Open Medicine

Giant borderline ovarian tumours – review of the literature

Abstract Introduction Giant borderline ovarian tumours (GBOTs) are rare neoplasms that require meticulous management to prevent high-risk operative complications. The broader goal of this systematic review is to consolidate the existing knowledge on GBOTs by focusing on diagnostic approaches, differential diagnoses, and treatment strategies. Furthermore, the relationship between the clinical features of GBOTs and the types of diagnostic and therapeutic procedures implemented was determined. Materials and methods The publications were analysed for the following data: histopathological type of GBOT; patient’s age; dimensions, weight, and/or volume of the tumour; levels and types of tumour markers determined; types of imaging tests performed; type of treatment applied. Results Twenty-one articles describing the clinical situation of 22 patients met the inclusion criteria for the systematic review. The mean age of the patients included in the analysis was 46.68 years (SD: 19.1 years); the youngest patient was 12, and the oldest was 76 years of age. In the analysed literature, patients most often (81.8%) had the mucinous type of GBOT. In the vast majority of cases (86.36%), based on the analysed literature, the surgical treatment method for the patients was laparotomy. In more than half of the patients (54.55%), the uterus was removed during surgical treatment. In the analysed literature, the hysterectomy procedure was not performed in patients under 40 years of age. Based on the analysed literature, it was found that if the CA 125 concentration in the blood serum of patients with mucosal tumours exceeded 40 U/mL, laparoscopy was not performed and the patients were treated using an open approach. Conclusions GBOTs are rare neoplasms that require meticulous management to prevent high-risk operative complications. Despite the diagnostic and therapeutic challenges posed by the large size and potential complications of these tumours, with proper medical care, patients can achieve successful outcomes and a good prognosis.

Molecular landscape of borderline ovarian tumours: A systematic review

Abstract Borderline ovarian tumours (BOTs) show intriguing characteristics distinguishing them from other ovarian tumours. The aim of the systematic review was to analyse the spectrum of molecular changes found in BOTs and discuss their significance in the context of the overall therapeutic approach. The systematic review included articles published between 2000 and 2023 in the databases: PubMed, EMBASE, and Cochrane. After a detailed analysis of the available publications, we qualified for the systematic review: 28 publications on proto-oncogenes: BRAF, KRAS, NRAS, ERBB2, and PIK3CA, 20 publications on tumour suppressor genes: BRCA1/2, ARID1A, CHEK2, PTEN, 4 on adhesion molecules: CADM1, 8 on proteins: B-catenin, claudin-1, and 5 on glycoproteins: E-Cadherin. In addition, in the further part of the systematic review, we included eight publications on microsatellite instability and three describing loss of heterozygosity in BOT. Molecular changes found in BOTs can vary on a case-by-case basis, identifying carcinogenic mutations through molecular analysis and developing targeted therapies represent significant advancements in the diagnosis and treatment of ovarian malignancies. Molecular studies have contributed significantly to our understanding of BOT pathogenesis, but substantial research is still required to elucidate the relationship between ovarian neoplasms and extraneous disease, identify accurate prognostic indicators, and develop targeted therapeutic approaches.