Borderline ovarian tumors
- Lee-may Chen, MD
Lee-may Chen, MD
- Professor of Obstetrics, Gynecology, & Reproductive Sciences
- Division of Gynecologic Oncology
- UCSF Helen Diller Family Comprehensive Cancer Center
- Jonathan S Berek, MD, MMS
Jonathan S Berek, MD, MMS
- Laurie Kraus Lacob Professor
- Director, Stanford Women's Cancer Center
- Stanford Comprehensive Cancer Institute
- Chair, Department of Obstetrics & Gynecology
- Stanford University School of Medicine
- Section Editors
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Professor of Gynecologic Oncology
- University of Washington
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Clinical Co-Director, Gynecologic Oncology
- Founder and Director, The Oncology Sexual Health Clinic
- Massachusetts General Hospital Cancer Center
- Associate Professor of Medicine
- Harvard Medical School
- Deputy Editors
- Sandy J Falk, MD, FACOG
Sandy J Falk, MD, FACOG
- Senior Deputy Editor — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Clinical Instructor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- Sadhna R Vora, MD
Sadhna R Vora, MD
- Deputy Editor — Oncology
- Instructor in Medicine
- Harvard Medical School
Borderline tumors of the ovary (also called tumors of low-malignant potential) are a heterogeneous group of lesions defined histologically by atypical epithelial proliferation without stromal invasion . The behavior of these tumors is distinct from low-grade ovarian carcinoma and they are considered a distinct clinical entity.
The epidemiology, diagnosis, and treatment of borderline ovarian tumors are reviewed here. Ovarian cancer is discussed separately. (See "Overview of epithelial carcinoma of the ovary, fallopian tube, and peritoneum" and "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Epidemiology and risk factors" and "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Clinical features and diagnosis" and "Cancer of the ovary, fallopian tube, and peritoneum: Staging and initial surgical management" and "First-line chemotherapy for advanced (stage III or IV) epithelial ovarian, fallopian tubal, and peritoneal cancer".)
Borderline ovarian epithelial neoplasms are non-invasive neoplasms that occasionally have intraperitoneal spread . This group of neoplasms exhibit behavior that is intermediate between benign cystadenomas and invasive carcinomas. These have been referred to by different terms, including: borderline, atypical proliferative, and tumors of low-malignant potential. Borderline neoplasm is currently the most widely used designation by pathologists, gynecologists, and oncologists, and has been adopted into the World Health Organization classification .
Borderline tumors account for 14 to 15 percent of all primary ovarian neoplasms .
Borderline tumors occur in a variety of histologies, as in epithelial ovarian carcinoma [5,6]. The majority of cases are serous or mucinous. Rarely, endometrioid, clear-cell, or transitional cell (Brenner) borderline tumors are found.
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- Serous borderline tumors
- Mucinous borderline tumors
- EPIDEMIOLOGY AND RISK FACTORS
- CLINICAL PRESENTATION
- DIAGNOSTIC EVALUATION
- Pelvic ultrasound
- Tumor markers
- Surgical exploration
- - Frozen section
- DIFFERENTIAL DIAGNOSIS
- STAGING AND SURGICAL TREATMENT
- Complete staging versus conservative surgery
- - Desire fertility preservation
- Bilateral tumors
- - Advanced disease
- - Do not desire fertility preservation
- Laparotomy versus laparoscopy
- Posttreatment surveillance
- Future pregnancy
- Hormone therapy
- MANAGEMENT OF RECURRENCE
- SUMMARY AND RECOMMENDATIONS