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Ovarian tumors of low malignant potential

INTRODUCTION

Tumors of low malignant potential (also called borderline tumors) are a heterogeneous group of lesions defined histologically by atypical epithelial proliferation without stromal invasion [1].

INCIDENCE AND EPIDEMIOLOGY

Borderline tumors account for 10 to 20 percent of ovarian epithelial tumors [2,3]. Approximately 4,000 cases of borderline or low malignant potential ovarian tumors are diagnosed annually in the United States. The average age at diagnosis is 40 to 60 years old, but the highest frequency relative to invasive ovarian cancer of these tumors occurs in the 15 to 29 year-old age group. Thus, the disease frequently affects women with a desire to preserve childbearing potential.

Although BRCA gene mutations are associated with an increased risk of developing invasive ovarian cancer, these mutations do not appear to confer an increased risk for tumors of low malignant potential [4-6]. Oral contraceptive use does not appear to be protective; however, increasing parity and lactation appear to reduce the risk of borderline ovarian tumors in women aged 50 to 74 years [7]. (See "Epithelial ovarian cancer: Pathogenesis, epidemiology, and risk factors".)

Use of fertility drugs was a risk factor for development of borderline ovarian tumors in some studies [8-10]; however, other studies have not shown this association.

HISTOLOGIC TYPES

These tumors probably represent a variety of histologies with different molecular biology, prognosis, and response to therapy [11]. There is no consensus on how to best categorize them. Common nomenclature is described below:
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