Clinical analysis of borderline ovarian tumors

Purpose: The goal of this study was to evaluate the incidence and clinical features of borderline ovarian tumors (BOTS). Methods: We retrospectively performed chart reviews of 22 patients with BOTS who were diagnosed and treated in the university medical center from 1998 to 2009 inclusively. Results: BOTS among ovarian pathology in our hospital were detected in 22 patients (1.79%). The mean age was 50 years, range (20-90). Post surgical FIGO staging was Stage I = 86.4%, and Stage II = 13.6%. The most common histologic subtype was mucinous (59%). Five patients (22.7%) had a unilocular cyst at ultrasonography. Conservative surgery was performed in 31.8%. One patient of them had normal spontaneous delivery after term pregnancy. Two patients had a recurrence. One patient with recurrent disease underwent transformation to invasive cancer and died 35 months after the initial diagnosis. Conclusion: Clinicians should warn patients about the early relapse of BOTS and these patients may need careful follow-up due to the possibility of recurrences.

Borderline ovarian tumors; Conservative surgery; Recurrence

[1] Trope C.G., Kristensen G., Makar A.: “Surgery for borderline tumor of the ovary”. Sem. Surg. Oncol., 2000, 19, 69.

[2] David M.G.: “Clinical management potential tumours of low malignancy”. Best Prac. Res. Clin. Obstet. Gynaecol., 2002, 16, 513.

[3] Bell D.A., Longacre T.A., Prat J., Kohn E.C., Soslow R.A., Ellenson L.H. et al.: “Serous borderline (low malignant potensial, atypical proliferative) ovarian tumors: workshop perspectives”. Hum. Pathol., 2004, 35, 934.

[4] Skırnisdottir I., Garmo H., Wilander E., Holmberg L.: “Borderline ovarian tumors in Sweden 1960-2005: Trends in incidence and age at diagnosis compared to ovarian cancer”. Int. J. Cancer, 2008, 123, 1897.

[5] Denkert C., Dietel M.: “Borderline tumors of the ovary and peritoneal implants”. Verh. Dtsch. Ges. Path., 2005, 89, 84.

[6] Buttin B.M., Herzog T.J., Powell M.A., Radar J.S., Mutch D.G.: “Epithelial ovarian tumors of low malignant potential: The role of microinvasion”. Obstet. Gynecol., 2002, 99, 11.

[7] Mirjam J.E., Henk W.B., Harrie H., Klaske H., Pax H.W., Jan G.A. et al.: “Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors”. Gynecol. Oncol., 2000, 78, 16.

[8] Behtash N., Modares M., Abolhasani M., Ghaemmaghami F., Mousavi M., Yarandi F., Hanjani P.: “Borderline ovarian tumours: clinical analysis of 38 cases”. J. Obstet. Gynaecol., 2004, 24, 157

[9] Chang S.J., Ryu H.S., Chang K.H., Yoo S.C., Yoon J.H.: “Prognostic significance of the micropapillary pattern in patients with serous borderline ovarian tumors”. Acta Obstet. Gynecol., 2008, 87, 476.

[10] Shin H.R., Ahn Y.O., Bae K.M., Shin M.H., Lee D.H., Lee C.W. et al.: “Cancer incidence in Korea”. Cancer Res. Treat., 2002, 34, 405.

[11] Chang S.J., Ji Y.I., Kim D.Y., Suh D.S., Kim J.H., Kim Y.M. et al.: “Clinical significance of surgical staging and lymphadenectomy in patients with borderline ovarian tumors”. Korean J. Gynecol. Oncol., 2006, 17, 68.

[12] Nomura K., Aizawa S.: “Noninvasive, microinvasive, and invasive mucinous carcinomas of the ovary”. Cancer, 2000, 89, 1541.

[13] Lee K.R., Scully R.E.: “Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with ‘pseudomyxoma peritonei’”. Am. J. Surg. Pathol., 2000, 24, 1447.

[14] Morris R.T., Gershenson D.M., Silva E.G., Follen M., Morris M., Wharton J.T.: “Outcome and reproductive function after conservative surgery for borderline ovarian tumors”. Obstet. Gynecol., 2000, 95, 541.

[15] Exacoustos C., Romanini M.E., Rinaldo D., Amoroso C., Szabolcs B., Zupi E. et al.: “Preoperative sonographic features of borderline ovarian”. Tumors Ultrasound Obstet. Gynecol., 2005, 25, 50.

[16] Gotlieb W.H., Soriano D., Achiron R., Zalel Y., Davidson B., Kopolovic J., Novikov I., Ben-Baruch G.: “CA 125 measurement and ultrasonography in borderline tumors of the ovary”. Am. J. Obstet. Gynecol., 2000, 183, 541.

[17] Pascual M.A., Tresserra F., Grases P.J., Labastida R., Dexeus S.: “Borderline cystic tumors of the ovary: grey-scale and color Doppler sonographic findings”. J. Clin. Ultrasound, 2002, 30, 76.

[18] Fumitaka K., Akihiro N., Hiroaki K., Kiyosumi S., Kazuhiko I., Seiji N.: “Clinical characteristics and prognosis of mucinous tumors of the ovary”. Gynecol. Oncol., 2006, 103, 171.

[19] Ingrid M.R., Jaime P.: “Mucinous tumors of the ovary a clinicopathologic analysis of 75 borderline tumors (of intestinaltype) and carcinomas”. Am. J. Surg. Pathol., 2002, 26, 139.