A 30-year-old woman has a right ovarian cyst with ultrasound features of dermoid (echogenic focus, posterior shadowing). CA-125 is normal. At laparoscopy, the contralateral ovary appears normal. The most appropriate surgical management is:

• A Right oophorectomy
• B Right salpingo-oophorectomy
• C Total abdominal hysterectomy with bilateral salpingo-oophorectomy
• D Right ovarian cystectomy ✓

Explanation

In a young woman of reproductive age with a benign-appearing dermoid cyst (mature cystic teratoma), ovarian cystectomy (removal of the cyst with preservation of the remaining ovarian tissue) is preferred to preserve fertility and ovarian function. Oophorectomy would sacrifice the entire ovary unnecessarily. TAHBSO is inappropriate for a presumed benign lesion in a young woman.

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

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Written and medically reviewed by the StethoPrep medical team.