Immunohistochemistry combined with Alcian Blue-Periodic Acid Schiff (AB-PAS) staining in the differentiation of ovarian seromucinous borderline tumors and mucinous borderline tumors.

Prior research on the association between thyroid disease, ovarian cancer and borderline ovarian tumors has been inconsistent. This nationwide cohort study investigated the risk of epithelial ovarian cancer and borderline ovarian tumors among 1,058,745 Danish women born between January 1, 1960, and December 31, 1997, and were followed until December 31, 2022, in relation to hypothyroidism and hyperthyroidism. Data on thyroid diagnoses, ovarian tumors, covariates, migration, and vital status were retrieved from Danish national registers. Hazard ratios (HRs) and 95% confidence intervals (CIs) for ovarian cancer and borderline ovarian tumors overall and for histological subtypes were estimated using adjusted Cox proportional hazard models. A landmark analysis assessed ovarian tumor risk at age 60 by thyroid disease status before age 40. Over a median 18.4 years of follow-up, 49,015 women developed hypothyroidism, 26,950 hyperthyroidism, 905 ovarian cancer and 1,111 borderline ovarian tumors. No association was found between hypothyroidism and ovarian cancer (HR: 1.10, CI: 0.78-1.55) or borderline tumors (HR: 0.88, CI: 0.60-1.29). Hyperthyroidism was associated with increased rates of serous ovarian cancer (HR: 1.62, CI: 1.00-2.63) and borderline ovarian tumors (HR: 1.78, CI: 1.26-2.52), especially in postmenopausal and premenopausal women, respectively. However, absolute risk differences at age 60 were small and not statistically significant. Hyperthyroidism may increase the rate of epithelial ovarian tumors, though clinical significance remains unclear, warranting further research. These findings indicate that hyperthyroidism may modestly influence epithelial ovarian tumor risk, underscoring the need to clarify shared biological mechanisms between thyroid and ovarian function.

A clinicopathological study of borderline ovarian tumors: insights from a tertiary care center in Saudi Arabia.

Mucinous ovarian cancer (MOC) is a rare epithelial ovarian cancer subtype with poor prognosis, particularly in advanced stages. Differentiating MOC from mucinous borderline ovarian tumor (MBT) remains clinically challenging, often leading to delayed or inadequate treatment. Accurate preoperative diagnosis is crucial for guiding surgical strategies and improving patient outcomes. This study evaluated preoperative clinical factors that can distinguish MOC from MBT. We retrospectively analyzed 46 ovarian mucinous tumors diagnosed between 2017 and 2021, including 15 MOC and 31 MBT cases confirmed by histopathology. Patient age, tumor laterality, tumor size, tumor markers (CA125, CA19-9, CA72-4, CEA), and tumor volume were assessed. Tumor size was measured as the maximum magnetic resonance imaging diameter, whereas volume was calculated using three-dimensional imaging. Statistical analyses included the Mann-Whitney U test and receiver operating characteristic curve analysis, with AUC as a measure of diagnostic accuracy. Among the tumor markers, CA72-4 exhibited the highest diagnostic accuracy (area under the curve [AUC]: 0.834), with significantly higher levels in MOC than in MBT (p < 0.001). Tumor size alone was an unreliable discriminator (AUC: 0.42). The tumor volume tended to be larger in MBT than in MOC (median: 2 362 878 cm3 vs. 1 262 436 cm3; p = 0.77). However, the combination of CA72-4 and tumor volume improved the diagnostic performance (AUC: 0.875). The combination of CA72-4 levels and tumor volume enhances preoperative differentiation between MOC and MBT. This combined approach may optimize surgical planning and improve patient outcomes.

