ArticleFrontiers in oncology2026
Endometriotic cyst mimicking recurrence after treatment for ovarian immature teratoma: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Endometriosis is common in reproductive-age women, but the development of an endometriotic cyst that mimics tumor recurrence during follow-up after treatment for ovarian immature teratoma poses a significant diagnostic challenge, particularly for young patients requiring fertility preservation. Case presentation: A 23-year-old woman with a history of two fertility-sparing surgeries and BEP (bleomycin, etoposide, cisplatin) chemotherapy for ovarian immature teratoma was followed up. Pelvic MRI revealed a 5.7×4.5cm left adnexal multicystic lesion, suggestive of hemorrhagic content, and without restricted diffusion. Tumor markers (CA125, CA199, AFP, CEA) remained within normal limits. Although a clinical diagnosis of endometriotic cyst was considered, the possibility of recurrence could not be completely ruled out. Given the high risk of irreversible ovarian damage from a third surgery and the patient's refusal of needle biopsy, a trial of gonadotropin-releasing hormone agonist (GnRH-a) therapy was initiated. After three cycles, the mass markedly decreased to 1.4 × 0.9 cm. Maintenance dienogest was subsequently given. At one-year follow-up, there was no evidence of disease progression; the patient maintained regular menstrual cycles and ovarian reserve was preserved (anti-Müllerian hormone (AMH) >2ng/mL), supporting a clinical diagnosis consistent with an endometriotic cyst. Conclusion: This case suggests that, in carefully selected patients with reassuring clinical, imaging, and laboratory findings and under close oncologic surveillance, a therapeutic trial of hormonal therapy may serve as an alternative to immediate surgical exploration for a newly developed adnexal mass after treatment for malignant ovarian tumors, especially when fertility preservation is a priority.
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