Epithelial borderline ovarian tumor: Diagnosis and treatment strategy

Abstract

Epithelial borderline ovarian tumors (BOT) are distinctive from benign tumors and carcinoma. They occur in younger women more often than carcinoma, and there is some difficulty making correct diagnosis of BOT. Two subtypes of BOT, serous and mucinous borderline tumor have different characteristics and very different clinical behavior. Serous borderline tumor (SBT) with micropapillary pattern shows more incidence of extra ovarian disease and often coexists with invasive implant. SBT with micropapillary pattern in advanced stage has showed a worse prognosis than typical SBT. Huge mucinous borderline tumors have histologic heterogeneity, and the accuracy of frozen section diagnosis is relatively low. Extensive sampling is required to reach a correct pathological diagnosis. Mucinous adenoma (intestinal type) also runs the risk of recurrence after cystectomy, or intraoperative rupture of cyst. Laparoscopic procedure for BOT has not increased the risk of recurrence. Fertility preserving procedures are generally accepted, except in advanced stage SBT with invasive implants. Only cystectomy shows a significant risk of recurrence. Re-staging surgery and full staging surgery is not necessary for all BOT. We should not attempt to treat them uniformly, by the single diagnosis of "borderline tumor". It depends on histologic type. Close communication with the pathologist is necessary to gain more detail and ask more pathological samples in order to make the optimal treatment strategy for each individual patients.

Recurrence rate and associated factors of borderline ovarian tumors in the south of Vietnam

“…Nevertheless, when we particularly examined whether the surgical type was cystectomy or not (Model B), cystectomy increased the risk of recurrence. This finding is consistent with results from a multi‐center study, systematic reviews and meta‐analysis which showed that cystectomy was a significant risk factor for BOT recurrence …”

Mucinous borderline ovarian tumors with and without Intraepithelial Carcinoma: Differences in clinicopathologic features and fertility results

“…IECA is thought to be the further deterioration of MBOTs and precancerous lesions of ovarian cancer. MBOTs, IECA, microinvasive carcinoma, and invasive mucinous carcinoma are thought to be a continuous process . The overall prognosis of patients with MBOTs is excellent.…”

“…MBOTs, IECA, microinvasive carcinoma, and invasive mucinous carcinoma are thought to be a continuous process. 3,4 The overall prognosis of patients with MBOTs is excellent. It was reported that the 5-year survival rate of MBOTs was up to 90% or even higher.…”

Borderline tumors of the ovary: A clinicopathological study

“…Histopathologically, this group of neoplasms exhibit behaviour that is intermediate between benign cyst-adenomas and invasive carcinomas. Two subtypes of BOTs, serous and mucinous borderline tumors are more common and have different characteristics as well as different clinical behaviour 8,9. Rarely other types like endometroid, clear-cell or transitional cell (Brenner) borderline tumors are also present 10…”