32-year-old woman with borderline serous ovarian tumor (Stage IA) desires future fertility. What is the appropriate surgical management?

• A Bilateral salpingo-oophorectomy with total hysterectomy and omentectomy
• B Observation alone with serial CA-125 monitoring
• C Cystectomy alone to preserve the ovary
• D Unilateral salpingo-oophorectomy with comprehensive staging (washings, omentectomy, biopsies) ✓

Explanation

For Stage IA borderline serous ovarian tumor in a woman desiring fertility, fertility-sparing surgery is appropriate: unilateral salpingo-oophorectomy (rather than simple cystectomy, which has higher recurrence) combined with comprehensive surgical staging including peritoneal washings, omentectomy, and peritoneal biopsies. The contralateral ovary and uterus are preserved. Adjuvant chemotherapy is not indicated for borderline tumors.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.