Fertility-Sparing Surgery Shows Promising Outcomes in Rare Ovarian Immature Teratoma With Gliomatosis Peritonei

Women and girls treated for a rare ovarian tumor complicated by gliomatosis peritonei—a condition in which mature glial tissue implants on the peritoneum—appear to fare well both oncologically and reproductively, according to a single-center retrospective study published in Archives of Gynecology and Obstetrics.

Researchers reviewed the clinicopathological records of 38 patients with pure ovarian immature teratoma and gliomatosis peritonei treated at a single center between January 2000 and December 2024. The median age at diagnosis was 22.5 years, with patients ranging from 9 to 41 years old. Most disease was detected early: 25 of the 38 patients (65.8%) had stage I disease, seven (18.4%) had stage II, and six (15.8%) had stage III. Tumor grades were distributed across the spectrum, with 11 patients (28.9%) grade 1, 13 (34.2%) grade 2, and 14 (36.8%) grade 3.

Treatment was fertility-focused in the vast majority of cases. Surgeons performed fertility-sparing surgery in 35 of the 38 patients (92.1%), and 30 patients (78.9%) received postoperative adjuvant chemotherapy. Fertility-sparing surgery was used in the vast majority of these young patients, and the authors note that gliomatosis peritonei may remain clinically indolent and asymptomatic for a long period.

During a median follow-up of 88 months—ranging from 11 to 268 months—15 patients experienced recurrence. Notably, most recurrences were of mature teratoma rather than the immature tumor itself: 12 patients had mature teratoma recurrence, while only 3 had immature teratoma recurrence. All patients underwent successful salvage therapy except for one death. By the end of follow-up, 34 patients were alive without disease, three were alive with disease but without symptoms, and one patient had died of disease progression after relapse.

Reproductive outcomes were similarly encouraging. Of the 11 patients who attempted to conceive, 10 subsequently had successful pregnancies, resulting in a total of 13 live births. The authors conclude that patients with immature teratoma and gliomatosis peritonei exhibit a favorable overall prognosis, that gliomatosis peritonei may remain clinically indolent and asymptomatic for a long period, and that reproductive outcomes are promising.

The findings carry important caveats. The study is retrospective, involves a single center, and includes a relatively small cohort of 38 patients collected over nearly a quarter century, so the results may not generalize to all treatment settings. The article is also an early-release, peer-reviewed accepted version that remains subject to further edits before the final version of record. Nevertheless, for a condition defined by its rarity, the long follow-up window—median nearly seven and a half years, with some patients followed more than 22 years—adds weight to the observation that long-term survival and fertility preservation can coexist in this patient population.

Subject of Research: Oncologic and fertility outcomes in patients with pure ovarian immature teratoma and gliomatosis peritonei

Article Title: Oncologic and fertility outcomes in patients with pure ovarian immature teratoma and gliomatosis peritonei: a single-center experience

Article References: Tang, P., Wang, D., Jia, C., Wei, Y., Yang, J., Yang, J., Peng, P., Cao, D., Yang, J., & Xiang, Y. (2026). Oncologic and fertility outcomes in patients with pure ovarian immature teratoma and gliomatosis peritonei: a single-center experience. Archives of Gynecology and Obstetrics. https://doi.org/10.1007/s00404-026-08597-8

Image Credits: AI Generated

DOI: 10.1007/s00404-026-08597-8

Keywords: ovarian immature teratoma, gliomatosis peritonei, fertility-sparing surgery, gynecologic oncology, recurrence, adjuvant chemotherapy, retrospective study, reproductive outcomes, peritoneal implants, tumor grade, Oncologic, fertility