Gynaecological oncology: immature teratoma: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: immature teratoma

Sample item

A 14-year-old girl has a 20 cm solid-cystic ovarian mass. Histology after unilateral oophorectomy shows immature neural tissue graded as grade 3, and the tumour extends to the peritoneum. What is the next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Complete surgical staging and adjuvant BEP chemotherapy, preserving the uterus and contralateral ovary

Immature teratoma is a malignant germ cell tumour of young women, graded by the amount of immature neuroepithelium. Stage IA grade 1 disease needs surgery alone, while higher grade or stage disease is treated with BEP chemotherapy (bleomycin, etoposide, cisplatin). Fertility-sparing unilateral surgery is standard because of high chemosensitivity.

Option by option

  • A. Bilateral oophorectomy and hysterectomy

    Radical surgery is unnecessary in these chemosensitive tumours.

  • B. Observation only

    Observation is only for stage IA grade 1.

  • C. Complete surgical staging and adjuvant BEP chemotherapy, preserving the uterus and contralateral ovary (correct)

    Correct. Higher stage or grade needs chemotherapy with fertility-sparing surgery.

  • D. Radiotherapy alone

    Radiotherapy is not the standard treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Complete surgical staging and adjuvant BEP chemotherapy, preserving the uterus and contralateral ovary. Immature teratoma is a malignant germ cell tumour of young women, graded by the amount of immature neuroepithelium.

Why is "Bilateral oophorectomy and hysterectomy" not the answer?

Radical surgery is unnecessary in these chemosensitive tumours.

Why is "Observation only" not the answer?

Observation is only for stage IA grade 1.

Why is "Radiotherapy alone" not the answer?

Radiotherapy is not the standard treatment.

What concept does this question test?

It tests Gynaecological oncology: immature teratoma in OBG. Stage IA grade 1 disease needs surgery alone, while higher grade or stage disease is treated with BEP chemotherapy (bleomycin, etoposide, cisplatin). Fertility-sparing unilateral surgery is standard because of high chemosensitivity.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: immature teratoma?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.