Borderline ovarian tumor in the pediatric and adolescent population: a clinopathologic analysis of fourteen cases.

Borderline ovarian tumors (BOTs) are rare among children and adolescents. This study was to probe into the clinicopathologic characteristics and prognosis in children and adolescents with BOT. A retrospective investigation was performed on 14 adolescents younger than age 21 years diagnosed with BOT. Clinical presentation, preoperative characteristics, surgery, tumor stage, histology, and recurrence were collected. The results showed that median age at diagnosis was 17.5 years, mostly after menarche. Abdominal mass/pain were the most common presenting symptoms. Median tumor size was 14 cm. Cancer antigen-125 (CA-125) in the blood serum was elevated by 41.67% (5/12), and CA-199 was elevated by 16.67% (2/12). All patients had fertility-preserving surgery: 66.67% (8/12) via laparoscopy (LSC) and cystectomy, 33.33% (4/12) via laparotomy and unilateral salpingo-oophorectomy (USO), and 1 case recurred, and underwent panhysterectomy and bilateral salpingo-oophorectomy. 4 out of 14 tumors (28.57%) had serous and 10 of 14 (71.43%) had mucinous histology. Five tumors showed histological microinvasion. Median follow-up time was 52 months. 10 of 14 cases were alive at last follow-up without disease, and 4 of 14 cases were at lost visit. Thus BOTs in children and adolescents are very rare tumors which have excellent prognosis even in advanced stages, when managed with fertility-preserving procedures. Close follow-up is important because of the high recurrence rates many years after diagnosis.