Autoethnography is a qualitative research method that combines the elements of autobiography and ethnography. Ellis and Bochner (2000) studied autoethnography as a tripartite model. It is an autoethnographic research process that uses personal experience (auto) to define (ethno) and interpret (graphy) cultural experiences, beliefs, and practices. As a qualitative research method, autoethnographic studies are of great importance for nursing science. It is believed to contribute to the nursing profession and the quality of nursing care with the development of nursing theories and the increase in research culture. In the life cycle that starts with birth and ends with death, it is what we experience that makes us who we are. And the profession I chose changed and shaped my life perspective over the years without realizing it. Hospitals were like the summary of life for me. There you could see all the emotions a human being can experience: health, illness, excitement, peace, fear, anxiety, worry, birth, and death. Life began with birth in the hospital and ended with death at the very same place. While working as a nurse, I always wanted to leave positive impressions in people's lives. Those hospitalized could have been my loved ones. But then I realized that I had never thought I could be the patient. In this article, as an academic nurse who was diagnosed with a borderline ovarian tumor, underwent surgery, and received chemotherapy, I shared my autobiographic experiences in the processes of diagnosis, treatment, and follow-up.

Survival analysis of borderline ovarian tumors: a 23-year retrospective study in a Middle Eastern cohort

Fertility preservation is a critical consideration in the care of reproductive-aged patients with gynecologic cancers, yet referral to reproductive specialists remains low, indicating a gap between guidance and practice. We compared 28 clinical guidelines that addressed fertility-sparing management of endometrial, cervical, and ovarian cancers, and reviewed diagnostic workup, eligibility thresholds, surgical approaches, and surveillance protocols. Recommendations were synthesized into stage-specific pathways to delineate areas of consensus, highlight discrepancies, and map evidence gaps. There is broad agreement across multiple independent guidelines to support fertility-sparing treatment for carefully selected patients with: grade 1, stage IA endometrioid endometrial carcinoma; stage IA1-IB1 cervical tumors measuring less than 2 cm without high-risk features; and borderline ovarian tumors and most malignant germ cell tumors. Recommendations for higher stage disease and uncommon histologies, however, diverge and remain inconsistent. Overall guideline quality was moderate to high but frequently relied on limited evidence or expert opinion outside early-stage, low-risk conditions. Synthesizing current guidance clarifies areas where practice can be standardized and prospective data are needed. Embedding routine fertility counseling and referral into standardized pathways is an important step to improve uptake while maintaining oncologic safety and preserving fertility potential.

Fertility preservation is a growing priority in the management of young women with rare ovarian tumors, including malignant ovarian germ cell tumors (MOGCTs), sex cord-stromal tumors (SCSTs), and borderline ovarian tumors (BOTs). These malignancies often affect adolescents and women of reproductive age and are frequently treated with fertility-sparing surgery and platinum-based chemotherapy. Our objective is to systematically evaluate reproductive outcomes, menstrual function recovery, and fertility preservation strategies in female survivors of rare cancers such as MOGCTs, SCSTs, and BOTs. A systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Scopus, and BioMed Central were searched for studies published between 2005 and 2025. Eligible studies included observational or cohort designs reporting on fertility status, menstrual recovery, and reproductive outcomes following treatment for rare tumors. A total of 24 studies met the inclusion criteria. Data extraction included fertility preservation approaches, rates of natural versus assisted conception, menstrual function outcomes, and the incidence of premature ovarian insufficiency (POI). Fertility-sparing surgery with or without chemotherapy was the most applied fertility preservation strategy. Spontaneous conception was predominant, with pregnancy rates ranging from 50% to over 90%. Menstrual recovery occurred in 71-100% of patients. POI was rare in solid tumor survivors but occurred in up to 87% of leukemia patients. Long-term follow-up showed durable ovarian function and no increase in cancer recurrence. Ovarian tissue cryopreservation (OTC) and oocyte retrieval were effective in selected high-risk cases. Fertility preservation in patients with rare ovarian malignancies is both safe and effective. Early fertility counseling and individualized, risk-adapted strategies should be integrated into standard cancer care, especially for patients at high risk for gonadal failure.

There is limited data on contraceptive options in the setting of gynecologic and breast dysplasia. Despite this, many patients who report a history of these precancers retain their reproductive organs and seek contraception to avoid pregnancy. These patients require evidence-based counseling to guide their contraceptive choices, particularly in the setting of hormonally driven pathology. In this review article, we outline known data on contraceptive options for patients with borderline ovarian tumors, endometrial hyperplasia, cervical/vulvar dysplasia, and atypical lobular and ductal hyperplasia. We also identify gaps in knowledge and opportunities for further research. Patients with gynecologic and breast dysplasia benefit from comprehensive contraception counseling. More research is needed on contraceptive options for patients with dysplasia.

