Borderline tumors : diagnosis and management : about 10 cases.

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Published May 5, 2010
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Vol. 88 No. 5 (2010): Issue May 2010

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Dorra Zeghal Souki
Haifa Bouchahda
walid Limem
Sami Mahjoub
Mohamed Aymen Zakraoui
Rim Ben Hmid
Faouzia Zouari

Abstract

Background: Since their discovery in 1929 by Taylor border tumors of the ovary, also known as borderline tumor (TOLM) inspired confusion, apprehension and disagreement.
Aim: Identify epidemiological, clinical and therapeutic particularities of borderline tumors of the ovary.
-Study the different surgical approaches for borderline tumors of the ovary.
-Assess the value of frozen section in this pathology.
Methods: This is a retrospective study of 10 patients operated for borderline tumor of the ovary and collected at the department C of the center of maternity and newborn in Tunis.
Results: The average age of our patients was 35.6 years
Pelvic pain was the main circumstance of discovery, it accounted for 50% of the cases. The discovery was fortuitous in 40% of the cases
Ultrasound has shown purely cystic tumors in 70% of cases and solido-cystic ones in 30% of cases. There was a tumor in the controlateral ovary in only one case. The surgery was conservative whenever possible. Histological examination concluded to 6 cases of serous tumor and 4 cases of mucinous ones. Among the 10 patients, 8 were classified as stage Ia, one stage Ib and one stage Ic. The frozen section was performed in 8 cases
Conclusion: The diagnosis of borderlines tumors of the ovary remains difficult. The laparoscopy is of great use in the management of this pathology. Histological examination is an interesting addition and the conservative treatment is the more appropriate treatment.

Keywords:

Gynecology, anatomopathology, ovarian tumor, borderline tumor, frozen section

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References

  1. L. Tulpin, R. Rougier, O. Morel, C. Malartic, E. Dara›, E. Barranger. Tumeurs borderline de l'ovaire: état des lieux. Gynécologie Obstétrique & Fertilité 2008; 36:422-429
  2. R. Fauvet, C. Poncelet, E. Daraï. Faisabilité et limites du traitement coelioscopique des tumeurs frontières de l'ovaire. Gynécologie Obstétrique & Fertilité 2006;34: 470-478
  3. Harris R, Whitmore AS, Itnyre J and collaborative ovarian cancer group. Charactristics relating to ovarian cancer risk: collaborative analysis of 12 US control studies. Epithelial tumors of low malignant potential in white women. Am J Epidemiol 1992;136:1204-11.
  4. Riman T, Dickman W, nelson S and al. Risk factors for epithelial borderline ovarian tumors: Results of a Swedish case-control study. Gynecologic oncology 2001; 83:575-85.
  5. Baraket RR. Borderline tumors of the ovary. Obstet Gynecol Clin North Am 1994; 21:93-105.
  6. Karen J, Trope CG, Abeler VM. A retrospective study of 370 borderline tumors of the ovary treated at the Norwegian Radium Hospital from 1979 to 1982. Cancer 1993; 71:1810-20.
  7. Parazzini F, Negri E, La VecchiaC. Treatement for fertility and risk of ovarian tumors of borderline malignancy. Gynecol Oncol 1998; 68:226-8.
  8. Mantzavinos T, kanakas N, Genatas C, Papadias K, Zourlas P. Five years'follow-up in two patients with borderline tumors of the ovary hyperstimulated by gonadotrophin therapy for in-vitro fertilization.Human Reprod 1994;9:2032-3.
  9. Fine BA, Valente P, Schroeder B. Parovarian borderline malignancy in pregnancy. Arch gynecol obstet 1996;228:105-8.
  10. Sekotory A, Ahmed M, Lawton FG. Borderline ovarian tumors:Current concepts and management. Reviews in Gynacological practice 2005;5:139-51.
  11. Darai E, Teboul J, Fauconnier A. Management and outcome of borderline ovarian tumors incidentally discovered at or after laparoscopy. ACTA Obstet Gynecol Scand 1998;77:451-7.
  12. Desfeux P, Camatte S, Chatellier G, Blanc B, Querleu D, Lecuru F.Impact of surgical approach on the management of macroscopic early ovarian borderline tumors. Gynecol Oncol 2005;98:390-5.
  13. Fauvet R, Boccara J, Dufournet C, Poncelet C, Daraï E. Laparoscopic management of borderline ovarian tumors: results of a French multicenter study. Ann Oncol 2005; 16:403-10.
  14. Camatte S, Morice P, Thoury A, Fourchotte V, Pautier P, Lhomme C,et al. Impact of surgical staging in patients with macroscopic "stage I"ovarian borderline tumours: analysis of a continuous series of 101cases. Eur J Cancer 2004;40:1842-9.
  15. Maneo A, Vignali M, Chiari S, Colombo A, Mangioni C, Landoni F. Are borderline tumors of the ovary safely treated by laparoscopy?Gynecol Oncol 2004;94:387-92.
  16. Deffieux X, Morice P, Camatte S, Fourchotte V, Duvillard P, Castaigne D.Results after laparoscopic management of serous borderline tumor of the ovary with peritoneal implants. Gynecol Oncol 2005;97:84-9.
  17. Menzin AW, Rubin SC, Noumoff JS, LiVolsi VA. The accuracy of a frozen section diagnosis of borderline ovarian malignancy. Gynecol Oncol 1995; 59:183-5.
  18. Blanc B, D'Ercole C, Nicoloso E, Boubli L. Laparoscopic management of malignant ovarian cysts: a 78-case national survey. Part 2: Follow-up and final treatment. Eur J Obstet Gynecol Reprod Biol 1995; 61:147-50.
  19. Gotielb WH, Flikker S, Davidson B, Korach Y, Kololovic J, Ben Baruch G. Borderline tumors of the ovary, fertility treatment, conservative management and pregnancy outcomes. Cancer 1998; 82:141-6.
  20. Duvillard P. Tumeurs ovariennes à la limite de la malignité, données actuelles. Ann Pathol 1996 ; 16 :396-405.
  21. Leake JF, Rader JS, Woodwff JD ,Rosenshein NB.Retroperitoneal lymphatic involvement with epithelial ovarian tumors of low malignant potential. Gynecol Oncol 1991; 42:124-30.
  22. Tropé C, Karen J, Vergotte B, Kristensen G, Abler V. Are borderline tumors of the ovary over treated both surgically and systemically? A review of four prospective randomized trials including 253 patients with borderline tumors. Gynecol Oncol 1993; 51 :236-43.