We conducted a systematic evaluation of the macroscopic and microscopic tumor spreads in. Nccn offers guidelines for borderline ovarian cancer. Borderline ovarian tumors occur during third to fourth decades of womens lives and are diagnosed as being limited to one ovary in 80% of cases. Icd10 for mucinous borderline ovarian tumor tci forum. Borderline ovarian tumours are abnormal cells that form in the tissue covering the ovary. The term seromucinous has a confusing name, but merely refers to a tumor of mixed epithelial types i. Borderline ovarian tumors bots are rare entities with excellent prognosis depending on tumor stage and presence of invasive implants. Borderline ovarian tumors are lesions with certain abnormalities, shaped within the tissue covering the ovary. Approximately 924% of cases of epithelial ovarian cancer 25 and approxi mately 4. But the instruction in icd10 seems clear from both the index and guidelines perspective.
Im healing okay, got my staples out yesterday, where they told me my diagnosis. Ovarian low malignant potential tumors treatment pdq. Serous and mucinous borderline ovarian tumors are the two most common types, while endometrioid, brenner, and clear cell borderline ovarian tumors are much less common. Management of borderline ovarian tumours brafkras pathway. When disease is found in one ovary, the other ovary should also be checked carefully for signs of disease. Management and prognosis of clear cell borderline ovarian. To date, only one randomized trial, including 32 women with bilateral borderline ovarian tumors mainly sbots, has been published and demonstrated that the use of bilateral ovarian cystectomy boc compared with unilateral adnexectomy plus contralateral cystectomy uac significantly improved reproductive effectiveness without increasing the. Others believe that smoking can predispose a woman toward this type of ovarian tumor. The lack of consensus around best practices for management of borderline ovarian tumors bot is, in part, to the lack of available data and of clarity in interpreting relationships among various factors that impact outcomes.
Causespecific survival was defined the time interval between the date of borderline ovarian tumor diagnosis and the date of death due to borderline ovarian tumor. The role of imaging in evaluation of ovarian cancer and the ct technique and diagnostic pitfalls are then discussed. Standard management is similar to that of invasive ovarian cancer. Borderline ovarian tumors are in the middle, with some clinical and microscopic characteristics appearing like a carcinoma more aggressive than a benign cyst, but with no evidence of invasive cancer. Role of hysterectomy and lymphadenectomy in the management. Ovarian low malignant potential tumors have abnormal cells that may become cancer, but usually do not. In contrast to the decrease in lgsoc, there has been a concurrent increase in the number of serousbot cases in the past few decades 8, 9. If the surgical codes did not include hysterectomy, the cases were considered as no hysterectomy performed. The addition of a guideline for the cancer that appears to have little risk of lethal consequenceunlike the tumors epithelial counterparthighlighted the work of the ovarian cancer panel, headed by robert morgan jr. The histology of bot was defined by the world health organization as that exhibiting atypical epithelial proliferation. Recurrence and prognostic factors in borderline ovarian tumors. Unlike the invasive carcinomas, borderline ovarian tumors are characterized by cytoplasmic and nuclear atypia, element of differential diagnosis with benign. Or if papillary structures exist inside a tumor, does that automatically make them borderline.
Management of borderline ovarian tumors annals of oncology. Current update on borderline ovarian neoplasms ajr. Epithelialstromal tumors are classified on the basis of the epithelial cell type, the relative amounts of epithelium and stroma, the presence of papillary processes, and the location of the epithelial elements. Preoperative sonographic features of borderline ovarian tumors. Most tumors are either serous or mucinous in histology and. They are not cancerous and are treated by surgery which is usually a complete cure. I was told that if we want to have kids, we need to do so right away, after i have healed from surgery. Borderline ovarian tumors are relatively uncommon with an incidence of 1. This report describes a case of a typical serous borderline tumor of the ovary in a 6yearold pointer dog. This will also be done at 6 monthly intervals for 3 years and annually years 4 and 5. Fewer than 25 cases have been reported in the literature including details on clinical management and outcomes. Ovarian low malignant potential tumors treatment includes surgery only for early stage and surgery with chemotherapy for advanced stage disease. Symptoms were obtained using a standardized inperson interview. The world health organization histological classification for ovarian tumors separates ovarian neoplasms according to the most probable tissue of origin.
