Navigating the Complexities of Borderline Ovarian Tumors: A Clinical Perspective - A Case Series

• Jyoti Rao P,*  
• Dr Mariam A M Al Beiti

Abstract

Introduction: Ovarian cancer accounts for 23% of gynecological malignancies and significantly contributes to mortality. Borderline Ovarian Tumors (BOTs) represent 10-20% of ovarian neoplasms, commonly affecting pre-menopausal women aged 34-40 years. BOTs exhibit intermediate histopathological features between benign cystadenomas and invasive carcinomas, with serous and mucinous subtypes being the most prevalent. Despite the potential for spread beyond the ovary, BOTs typically lack stromal invasion and have a favorable prognosis. Aim: This study aims to discuss the clinical management of BOTs, with an emphasis on surgical intervention and the balance between fertility preservation and complete surgical staging. The goal is to illustrate the complexities in managing these tumors through clinical cases and highlight the importance of personalized treatment plans. Results: Four clinical cases were reviewed, showcasing the diverse presentations and management strategies for BOTs. These cases demonstrate the challenges in decision-making, particularly regarding conservative surgery versus completion surgery, and the complexities involved in managing BOTs during pregnancy. Fertility-sparing surgery was considered for younger patients, with close follow-up using CA-125 and transvaginal ultrasound. Conclusion: The management of BOTs requires a personalized approach, balancing the need for thorough surgical staging with the preservation of fertility in reproductive-aged women. The favorable prognosis of BOTs underscores the importance of timely and appropriate surgical intervention. Ongoing follow-up is crucial to monitor for recurrence, particularly in patients who opt for fertility-sparing surgery. The review highlights the importance of clear communication between clinicians and patients to ensure informed decision-making and adherence to follow-up protocols. Early detection and appropriate management are key to favorable long-term outcomes in BOTs.

Keywords

Borderline ovarian tumour,Gynecological malignancies,CA-125