Borderline Ovarian Tumor in the Pediatric and Adolescent Population: A Case Series and Literature Review

Abstract

Study ObjectiveTo determine the diagnosis, management, and outcome for children and adolescents with borderline ovarian tumor (BOT), and to provide a review of the literature on BOT in children and adolescents. DesignA retrospective cohort study of female adolescents younger than age 21 years diagnosed with BOT between January 2001 and May 2016. SettingTexas Children's Hospital, Houston, Texas. ParticipantsFourteen patients (ages 12 to 18 years) diagnosed with BOT. Main Outcome MeasuresClinical presentation, preoperative characteristics, surgical technique, cancer stage, histology, treatment, and recurrence. ResultsMedian age at diagnosis was 15.5 years, with most postmenarchal. Abdominal mass/pain were the most common presenting symptoms. Median tumor size was 16.6 cm (range, 4-32 cm). Preoperative cancer antigen 125 (CA 125) was elevated in 54% (7/13) of cases. All patients had fertility-preserving surgery, either cystectomy (CY) or unilateral salpingo-oophorectomy (USO): 5 via laparoscopy (LSC) and 9 via laparotomy. Most were stage I with 5 serous and 9 mucinous BOT histology. No one received adjuvant chemotherapy. Two patients had recurrence. One had ipsilateral recurrence 2 months after LSC CY for FIGO stage IC1 mucinous BOT. The second had contralateral recurrence 15 months after laparotomy, right USO for FIGO stage IIIC serous BOT treated with LSC CY, then a second recurrence treated with USO after oocyte cryopreservation for fertility preservation. All patients were alive at last follow-up, 1 with disease. ConclusionsBOT in children and adolescents can be treated conservatively with fertility-preserving techniques and surveillance with good outcome. The role of adjuvant therapy is not known.