Four cases of endometrioid borderline ovarian tumour: case reports and literature review

Abstract

Endometrioid borderline tumours (EBTs) of the ovary are uncommon tumours of low malignant potential. They consist of atypical endometrioid cells lacking destructive stromal invasion. As the prognosis of EBT is excellent, excessive treatment should be avoided and preoperative diagnosis is important. Here we report four cases of ovarian EBTs along with imaging findings and a review of literature. The average patient age was 52 years. They presented with abdominal discomfort or abnormal vaginal bleeding. The final diagnoses for all four cases were EBT Stage IA with endometriosis. Pathologically, one case was an adenofibromatous type tumour, and three cases were intracystic type tumours. Two patients had concurrent endometrial cancer. MRI of the tumours showed enhanced solid components. The intracystic type tumours presented a dendritic structure in the cyst; fine papillary branches surrounded a low-signal trunk on T2 weighted imaging. Positron emission tomography demonstrated marked fluorodeoxyglucose uptake in the solid component. One case with MRI 3 years before diagnosis indicated that the tumour arose in ovarian endometriotic cyst. EBT cases were difficult to distinguish from malignant ovarian tumours preoperatively. Intraoperative frozen section analysis may aid to determine treatment. Prognoses were excellent. Care should be taken for co-existing endometrial cancer.

<p>Ultraconservative, Fertility Sparing Treatment of Bilateral Borderline Ovarian Tumors: A Case Report of a 26-Year-Old, 0-Gravida with an Endometrioid Borderline Ovarian Tumor of the Right Ovary and a Sero-Mucinous Borderline Ovarian Tumor of the Left Ovary and a Review of the Literature</p>

“…EBOTs occur mainly unilaterally, are almost always diagnosed at an early stage and present a good overall prognosis. 1,21,23,25,26,28,29 Conservative surgery with USOP or even UCE, including endometrial sampling, can thus be proposed to young eBOT patients with a future childbearing desire, with unilateral involvement of the ovaries, under careful follow-up. However, more data is needed on the natural history of bilateral eBOTs or bilateral BOTs including an eBOT, as well as on the prognosis and fertility outcomes following conservative and ultraconservative surgery in such cases.…”

“…Nr. 1,21,23,25,27,28,29). Two additional articles on eBOTs were selected due to their frequent citation in several of the eBOT papers (Ref.…”

“…5,12,19 With regards to the occurrence of malignant transformation in BOTs, a large multicenter study on BOTs calculated an incidence rate of 2.3% for invasive relapses in a study population that already presented an overall low recurrence rate of 7%, thereby showing that only one-third of the occurring relapses were invasive. 20 Among BOTs, endometrioid borderline ovarian tumors (eBOTs) constitute a rare group, comprising up to only 0.2% of all epithelial ovarian tumors 21,22 and 2-10% of BOTs. 1,23,24 Very little data is available on the prognosis and therefore recommendations concerning the surgical management with respect to fertility in specific.…”