Recurrence of borderline ovarian tumor during pregnancy – is wait-and-see approach a possible strategy? Case report and literature review
https://doi.org/10.17650/1994-4098-2025-21-2-135-144
Abstract
Borderline ovarian tumors (BOT) are neoplasms with low malignant potential, which are characterized by atypical epithelial proliferation without destructive stromal invasion. They account for 15–20 % of all epithelial ovarian tumors, with serous and mucinous BOT being the most common. The incidence of BOT ranges from 1.5 to 4.8 cases per 100,000 women, with at least one-third of patients being younger than 40 years at the time of diagnosis. Therefore, one of the most critical aspects of treatment is fertility preservation. The “gold standard” for organ-sparing treatment is resection of the affected ovary or adnexectomy, accompanied by mandatory surgical staging. Most BOT are diagnosed at early stages (FIGO I), ensuring a favorable prognosis with a 5-year survival rate of 95 % and a 10-year survival rate of 90 %. Recurrences occur in 5–34 % of cases, most often as borderline tumors and less frequently as invasive ones. Although conservative treatment is considered one of the risk factors for subsequent recurrences, its impact on overall survival has not been proven. We describe a clinical case of fertility-sparing treatment for a recurrent during second pregnancy BOT, initially diagnosed in a young woman during the first trimester of her first pregnancy.
About the Authors
Yu. A. ChekinaRussian Federation
Yuliya Andreevna Chekina
2 Akkuratova St., Saint Petersburg 197341
Competing Interests:
The authors declare no conflict of interest
E. A. Kalinina
Russian Federation
2 Akkuratova St., Saint Petersburg 197341
Competing Interests:
The authors declare no conflict of interest
O. A. Li
Russian Federation
2 Akkuratova St., Saint Petersburg 197341
Competing Interests:
The authors declare no conflict of interest
E. G. Koshevaya
Russian Federation
2 Akkuratova St., Saint Petersburg 197341
Competing Interests:
The authors declare no conflict of interest
A. D. Dzharbaeva
Russian Federation
2 Akkuratova St., Saint Petersburg 197341
Competing Interests:
The authors declare no conflict of interest
E. L. Dikareva
Russian Federation
2 Akkuratova St., Saint Petersburg 197341
Competing Interests:
The authors declare no conflict of interest
A. F. Urmancheeva
Russian Federation
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
41 Kirochnaya St., Saint Petersburg 191015
Competing Interests:
The authors declare no conflict of interest
E. A. Ulrikh
Russian Federation
2 Akkuratova St., Saint Petersburg 197341
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
41 Kirochnaya St., Saint Petersburg 191015
Competing Interests:
The authors declare no conflict of interest
References
1. Kipp B., Vidal A., Lenick D., Christmann-Schmid C. Management of Borderline ovarian tumors (BOT): Results of a retrospective, single center study in Switzerland. J Ovarian Res 2023;16(1):20. DOI: 10.1186/s13048-023-01107-3
2. Davydova I.Yu., Ashrafyan L.A., Valiev R.K. et al. Practical recommendations for the treatment of borderline ovarian tumors. Prakticheskie rekomendatsii RUSSCO, chast 1.2. Zlokachestvennye opukholi = Practical Recommendations RUSSCO, Part 1.2. Malignant Tumors 2024;14(3s2):124–35. (In Russ.).
3. Poulain M., Vandame J., Tran C. et al. Fertility preservation in borderline ovarian tumor patients and survivors. Horm Mol Biol Clin Investig 2020;43(2):179–86. DOI: 10.1515/hmbci-2019-0072
4. Du Bois A., Trillsch F., Mahner S. et al. Management of borderline ovarian tumors. Ann Oncol 2016;27(Suppl 1):i20–2. DOI: 10.1093/annonc/mdw090