PurposeThis systematic review and meta-analysis aimed to examine the relationship between ovarian and colorectal cancer, with a particular focus on the standardized incidence ratio (SIR).MethodsA comprehensive search was conducted across multiple databases, including Scopus, Web of Science, PubMed, and Google Scholar. A total of 20 studies were included in the final analysis.ResultsThe results indicated that women with ovarian cancer had a significantly higher incidence of colorectal cancer (SIR, 1.69; 95% confidence interval [CI], 1.39–1.98), with an increased risk for both colon (SIR, 1.57; 95% CI, 1.14–1.99) and rectal cancers (SIR, 1.58; 95% CI, 1.38–1.78). Subgroup analysis of borderline ovarian tumor revealed an SIR for colorectal cancer of 1.27 (95% CI, 0.99–1.55), with a significant risk in the serous subtype (SIR, 1.38; 95% CI, 1.09–1.67). Conversely, studies examining ovarian cancer in women diagnosed with colorectal cancer showed an SIR of 1.48 (95% CI, 1.17–1.79). Specifically, women with colon cancer had a higher incidence of ovarian cancer (SIR, 1.64; 95% CI, 1.25–2.03), while women with rectal cancer showed a decreased risk (SIR, 0.88; 95% CI, 0.77–0.99). The results underscore the potential bidirectional relationship between ovarian and colorectal cancers, which may be influenced by genetic predispositions.ConclusionFuture advanced genetic studies are needed to better understand the underlying molecular mechanisms. Additionally, the results emphasize the importance of careful cancer surveillance and early detection strategies for women with a history of either ovarian cancer or colorectal cancer.

Background/Objectives: To determine whether long-term oncological follow-up is required following fertility-sparing surgery (FSS) for mucinous borderline ovarian tumours (MBOTs). Methods: A retrospective cohort study set in the tertiary gynaecology oncology centre at Imperial College Healthcare NHS Trust. Patients included were those under follow-up post-surgery for an MBOT in the ovarian clinic from 2007 to 2025. Rate of recurrence was compared amongst patients who underwent ovarian cystectomy, unilateral salpingo-oophorectomy (USO) or bilateral salpingo-oophorectomy (BSO) +/- hysterectomy. Results: From 74 patients diagnosed with MBOT, 36.5% (27/74) underwent BSO +/- hysterectomy and 63.5% (47/74) had FSS. Of the patients who underwent FSS, 59.6% (28/47) had an initial USO and 40.4% (19/47) underwent ovarian cystectomy. Subsequently, 63.2% (12/19) of patients who initially had ovarian cystectomy proceeded with completion USO, leading to a total of 40 USOs performed. There were no recurrences following BSO +/- hysterectomy, primary USO or completion USO after a median follow-up of 49.0, 65.5 and 48.0 months, respectively. Of the patients who underwent ovarian cystectomy, 15.8% (3/19) were found to have residual MBOT (n = 1) two months post-cystectomy or MBOT recurrence (n = 2) at 10- and 66-months post-cystectomy, all diagnosed at USO. There is a significant association between ovarian cystectomy and disease recurrence (Fisher's exact test p = 0.015). Conclusions: Patients of reproductive age who undergo USO for a MBOT can be offered a reduced follow-up schedule as the risk of recurrence is very low. In contrast, patients who are managed by ovarian cystectomy have a higher risk of recurrence and require long-term surveillance monitoring.

This article presents a rare clinical case of laparoscopic port hernia in a 47-year-old patient after surgical intervention for serous borderline ovarian tumor. No complications occurred during the operation: the laparoports were placed in standard points, evacuation of the removed tissues was performed transvaginally in the endobag. However, in the postoperative period, the patient developed dyspeptic phenomena without significant effect of conservative therapy. In the course of dynamic examination the increasing symptoms of partial high small intestinal obstruction were revealed, in this connection, taking into account the ineffectiveness of conservative therapy, a laparotomy was performed on the 12th day of the postoperative period. The revision of the abdominal cavity revealed a loop of small intestine fixed to the trocar wound.

