Comparative Analysis of Borderline Ovarian Tumors: A 5-Year Tertiary Center Experience

INTRODUCTION: This studyaims to evaluate clinical, pathological, biochemical, and imaging differences among borderline ovarian tumors (BOTs) subtypes, serous, mucinous, and seromucinous, to improve preoperative diagnosis.
METHODS: A retrospective analysis was conducted at Kartal City Hospital between January 2018 and October 2023, including 59 patients with histologically confirmed BOTs. Patients were classified into serous (n=36), mucinous (n=18), and seromucinous (n=5) subtypes. Demographic data, tumor markers, inflammatory indices, imaging characteristics, intraoperative frozen section results, and final histopathology were compared.
RESULTS: A total of 59 patients with BOTs were analyzed: 36 (61.0%) serous, 18 (30.5%) mucinous, and 5 (8.5%) seromucinous. The mean age was similar across groups: serous 44.1 ± 12.2 years, mucinous 47.5 ± 19.5 years, seromucinous 45.2 ± 4.3 years (p=0.725). Mucinous tumors were larger (14.0 ± 8.8 cm) than serous (6.9 ± 2.4 cm) and seromucinous (7.7 ± 4.5 cm) (p=0.001). CA-125 and CA19-9 levels differed significantly (p=0.007 and p=0.017), with the highest levels in seromucinous tumors. Solid components on ultrasound were more frequent in serous (50%) and seromucinous (60%) tumors compared to mucinous (16.7%) (p=0.041). MRI septation was most common in mucinous tumors (66.7%, p=0.036). No significant differences were observed for menopausal status, comorbidities, tumor laterality, or frozen section results. AARPTI values differed significantly (p=0.001), highest in mucinous tumors (0.66 ± 0.33).
DISCUSSION AND CONCLUSION: This study revealed that mucinous BOTs are characterized by larger tumor size and higher AARPTI values, while seromucinous tumors exhibit elevated CA-125 and CA19-9 levels. Ultrasound and MRI findings also may aid in the differentiation among subtypes. These distinctions can enhance preoperative diagnosis and guide tailored surgical management.

Keywords: Borderline ovarian tumor, serous borderline tumor, mucinous borderline tumor, seromucinous borderline tumor, preoperative diagnosis, tumor markers, imaging features