5. Borderline ovarian tumors. Clinical guidelines of the Ministry of Health of Russia. (In Russ.).
6. Della Corte L., Mercorio A., Serafino P. et al. The challenging management of borderline ovarian tumors (BOTs) in women of childbearing age. Front Surg 2022;9:973034. DOI: 10.3389/fsurg.2022.973034
7. Sangnier E., Ouldamer L., Bendifallah S. et al. Risk factors for recurrence of borderline ovarian tumors in France: A multicenter retrospective study by the FRANCOGYN group. J Gynecol Obstet Hum Reprod 2021;50(4):101961. DOI: 10.1016/j.jogoh.2020.101961
8. Ozenne A., De Berti M., Body G. et al. Risk factors for recurrence of borderline ovarian tumours after conservative surgery and impact on fertility: A multicentre study by the Francogyn group. J Clin Med 2022;11(13):3645. DOI: 10.3390/jcm11133645
9. Vasconcelos I., de Sousa Mendes M. Conservative surgery in ovarian borderline tumours: A meta-analysis with emphasis on recurrence risk. Eur J Cancer 2015;51(5):620–31. DOI: 10.1016/j.ejca.2015.01.004
10. Delle Marchette M., Ceppi L., Andreano A. et al. Oncologic and fertility impact of surgical approach for borderline ovarian tumours treated with fertility sparing surgery. Eur J Cancer 2019;111:61–8. DOI: 10.1016/j.ejca.2019.01.021
11. Chevrot A., Héquet D., Fauconnier A., Huchon C. Impact of surgical restaging on recurrence in patients with borderline ovarian tumors: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020;248:227–32. DOI: 10.1016/j.ejogrb.2020.03.023
12. Gouy S., Maria S., Faron M. et al. Results after conservative surgery of stage II/III serous borderline ovarian tumors. Ann Surg Oncol 2021;28(7):3597–604. DOI: 10.1245/s10434-020-09250-7
13. Plett H., Harter P., Ataseven B. et al. Fertility-sparing surgery and reproductive-outcomes in patients with borderline ovarian tumors. Gynecol Oncol 2020;157(2):411–7. DOI: 10.1016/j.ygyno.2020.02.007
14. Casanova J., Maciel R., Ferreira V. et al. Borderline ovarian tumor during pregnancy: A case report. Case Rep Obstet Gynecol 2013;2013:160319.
15. Wang M., Li Y., Xu T. et al. Clinical analysis of 17 cases of borderline ovarian tumors during pregnancy. Front Oncol 2022;12:934751. DOI: 10.3389/fonc.2022.934751
16. Zilliox M., Lecointre L., Azais H. et al. Management of borderline ovarian tumours during pregnancy: Results of a French multi-centre study. Eur J Obstet Gynecol Reprod Biol 2021;256:412–8. DOI: 10.1016/j.ejogrb.2020.11.033
17. Vidal Urbinati A.M., Iacobone A.D., Di Pace R.C. et al. Borderline ovarian tumor in pregnancy: Can surgery wait? A case series. Arch Gynecol Obstet 2021;304(6):1561–8. DOI: 10.1007/s00404-021-06080-0
18. Lombardi Fäh V., Del Vento F., Intidhar Labidi-Galy S., Undurraga M. Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors. Gynecol Oncol Rep 2024;56:101531. DOI: 10.1016/j.gore.2024.101531
19. Bonardi B., Massarotti C., Bruzzone M. et al. Efficacy and safety of controlled ovarian stimulation with or without letrozole co administration for fertility preservation: A systematic review and meta-analysis. Front Oncol 2020;10:574669. DOI: 10.3389/fonc.2020.574669
Review
For citations:
Chekina Yu.A., Kalinina E.A., Li O.A., Koshevaya E.G., Dzharbaeva A.D., Dikareva E.L., Urmancheeva A.F., Ulrikh E.A. Recurrence of borderline ovarian tumor during pregnancy – is wait-and-see approach a possible strategy? Case report and literature review. Tumors of female reproductive system. 2025;21(2):135-144. (In Russ.) https://doi.org/10.17650/1994-4098-2025-21-2-135-144