Machine learning-enhanced gas sensor technology identifies ovarian and endometrial cancer of all stages through plasma volatile organic compound patterns

Controlled ovarian stimulation (COS) is a feasible method for treating borderline ovarian tumors (BOTs) after fertility-sparing surgery (FSS). The recurrence rate does not appear to be higher in women treated with COS, and it is important to assess its effects on the pregnancy rate. There have been no reports comparing different COS regimens in patients with BOTs. This retrospective observational study included 73 BOT patients who underwent COS. Patients were divided into two groups according to the COS regimen: the mild stimulation group (36 patients) and the agonist/antagonist cycle group (37 patients). In this study, the effects of the COS regimens on pregnancy outcomes and the risk of tumor recurrence were compared. The follow-up time among the 73 patients was 61 (7-156) months. The proportion of patients with a serous histopathology and a micropapillary architecture was 33.3% in the mild stimulation group, which was significantly greater than that in the agonist/antagonist cycle group (P = 0.045). The initial dose of gonadotropin (Gn), the total dose of Gn, the duration of Gn treatment, and estradiol (E2) on trigger day were significantly lower in the mild stimulation group than in the agonist/antagonist cycle group. Furthermore, the number of oocytes retrieved, the number of good-quality embryos produced and the number of embryos frozen was also significantly lower in the mild stimulation group. The cumulative live birth rate (CLBR) was 46.4% (13/28) in the mild stimulation group and 53.3% (16/30) in the agonist/antagonist cycle group, and the difference between the two groups was not significant (P = 0.599). E2 on trigger day (HR: 15.217, 95%CI: 1.215-190.595, P = 0.035) and the total dose of Gn (HR: 12.578, 95%CI: 1.035-152.888, P = 0.047) were independent factors affecting tumor-related outcomes. However, the COS protocol had no significant effect on the tumor-related outcome (P = 0.122). E2 on trigger day and the total dose of Gn are independent factors affecting the tumor-related outcome. Overstimulation of the ovaries should be avoided. Mild stimulation regimens and agonist/antagonist cycle regimens are both safe and effective for treating infertile patients with BOTs. Mild stimulation is more suitable and safer for patients with high-risk factors such as recurrence prior to COS and a serous histopathology with a micropapillary architecture.

The study aimed to evaluate the incidence and features of the follicle-preserving sign (FPS) and investigate its usefulness in differentiating the grades of malignancy of ovarian tumors using magnetic resonance imaging (MRI). This retrospective study examined 234 patients of reproductive age with a confirmed diagnosis of ovarian lesions at Shinshu University Hospital between January 2014 and December 2023. Preoperative MR images of each patient were independently evaluated by two radiologists. First, 20 patients with malignant ovarian tumors were randomly selected. To define the MR findings of normal follicles, we observed the contralateral unaffected ovary. Next, the presence of FPS in the affected ovaries was examined in all patients. Finally, the FPS frequency was statistically analyzed in relation to patient age, maximum tumor diameter, tumor malignancy, MRI magnetic field strength, MRI slice thickness (MRIST), and histological subtype. Among 276 ovarian lesions (benign, 146; borderline, 51; malignant, 79), the follicle-preserving sign (FPS) was significantly more frequent in benign tumors than in malignant tumors (p < 0.001), while no significant difference was observed between borderline tumors and the other two groups. Multivariate analysis identified patient age, tumor diameter, and MRIST as independent factors associated with FPS, with MRIST exerting the greatest influence (OR = 0.75, p = 0.006). Compared with malignant tumors, benign tumors tended to be smaller and were imaged with thinner slices, contributing to a higher FPS incidence. Importantly, even after stratification by MRIST, benign tumors consistently showed a significantly higher FPS rate than malignant tumors across all subgroups (p < 0.05). FPS frequency also varied by histological subtype, being frequent in serous/seromucinous borderline tumors and immature teratomas, but uncommon in mucinous tumors irrespective of malignancy status. The incidence of FPS was significantly higher in benign tumors than malignant tumors. However, it should be noted that FPS expression is affected by MRIST.

Borderline ovarian tumours: A comprehensive review of published evidence.

