Borderline Ovarian tumours

Question 1

What are the USS features of a borderline tumour?

Answer 1

• multi-loculated (40% of mucinous, 30% of serous)
• solid/cystic components (40% of mucinous, 78% of serous)
• internal papilations (40% of mucinous, 78% of serous)
• thickened septa
• bilateral

Question 2

What are the histopathological features of a borderline tumour?

Answer 2

Tumour displaying atypical epithelial proliferation without stromal invasion
- High nuclear:cytoplasmic ratio
- enlarged nucleoli
- increased mitotic bodies/activity
most commonly serous or mucinous types

Question 3

list the types of borderline tumours

Answer 3

Serous (45-60%)
Mucinous (30-50%)
sero-mucinous, endometrioid, clear cell, Brenner 5-10%

Question 4

The majority of borderline tumours are _______. 75% are diagnosed with stage ___ disease. _____% of tumours are bilateral. Mucinous tumours are the most common cellular type. __% are stage 1 and less than ___% are bilateral

Answer 4

Serous
stage 1
25-50%
90% 
10%

Question 5

What is the treatment for a stage 1 unilateral borderline ovarian tumour?

Answer 5

Laparoscopic unilateral saplingoophorectomy of affected ovary + pelvic washings + omental biopsy + biopsy of any peritoneal lesions
If mucinous - recommend appendicectomy

Question 6

What are the 5 year survival rates based on Stage of disease for borderline ovarian tumours?

Answer 6

Stage I - 99%
Stage II - 98%
stage III - 96%
stage IV - 77%

Question 7

What 3 features characterise borderline ovarian tumours?

Answer 7

absence of stromal invasion
10% exhibit microinvasion
Histological subtypes - majority serous, could be mucinous

Question 8

What is the prognosis for serous borderline tumour?

Answer 8

75% stage I

25-50% bilateral

Question 9

What is the prognosis for mucinous borderline tumour?

Answer 9

90% stage I

<10% bilateral

Question 10

if you found what appeared to be a borderline tumour during a routine operation (c/s) which 3 people would you inform?

Answer 10

anaesthetist
consultant
patient

Question 11

which 3 surgical options would you have on finding a borderline tumour at C/S?

Answer 11

biopsy
cystectomy
oophorectomy

Question 12

What is your management on finding what appears to be a borderline tumour on routine C/S?

Answer 12

• inform 3 people
• biopsy, cystectomy or oophorectomy
• inspect other ovary
• inspect rest of abdomen + omentum + appendix