Laparoscopic management of unexpected borderline ovarian tumors in women of reproductive age

Purpose of investigation: The aim of this study was to review the clinical features of women with unexpected borderline ovarian tumours. Methods: Between October 1992 and December 2010, 1,332 out of 4,016 laparoscopies were performed for adnexal masses in women of reproductive age and 1,838 cysts were removed. When ultrasonographic findings did not meet the criteria for low risk malignancy, tumour markers, colour Doppler and MRI/CT were applied. At laparoscopy any solid component or papilla was sent for rapid frozen section. Results: Borderline ovarian tumours were found in eight (0.6%) out of 1,332 patients, two of which were bilateral. The mean age was 28.75 +/- 9.27 years and the mean diameter of the cysts was 5.1 +/- 1.7 cm. In two cases unexpected malignancy was discovered during the diagnostic and in six cases during the operative phase of the intervention. Conclusion(s): Risk of failure to diagnose cancer could be minimised with careful patient selection preoperatively. Adequate training on laparoscopic oncology is the necessary prerequisite for a safe laparoscopic approach.