Given that dysgerminomas occur in young patients in whom the preservation of fertility is important, the treatment usually consists of conservative surgery (unilateral oophorectomy) followed by close follow-up. If the contralateral ovary is grossly normal, it is not biopsied so as not to increase the risk of infertility. For recurrent or metastatic tumors, cisplatin-based chemotherapy is recommended. Dysgerminomas are highly sensitive to radiation; however, there has been move away from radiotherapy lately in an effort to preserve fertility. Patients who develop dysgerminoma in the setting of gonadal dysgenesis and a Y chromosome should undergo bilateral oophorectomy. In an older patient where fertility is not a factor, the treatment consists of hysterectomy with bilateral salpingo-oophorectomy. This is followed by cisplatin-based chemotherapy for high stage tumors. The image shows a focus of necrosis in a dysgerminoma.