Fertility-Sparing Surgery in Borderline Ovarian Tumour in Young: A Beacon in the Dark

Background Borderline ovarian tumors (BOTs) are not common tumors among epithelial ovarian tumors encountered by Gynecologists. These are often diagnosed at earlier stage, in younger age women and have better prognosis. This article outlines the recent literature and oncologic concerns with emphasis on controversies regarding mode of surgery, fertility sparing surgery and their outcomes. Our Experience We present four cases of BOTs in young who reported to our Gyneconcology OPD. Our first patient was a 30 years old Nulligravida who presented with large unilateral ovarian mass of 20 cms size. All tumor markers were normal & imaging revealed a multi-septate cystic lesion of 15cms. Second patient a 32 years old nulligravida who presented with abdominal distension with a large right ovarian mass 17cms size. Her CA125 was 234uIU/ml with HE4 90 pg/ml. Third case was a young 28 years old Nulligravida with pain abdomen and a large 30 cms size muti-loculated solid cystic Right ovarian mass. Fourth patient a 23 yrs old nulligravida presented with pain lower abdomen She had solid cystic Right adnexal mass of 5 cms with 4 cms cystic mass in Left adnexa on imaging. All patients underwent fertility sparing surgery and are under regular followup. Conclusion To conclude BOTs are uncommon ovarian tumors with excellent prognosis. Surgery is the main treatment modality. Young patients with early stage disease can safely undergo fertility sparing surgery with diligent follow up. Completion surgery can be done at time of recurrence if family completed.