Design: Case study

Setting: Patient was placed in dorsal lithotomy position with OR setup for standard gynecologic laparoscopy

Patients or Participants: A 28 year old was referred for possible fertility sparing surgical management of multiple dermoid cysts bilaterally after multiple recommendations from other providers for bilateral oophorectomy.

Interventions: Laparoscopic bilateral ovarian cystectomy with mini-laparotomy creation for specimen removal

Measurements and Main Results: The patient underwent surgery with 7.8x5.3x5.2cm in composite of dermoid cyst removal. 6 months after surgery, her ovaries were found to measure 2.9x1.7x2.4cm on the right side and 3.4x1.7x2cm on the left side, which approximates normal ovarian size despite prior concern for no existing ovarian tissue.

Conclusion: Despite concern on initial imaging that the patient’s large dermoid cyst burden would result in minimal functional residual ovarian tissue, the patient did well with preservation of ovarian function with regular cycles. Presurgical imaging is not a good measure of residual ovarian volume following surgery and attempts should be made to always perform ovarian sparing surgery on young premenopausal patients.