Borderline epithelial tumors of the ovary

Abstract

The concept and terminology of borderline epithelial tumors of the ovary have been controversial for over a century, in spite of the acceptance of a borderline category in almost all current classifications of ovarian tumors. Typically, borderline tumors are noninvasive neoplasms that have nuclear abnormalities and mitotic activity intermediate between benign and malignant tumors of similar cell type. Borderline tumors of all surface epithelial cell types have been studied. The most common and best understood are serous borderline tumors and mucinous borderline tumors of intestinal type, which are the subject of this review. Some of the most challenging issues for serous tumors include: the criteria and clinical behavior of stromal microinvasion; the high prevalence of synchronous extraovarian disease; the classification and histopathologic features of associated peritoneal tumor implants, especially invasive implants; and, the prognostic significance of micropapillary tumors. The mucinous borderline tumors of intestinal type have a different set of considerations, including: their frequently heterogeneous composition with coexisting benign, borderline and malignant elements; the classification and significance of accompanying noninvasive carcinoma; the recognition of stromal invasion, including microinvasion and expansile invasion; and, the historically misunderstood relationship to pseudomyxoma peritonei. All of these issues are discussed in this presentation, as are the important gross and microscopic features of serous and mucinous borderline tumors and pertinent information on their treatment and prognosis. Modern Pathology (2005) 18, S33-S50.

Surface epithelial tumors of ovary - an analysis in a tertiary referral hospital

“…Borderline tumors may show peritoneal implants and lymphatic metastasis and these findings should not lead to an erroneous diagnosis of carcinoma in a morphologically borderline tumor. 14,22 Our cases however did not show any implants or metastasis.…”

“…Microscopically, cells formed 3 or less layers with or without papillae over a continuous extent of at least 5mm. 4,21,22 Out of 6 cases, 5 cases were more than 40 years age and one case was below 40 years, all were unilateral and four cases were of size more than 10cms. In our study, three cases showed endocervical type of lining epithelium ( fig.2).…”

Clinical management of borderline tumours of the ovary: results of a multicentre survey of 323 clinics in Germany

“…Especially for our assessment, this involves the often-used CT and MRI examinations. Moreover, the commonly observed tumour marker CA-125 -which is much less enhanced in BOTs than in ovarian cancers -does not suitably improve any positive or negative predictive value of the examination (Hart, 2005;Schmalfeldt and Pfisterer, 2007).…”

“…Borderline tumours of the ovary constitute 8 -10% of all ovarian tumours. Having an incidence of 1.8 -4.8 out of 100 000 women per year, they belong to the seldom 'non-benign' epithelial ovarian tumours (Hart, 2005;Tinelli et al, 2006;Wong et al, 2007). In contrast to the case of ovarian carcinomas, most of the patients are diagnosed at an early stage I (Gotlieb et al, 2005;Yokoyama et al, 2006;Cusido et al, 2007).…”

“…In contrast to the case of ovarian carcinomas, most of the patients are diagnosed at an early stage I (Gotlieb et al, 2005;Yokoyama et al, 2006;Cusido et al, 2007). Today no specific diagnostic method is able to discriminate reliably between an early carcinoma of the ovary and a borderline tumour Hart, 2005;Sehouli et al, 2005a, b;Kurman et al, 2008). For many years, BOT of the ovary was considered to be a pre-malignant disease.…”