Recurrent borderline ovarian tumor in a patient of reproductive age

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Abstract

Borderline ovarian tumors account for approximately 20% of epithelial ovarian tumors and are frequently diagnosed in women of reproductive age. Therefore, fertility preservation during treatment of these tumors is of particular importance. Organ-preserving surgeries are the preferred treatment method; however, they are associated with an increased risk of disease recurrence.

The aim of this study was to present a clinical case of managing a patient with recurrent borderline ovarian tumor and to assess the possibilities of preserving reproductive function using organ-preserving approaches.

We report the clinical case of a 36-year-old patient with recurrent serous borderline cystadenoma of the ovary. In 2018, laparoscopic resection of the left ovary was performed, followed by left-sided adnexectomy. Recurrences occurred in 2022 and 2024, requiring repeated surgical interventions. Menstrual function and the possibility of pregnancy planning using assisted reproductive technology were evaluated during follow-up.

Organ-preserving surgeries allowed preservation of the patient’s menstrual function and fertility potential despite multiple tumor recurrences. Timely surgical treatment and careful dynamic monitoring contributed to the absence of severe complications and maintenance of reproductive health.

Organ-preserving treatment methods for borderline ovarian tumors represent an effective approach to fertility preservation in women of reproductive age. Nevertheless, they require individualized treatment strategies and continuous monitoring, taking into account the patient’s reproductive plans and risk of recurrence.

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About the authors

Polina A. Morozova

Almazov National Medical Research Centre

Email: morozova_pa@mail.ru
ORCID iD: 0009-0007-3799-8547
Russian Federation, Saint Petersburg

Anastasia O. Ivasko

Almazov National Medical Research Centre

Email: nastya.ivasko@yandex.ru
ORCID iD: 0009-0001-5326-6430
SPIN-code: 8066-3020
Russian Federation, Saint Petersburg

Nikita A. Nosov

Almazov National Medical Research Centre

Author for correspondence.
Email: nikita-nosov-1999-1@mail.ru
ORCID iD: 0009-0007-3806-0964

MD

Russian Federation, Saint Petersburg

Anna E. Protasova

Almazov National Medical Research Centre

Email: protasova1966@yandex.ru
ORCID iD: 0000-0001-7930-8048
SPIN-code: 4097-0969

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Saint Petersburg

Elena A. Ulrikh

Almazov National Medical Research Centre

Email: ulrikh_ea@almazovcentre.ru
ORCID iD: 0000-0002-1127-8863
SPIN-code: 1110-1844

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Irina E. Zazerskaya

Almazov National Medical Research Centre

Email: zazerskaya@almazovcentre.ru
ORCID iD: 0000-0003-4431-3917
SPIN-code: 5683-6741

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

References

  1. Davydova IYu, Valiev RK, Karseladze AI, et al. Practical recommendations for drug treatment of borderline ovarian tumors. Practical recommendations RUSSCO, part 1.2. Malignant tumors. 2023;13(3s2):235–245. EDN: FMIANE doi: 10.18027/2224-5057-2023-13-3s2-1-235-245
  2. Maramai M, Barra F, Menada MV, et al. Borderline ovarian tumours: management in the era of fertility-sparing surgery. Ecancermedicalscience. 2020;14:1031. EDN: RQQDHV doi: 10.3332/ecancer.2020.1031
  3. Carbonnel M, Layoun L, Poulain M, et al. Serous borderline ovarian tumor diagnosis, management and fertility preservation in young women. J Clin Med. 2021;10(18):4233. EDN: LDMFYS doi: 10.3390/jcm10184233
  4. All-Russian National Union “Association of Oncologists of Russia”, Russian Society of Clinical Oncology, Russian Society of Specialists in Prevention and Treatment of Reproductive System Tumors. Clinical guidelines: Borderline ovarian tumors. 2020. (In Russ.)
  5. Prat J. Pathology of borderline and invasive cancers. Best Pract Res Clin Obstet Gynaecol. 2017;41:15–30. doi: 10.1016/j.bpobgyn.2016.08.007
  6. Kasaven LS, Chawla M, Jones BP, et al. Fertility sparing surgery and borderline ovarian tumours. Cancers (Basel). 2022;14(6):1485. EDN: WWQMXE doi: 10.3390/cancers14061485
  7. Taylor H. Malignant and semi-malignant tumors of the ovary. Surg Gynecol Obstet. 1929;48:204–230.
  8. Bourdel N, Huchon C, Abdel Wahab C, et al. Borderline ovarian tumors: French guidelines from the CNGOF. Part 2. Surgical management, follow-up, hormone replacement therapy, fertility management and preservation. J Gynecol Obstet Hum Reprod. 2021;50(1):101966. EDN: UJMPEC doi: 10.1016/j.jogoh.2020.101966
  9. du Bois A, Trillsch F, Mahner S, et al. Management of borderline ovarian tumors. Ann Oncol. 2016;27 Suppl 1:i20–i22. doi: 10.1093/annonc/mdw090

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. Disease development, key events, and prognosis. КОК, combined oral contraceptives.

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