Borderline Tumors and Other Rare Epithelial Tumors of the Ovary

Borderline ovarian tumors are distinct from invasive ovarian malignancies. They account for 15% of all epithelial ovarian cancers. On average, the age at diagnosis is approximately 10 years younger than that of women with malignant ovarian cancer. More than 80% of women with borderline ovarian tumors present with stage I disease. Overall, the survival for women with borderline ovarian tumors, stage for stage, is also significantly better. The recommended management of clinically apparent early-stage borderline ovarian tumors, in women who have completed child bearing, includes bilateral salpingo-oophorectomy with hysterectomy and surgical staging. For young patients with apparent early-stage disease who desire fertility preservation, unilateral oophorectomy or ovarian cystectomy with a staging procedure is an acceptable alternative, although this approach may predispose to a higher risk of recurrence. For advanced-stage and recurrent disease, cytoreductive surgery is the cornerstone treatment, while adjuvant chemotherapy is reserved for selected cases only (e.g. unresectable disease, invasive metastatic implants, rapid growth rate with progressive symptomatology).