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Borderline epithelial ovarian tumors
Other Resources UpToDate PubMed

Borderline epithelial ovarian tumors

Contributors: Alexandra J. Morell MD, Mitchell Linder MD
Other Resources UpToDate PubMed

Synopsis

Borderline epithelial ovarian tumors are a group of heterogenous tumors arising from the external surface of the ovary that have nuclear atypia and changes in mitotic activity but have a low potential of progressing to malignant tumors.

Borderline epithelial ovarian tumors have an incidence of 1.8-4.8 per 100 000 women each year and are most common in women aged 30-50 years, with a median age at diagnosis of 45 years.

There are several histologic subtypes of borderline epithelial ovarian tumors including serous, mucinous, endometrioid, clear cell, Brenner, and mixed. Serous subtypes are the most common, followed by mucinous subtypes. The remaining subtypes make up only about 3%-4% of all borderline epithelial ovarian tumors. Serous subtypes are the most likely to present bilaterally.

Occasionally, borderline ovarian tumors can be associated with extraovarian (peritoneal) implants, which may or may not be invasive. The presence of these implants is related to the overall prognosis and risk of recurrence.

It is thought that multiparity and breastfeeding are associated with a decreased risk of these tumors, while a history of infertility and in vitro fertilization (IVF) is associated with an increased risk. Conflicting evidence exists regarding oral contraceptive use, but more recent studies suggest a protective effect.

A majority of borderline epithelial ovarian tumors are stage 1 at diagnosis and have an excellent prognosis, with a 10-year survival rate of 98% for stage 1 tumors. The recurrence rate for all stages of borderline ovarian tumors is approximately 11%, with about 70% representing recurrent borderline tumors and approximately 30% representing malignant carcinomas.

Related topic: benign epithelial ovarian tumor

Codes

ICD10CM:
D39.10 – Neoplasm of uncertain behavior of unspecified ovary

SNOMEDCT:
764791008 – Borderline epithelial tumor of ovary

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Consider both benign and malignant gynecologic and nongynecologic processes.

Benign ovarian or fallopian tube lesions include:
Malignant ovarian or fallopian tube lesions – Difficult to distinguish from borderline epithelial ovarian tumors given similar ultrasonographic characteristics; presence of ascites or a pleural effusion should raise concern for a malignant process. See ovarian cancer.

Nongynecologic causes of pelvic masses include benign and malignant lesions of the bladder, urethra, appendix, and gastrointestinal tract.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:10/13/2020
Last Updated:10/26/2020
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Borderline epithelial ovarian tumors
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Borderline epithelial ovarian tumors : Abdominal pain, Abdominal distension, Pelvic pain
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