Borderline tumor

Denkert C, Budczies J, Kind T, et al. Mass spectrometry-based metabolic profiling reveals different metabolite patterns in invasive ovarian carcinomas and ovarian borderline tumors. Cancer Res. 2006 66 10795-10804. 

Recently, Caduff et al. (1999) have evaluated abnormalities in p53 and Ki-ra.v in malignant and borderline ovarian tumors of various histological types in paraffin-embedded tissues. The patterns of these genetic alterations in borderline and malignant neoplasms were compared and correlated with cell type and stage. This preliminary molecular analysis suggests that serous borderline tumors have the same molecular features usually associated with malignancy but are unlikely to represent a precursor of invasive serous carcinoma. On the other hand, mucinous borderline tumors may represent a precursor or variant of mucinous carcinoma of the ovary. 

High uPAR levels in breast, colorectal, and lung cancers predict short overall survival. However, the opposite was found for uPAR in tumor tissue from ovarian cancer patients [143]. Proteins in this study were extracted from the tumor tissue using the Triton X-100-containing acidic buffer [124]. The levels of uPAR, measured with the E4 ELISA, were lower in benign as compared to invasive or borderline tumors. However, among the malignant tumors, the more advanced and poorly differentiated tumors contained lower levels of uPAR than the well-differentiated, less advanced tumors. 

Trope C, Kaern J, Vergote IB, et al. Are borderline tumors of the ovary over-treated both surgically and systemically A review of four prospective randomized trials including 253 pahents with borderline tumors. Gynecol Oncol 1993 51 236-243. 

Bell DA, Scully RE. Serous borderline tumors of the peritoneum. Am J Surg Pathol. 1990 14 230-239. 

Rutgers JL, Bell DA. Immunohistochemical characterization of ovarian borderline tumors of intestinal and mullerian types. Mod Pathol. 1992 5 367-371. 

Sherard et al. reported an average size of 11.5 cm in malignant lesions, in contrast to benign lesions, which showed an average size of 7.6 cm [48]. Furthermore, papillary projections were a typical finding of borderline tumors. 

The imaging features are nonspecific and may be similar to malignant tumors or borderline tumors. Variable amoimts of fibrous stroma in ovarian cystadenofibromas produces imaging features that vary from purely cystic to a complex cystic tumor with one ore more solid components (Fig. 9.27). In one series of 32 ovarian cystadenofibromas, 50% displayed as multiloculated masses identical to cystadenomas. The other half were complex cystic tumors with one or more solid components and smooth thickened septa [70]. 

Absence of ascites may not exclude a malignant disease, as 50% of borderline tumors and 83% of early-stage ovarian cancers are not associated with ascites [4]. Peritoneal carcinosis is characterized by various amounts of ascites and difiuse or focal peritoneal thickening. Benign forms of ascites displaying the same pattern such as postoperative inflammatory changes, bacterial peritonitis, or chronic hemodialysis cannot be differentiated from peritoneal carcinosis... 

Patients with malignant tumors of the ovary and borderline tumors account for 21% and 4% of primary ovarian tumors, respectively [12], Among these, epithelial cancer constitutes for the vast majority with 85%. Serous epithelial and mucinous ovarian cancer account for the majority of epithelial ovarian cancers and present approximately 49% and 36% of all ovarian epithelial tumors, respectively [3], Endometrioid cell cancers account for 8%. The other cancers occur with equal frequency of 2% [3],... 

Borderline tumors are epithelial ovarian cancers with low malignant potential. They account for approximately 4%-14% of all ovarian malignancies and present a different entity from invasive epithelial cancers. Serous and mucinous borderline tumors can be distinguished by specific histologic features including epithelial budding, multilayering of the epithelium, increased mitotic activity, nuclear atypia, and lack of stromal invasion cancer [2]. 

Borderline tumors may be large, with diameters ranging from 7 to 20 cm bilaterality is common. Mucinous tumors of borderline malignant potential tend to be larger, and may be associated with pseudomyxoma peritonei. 

Borderline tumors tend to be large unilateral or bilateral ovarian tumors that cannot be distinguished from invasive ovarian cancers in CT or MRI. Papillary projections ranging from 10 to 15 mm in size and protrude into the cyst wall are more frequently found in borderline tumors compared to benign and malignant epithelial ovarian tumors (Fig. 10.22) [22]. Rarely, borderline tumors may present as a unilocular cyst larger than 6 cm in size [43]. 

Mucinous cystadenoma usually occur in women. In contrast to (the always benign) serous cystadenoma, mucinous tumors represent a histologic spectrum, ranging from adenoma, borderline tumor to non-invasive and invasive carcinoma. With advancing age, the histologic grade of the tumor tends to worsen. The CT appearance is always macrocystic (therefore the synonym... 

---