Borderline ovarian tumors" A contemporary review of clinicopathological characteristics, diagnostic methods and therapeutic options.

Borderline ovarian tumors (BOTs) differ from the epithelial ovarian malignancies with their excellent prognosis, curability with surgery, and being seen in relatively young ages. Thus, fertility sparing and conservative surgical approaches are currently recommended. Preoperative diagnosis of BOTs can be challenging because, clinical and ultrasonographic features might overlap with invasive carcinomas and sometimes with benign adnexal masses. Certain characteristics such as stage at diagnosis, age of the patient and histologic features are important while deciding the extensiveness and the type of surgery. Detailed evaluation of the entire abdominal cavity and sampling all suspected areas are imperative during operation. Frozen section is essential for the intraoperative diagnosis, despite the fact that the diagnostic value of frozen section is not as high as in invasive ovarian carcinomas. Routine appendectomy and/or contralateral ovarian biopsy in cases of isolated tumor with normal appearing appendix and/or contralateral ovary are not recommended. Conservative approach might improve the recurrence rate without worsening the overall survival. The exact role of laparoscopic surgery with its advantages and disadvantages in the treatment of BOTs needs to be confirmed with further studies.