EDITORIAL COMMENT: We accepted this paper for publication as the youngest reported patient with clear‐cell carcinoma of the ovary and for the issues that arise in relation to the diagnosis and the sequelae of treatment. All cyst aspirate or tissue taken at any procedure must be submitted for cytological or histological examination and, as is evident in this case report, a specialist in gynaecological histopathology and cytology is essential for evaluation of the material. The dilemma of fertility preservation in such a young patient with Stage 1 disease has not been addressed by this paper and it is unclear whether the uterus and right ovary were removed. The classical teaching of complete pelvic clearance for disease greater than Stage la is now challenged on a number of issues. If the contralateral ovary and the uterus is retained will chemotherapy lead to infertility? If chemotherapy or surgical removal will result in infertility should the ovary be removed for cryostorage? The possibility of embryo donation or IVF with cryopreserved ovum would support the retention of the uterus in all nulliparous patients, as a major quality of life consideration. These become important issues for discussion and decision‐making by the patient and treating oncologist when dealing with potentially curable cancer in the young patient.
Summary: The risk of inadvertently treating an ovarian malignancy is always present regardless of the patient’s age, clinical history, ultrasound features, serum tumour markers, menopausal status and intraoperative findings. This risk can be minimized by paying particular attention to high‐risk characteristics in any of the above assessment criteria and by obtaining an intraoperative frozen section if there is any suspicion of malignancy. The same approach should be used whether the initial treatment is by laparotomy or laparoscopy. We present a case of clear‐cell carcinoma of the ovary in a 19‐year‐old woman where there was delay in diagnosis and treatment as a result of an incorrect initial histopathology assessment. This appears to be the youngest patient reported in the literature with a clear‐cell carcinoma of the ovary.