Borderline ovarian tumors: Recurrence patterns and management in a single-institution retrospective study.

Endometriosis and Borderline Ovarian Tumors: MRI Imaging Characteristics and Management

To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2022 and the Annual Treatment Report for 2017, on the outcomes of patients who started treatment in 2017. The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2022 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2017 was analyzed by using the Kaplan-Meier, log-rank, and Wilcoxson tests. Treatment was initiated in 2022 for 8039 patients with cervical cancer, 14 518 with endometrial cancer, 8524 with ovarian, tubal, and peritoneal cancer, 2360 with ovarian borderline tumors, and with the others (270 vulvar cancer, 179 vaginal cancer, 539 uterine sarcoma, 48 uterine adenosarcoma, 158 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients who initiated treatment in 2017 were as follows. For cervical cancer, the rates were 93.0%, 76.1%, 59.5%, and 28.3% for Stages I, II, III, and IV, respectively. For endometrial cancer, the rates were 94.9%, 88.8%, 72.7%, and 28.9% for Stages I, II, III, and IV, respectively. For ovarian cancer, the rates were 91.7%, 76.6%, 54.4%, and 45.2% for Stages I, II, III, and IV, respectively. The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.

To evaluate the strategies and outcomes of assisted reproductive technology (ART) for fertility enhancement and preservation in women with malignant tumors, and to analyze ART outcomes across different tumor types. We conducted a retrospective analysis of female patients who underwent ART for fertility enhancement and preservation at the Reproductive Medicine Center of the Women's Hospital, Zhejiang University School of Medicine, between January 1, 2018 and December 31, 2023. A total of 163 ART-aided pregnancy patients with malignant tumors were included in the case group, among which 6 patients underwent embryo cryopreservation for fertility preservation before radiotherapy or chemotherapy. Additionally, 11 unmarried women underwent oocyte cryopreservation due to borderline ovarian tumors, ovarian cancer, breast cancer, or hematological malignancies. The control group was selected from women without a history of malignant tumors who received ART treatment during the same period, using propensity score matching at a ratio of 1∶2, resulting in 326 cases. Data were collected through the reproductive medical record system and telephone follow-up (as of October 31, 2024). Baseline characteristics, controlled ovarian hyperstimulation parameters, laboratory indicators, and pregnancy outcomes were compared between case and control groups and among patients with different tumor types, and the tumor recurrence of the patients was followed up. Patients in the case group had significantly lower ovarian reserve (anti-Müllerian hormone, antral follicle count) and a higher proportion of diminished ovarian reserve compared to the control group (all P<0.01). Regarding the ovulation induction protocol, the proportion of patients using a minimal stimulation protocol in the case group was significantly higher than that in the control group (29.45% vs. 12.88%, P<0.01), and the total dosage of gonadotropins used was lower (P<0.01). In terms of ART outcomes, there were no statistically significant differences between the two groups in the number of retrieved oocytes, number of high-quality embryos, fertilization rate, cumulative pregnancy rate, cumulative live birth rate, or miscarriage rate (all P>0.05). However, the number of oocyte retrieval cycles and embryo transfer cycles required to achieve a live birth outcome in the case group were significantly higher than those in the control group (both P<0.05). Subgroup analysis showed that there were no significant differences in cumulative pregnancy rate and live birth rate among patients with different tumor types, such as thyroid cancer, reproductive system tumors, breast cancer and lung cancer (all P>0.05). Nevertheless, lung cancer patients had the lowest ovarian reserve and required the most oocyte retrieval cycles due to the older age; breast cancer patients had a relatively lower fertilization rate partially because some of them were complicated with male factors. 154 tumor patients were followed up. Among the 143 married patients undergoing embryo cryopreservation/embryo transfer, 6 patients (4.20%) had tumor recurrence, and one breast cancer patient died due to tumor recurrence. Among the 11 unmarried patients who had undergone oocyte cryopre-servation, none had yet used the cryopreserved oocytes for assisted pregnancy yet, and one patient died due to tumor recurrence. Women of reproductive age with malignant tumors are at risk of diminished fertility. ART can effectively enhance and preserve fertility, enabling favorable pregnancy and live birth outcomes.