Borderline ovarian tumors american journal of medicine. Fertility preservation strategies in borderline ovarian. Approximately 15 in 100 cases 15% of ovarian tumours are borderline tumours. Hereditary risk evaluation for borderline ovarian tumors. Serous surface borderline tumor is another variant that. Borderline ovarian tumors comprise a unique group of noninvasive ovarian neoplasms with characteristic histology and variable tumor biology that typically manifest as lowstage disease in younger women with resultant excellent prognosis. If you have any further questions or concerns, please do not hesitate to contact a doctor or nurse caring for you. Invasive peritoneal implants in serous borderline ovarian. Pdf unilateral typical type serous borderline ovarian. They are diagnosed in younger women, at an earlier stage, and have a better prognosis than malignant ovarian tumors. A laparotomy followed by right salpingooophorectomy was performed at 14 weeks of gestation and both the frozen section and the definitive histology revealed a. Borderline ovarian tumors are usually diagnosed at an early stage. For a small number of higher risk borderline ovarian tumours follow up will include. Doctors cant be sure whether a tumor is invasive or borderline until a biopsy sample has been taken usually.
Background the clear cell borderline ovarian tumor ccbot of the ovary is a rare tumor accounting for less than 1% of bot. Borderline ovarian tumors ovarian cancer facts ovarian. Although ovarian tumors are rare in dogs, epithelial tumors are the most frequently. The gastrointestinal type of mucinous bots does not present with peritoneal implants. The recommended treatment is hysterectomy with bilateral salpingo. Mucinous borderline ovarian tumor mbot accounts for about 30% to 50% of all bots and are less likely to be bilateral 7% 10. Ovarian low malignant potential tumor is a disease in which abnormal cells form in the tissue covering the ovary. Because borderline ovarian tumors are usually selfcontained, the treatment process is fairly straightforward. Nccn clinical practice guidelines in oncology nccn. For most borderline ovarian tumours no routine follow up is required. There are limited data regarding the intraoperative tumor pattern, the actual base of optimal treatment planning. In this article, the epidemiology of ovarian cancer, classification of primary ovarian tumors, types of epithelial ovarian tumors, staging of ovarian cancer, and therapy options for ovarian cancer are described. Borderline ovarian tumor stage 3 ovarian cancer inspire. Diagnosisshift between lowgrade serous ovarian cancer.
Systematic evaluation of the intraoperative tumor pattern. Borderline ovarian tumours this leaflet will tell you what a borderline ovarian tumour is, what treatment you will receive, and what to expect after your treatment. Borderline tumors of the ovary also called tumors of lowmalignant potential are a heterogeneous group of lesions defined histologically by atypical epithelial proliferation without stromal invasion. Preoperative sonographic features of borderline ovarian tumors c. Keywords fertilitysparing surgery invasive implants laparoscopy salpingooophorectomy surgical staging tumour markers. Borderline ovarian tumors most commonly affect white women of reproductive age typically during the fourth decade. The objective of this study was to identify clinicopathological factors that impact prognosis of patients with borderline ovarian tumors. Borderline epithelial tumors are also known as atypical proliferating tumors and used to be called low malignant potential tumors. Differentiation of borderline tumors from type i ovarian. Borderline ovarian tumorstumours of low malignant potential. Cases were women, ages 2069 years, diagnosed with invasive 616 and borderline 151 epithelial ovarian tumors from 1994 to 1998. To investigate the value of ct and mr imaging features in differentiating borderline ovarian tumor bot from type i ovarian epithelial cancer oec, which could be significant for suitable clinical treatment and assessment of the prognosis of the patient.
