Ovarian Dysgerminoma Complicating Pregnancy: A Case Report and Review of Management Strategies

Abstract

Abstract Background: Ovarian dysgerminoma is a rare germ cell tumor that is uniquely challenging to diagnoseduring pregnancy. This case report illustrates the complexity of managing such a condition in a pregnant patient, with a focus on clinical presentation, diagnostic workup, therapeutic options, and patient outcomes. Case Presentation: A 25-year-old woman, G6P4+1, presented with an 8-month history of amenorrhea and a 2-month history of progressively worsening lower abdominal pain, urine retention, and abdominal distension at 35 weeks of gestation. Upon examination, she was found to have an ovarian mass extending to the cervix. After a multidisciplinary discussion, a lower segment cesarean section was performed to deliver a live female infant, after which the ovarian mass was resected, which was later confirmed to be dysgerminoma with a yolk sac tumor. Diagnosis was established using ultrasound and supported by laboratory findings. The patient underwent surgery due to worsening symptoms, reflecting the urgent need for intervention. Postoperative management was complicated by the patient's refusal to continue with recommended chemotherapy. The patient initially recovered but later developed sudden abdominal distension and sought medical care at a rural facility. Despite the initial treatment, she experienced complications and tragically she passed away. Conclusion: This case study underscores the importance of a thorough diagnostic approach, timely intervention, and the need for adherence to postoperative chemotherapy in the management of ovarian dysgerminoma during pregnancy. The findings also highlight the necessity of patient education and the potential impact of patient autonomy on treatment outcomes.