Borderline ovarian tumors, also known as tumors of low malignant potential, represent a unique category of epithelial ovarian tumors, occupying the space between benign and malignant. They account for 10-20% of epithelial ovarian tumors, according to Dr. Nguyen Ba My Nhi, Director of the Obstetrics and Gynecology Center at Tam Anh General Hospital in Ho Chi Minh City. Mrs. Ngan's ultrasound at Tam Anh General Hospital revealed a 15x18x10 cm tumor in her right ovary, accompanied by multiple pelvic lymph nodes on both sides. Biomarker tests and risk assessments categorized the tumor as having malignant potential.

Doctors performed a total hysterectomy and bilateral salpingo-oophorectomy, along with removal of the greater omentum and biopsies of the paracolic gutters. Post-operative pathology confirmed a borderline serous tumor in the right ovary. The uterus, fallopian tubes, left ovary, and biopsied lymph nodes showed no abnormalities. "This indicated that the tumor cells were confined to the ovarian mass and had not spread," Dr. My Nhi explained.

The surgical team performing the total hysterectomy and bilateral salpingo-oophorectomy on Mrs. Ngan. Photo: Tue Diem

The surgical team performing the total hysterectomy and bilateral salpingo-oophorectomy on Mrs. Ngan. Photo: Tue Diem

Non-invasive borderline ovarian tumors are not simply benign due to their potential for recurrence and transformation over time. These tumors exhibit cellular abnormalities and growth potential but lack the full characteristics of malignancy. However, there remains a risk of progression to cancer. Given Mrs. Ngan's age and lack of desire for future pregnancies, a complete surgical approach was chosen.

She was discharged 3 days after the surgery. Follow-up appointments were scheduled for 4 weeks post-operation, then every 3 months for the first two years, and every 6 months thereafter.

According to Dr. My Nhi, the treatment for borderline ovarian tumors requires a personalized approach based on the patient's age, reproductive desires, and ovarian status. Studies show a 5-year survival rate of approximately 95% and a 10-year survival rate of 90% for patients with borderline ovarian tumors. Early detection and appropriate management are crucial for a positive prognosis. Prognosis also depends on the tumor's histological subtype, with serous and mucinous tumors generally having better outcomes. However, factors like the presence of small papillae, bilateral ovarian involvement, or microscopic invasion can increase the risk of recurrence.

Ovarian tumors often develop asymptomatically. Depending on their size, they can cause various symptoms. Most are incidentally discovered during routine checkups, abdominal ultrasounds, or during Cesarean sections. Women experiencing abnormal abdominal enlargement, persistent bloating, or unexplained weight changes should seek medical attention. There's currently no screening method for ovarian cancer, so women should undergo regular gynecological checkups every 6-12 months or seek immediate medical advice if they experience pelvic pain, menstrual irregularities, palpable masses, or unusual abdominal swelling.

Tue Diem

*The patient's name has been changed.