Six cases with borderline ovarian tumors diagnosed after laparoscopic cystectomy for benign ovarian tumors

Abstract

Objective: The laparoscopic management of borderline ovarian tumors is controversial. We examined the outcomes of six cases with borderline ovarian tumors diagnosed after laparoscopic cystectomy for benign ovarian tumors.Methods: Among 127 patients who were treated by laparoscopic cystectomy for benign ovarian tumors between 1998 and 2006 at the University of the Ryukyus Hospital, 6 women were pathologically-diagnosed with borderline ovarian tumors. We retrospectively investigated the clinical outcomes of these patients.Results: The mean age was 42.5±23.3 years (range, 23-74 years), and the tumor size was 15.7±6.5 cm (range, 8.1-25.0 cm) . Laparoscopic cystectomy was performed in four cases who wished to preserve fertility. The remaining two postmenopausal women were treated by laparoscopic bilateral salpingo-oophorectomy. All six cases had stage Ic (b) tumor due to intraoperative tumor rupture (three mucinous, two serous, and one carcinoid) . All of the patients were surveyed without re-laparotomy for surgical staging or postoperative chemotherapy. Two of 4 women who desired pregnancy became pregnant within 1 year, and 3 recurrences as borderline tumors occurred in patients treated by laparoscopic cystectomy, 3, 14, and 21 months after the initial laparoscopic surgery. Two recurrent patients underwent laparoscopic oophorectomy, and the other recurrence was treated by salpingo-oophorectomy and lymph node sampling. The patients remained disease-free for 44, 27, and 56 months.Conclusions: Although long-term follow-up is indispensable, patients with borderline ovarian tumors can safely undergo conservative surgery.