Types and duration of symptoms prior to diagnosis of. Borderline tumors are considered to be precursors of lowgrade ovarian cancers. Nccn guidelines index ovarian cancer toc discussion continued on next page ovb 5 of 86 of 8 footnotei revised. Management of borderline ovarian tumours obstetrics and. Fertility preservation strategies in borderline ovarian tumor recurrences. A laparotomy followed by right salpingooophorectomy was performed at 14 weeks of gestation and both the frozen section and the definitive histology revealed a borderline mucinous ovarian tumor. Is it the existence of papillary structures inside the borderline tumor with the lack of such in a benign tumor. Thirtythree patients with bots and 35 patients with type i oecs proven by pathology were. Recurrence and prognostic factors in borderline ovarian tumors ali ayhana, emine seda guvendag guvenb, suleyman guvena, turkan kucukalic adepartment of obstetrics and gynecology, division of gynecologic oncology, hacettepe university faculty of medicine, mahmut esat bozkurt caddesi no. Most lowgrade serous carcinomas are thought to arise from micro papillary borderline ovarian tumors. Borderline ovarian tumors bot are epithelial tumors of the ovaries with both malignant and nonmalig nant aspects. These tumors look the same as invasive epithelial ovarian cancers when seen on an ultrasound or ct scan. The accuracy of frozen section diagnosis of borderline ovarian malignancy. Serous borderline ovarian tumor serousbot represent noninvasive type serous ovarian tumors described initially in 1929 and classified in the world health organization who in 1971.
Pathology outlines who classification of ovarian neoplasms. Borderline ovarian tumors bots differ from the epithelial ovarian malignancies with their excellent prognosis, curabili ty with surgery, and being seen in. Microscopic pathological features determine whether a surface epithelialstromal tumor is benign, a borderline tumor, or malignant evidence of malignancy and stromal. Incomplete staging surgery as a major predictor of relapse of. Still others find evidence that a history of ovarian cancer among close female relatives is also a strong indicator. What is the difference between a benign ovarian tumor and one that is borderline. Borderline ovarian tumors bots are currently staged according to the international federation of gynecology and obstetrics figo classification of ovarian cancer. The aim of this study was to determine the prognosis of a series of ccbots collected in 2 reference centers. Frozen section diagnosis of ovarian epithelial tumors.
Identification of factors that impact recurrence in. If the advanced stage is detected, careful examination of the appendix and intestine is warranted to exclude an occult extraovarian primary tumor. I was just diagnosed yesterday with a borderline ovarian tumor, stage 3. Management of borderline ovarian tumours bagade 2012. The behavior of these tumors is distinct from lowgrade ovarian carcinoma and they are considered a distinct clinical entity. Oncofertility outcomes after fertilitysparing treatment. Borderline ovarian tumor bot was first described in 1929 by taylor 1, as the tumor having a pathological and clinical intermediate form, between benign and malignant ovarian tumor. This tumor often is associated with a significantly better prognosis than epithelial ovarian cancer. Borderline ovarian tumors bot are premalignant lesions. The objective was to describe and compare types and duration of symptoms among women with invasive versus borderline ovarian tumors. In general, the panel would recommend combination regimens, platinumbased regimens for platinumsensitive. Borderline ovarian tumours differ from epithelial ovarian cancer by their low incidence, frequent association with infertility, low association with mutations in bcra genes, different percentages of the most common histological types, early stage diagnosis, and high survival rate, even when associated with peritoneal involvement.
Borderline ovary tumor borderline serous cystadenoma the viewer on vitals enterprise platform, thanks to the combined visualization of the three t2 planes, the t1 with and without fat saturation, allows to confirm that the lesion depends on the ovary and that we do not find the presence of fat lesion type dermoid or blood figure 2. Get detailed treatment information in this summary for clinicians. Approximately, 3,000 cases of borderline ovarian tumors are annually diagnosed in the united states. Approximately 10% of all epithelial ovarian cancers are known to be hereditary with hereditary breast and ovarian cancer hboc accounting for approximately 90% of cases. By comparison with ovarian carcinomas, borderline ovarian tumours are characterised clinically by superior overall survival, even in women with peritoneal spread. Management of borderline ovarian tumours is individualised and depends on the age of the woman, the stage of the disease, the potential desire for pregnancy and the nature of the peritoneal implants figure 4.