Observational studyActa obstetricia et gynecologica Scandinavica2026
Seromucinous borderline ovarian tumors: Clinical and ultrasound characteristics and association with endometriosis.
Observational study in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSeromucinous borderline ovarian tumors represent a distinct borderline ovarian tumor histotype, yet their specific sonographic features and clinical associations remain undercharacterized. The objective of this study was to describe the ultrasound and clinical characteristics of seromucinous borderline ovarian tumors compared to other borderline tumor histotypes and to evaluate their association with endometriosis. MATERIAL AND
methodsThis single-center observational retrospective cohort study was conducted at a tertiary-level reference ultrasound unit. The primary outcome was to analyze the clinical and ultrasound characteristics of seromucinous borderline ovarian tumors compared to other histotypes. The secondary outcome was to evaluate their association with different endometriotic lesions. In women with borderline ovarian tumors, anamnestic data (age, body mass index, parity, menopausal status), preoperative serum carbohydrate antigens 125 and carbohydrate antigen 19.9 levels, ultrasound characteristics (according to the International Ovarian Tumor Analysis group), surgery type, and histological data, including endometriosis localization (superficial, deep, or ovarian), were extracted from medical records.
resultsAmong 151 women with borderline ovarian tumors, five had rare histotypes and were excluded. Of the 146 included women, 96 (63.6%) had a serous histotype, 27 (17.9%) a mucinous histotype, and 23 (15.2%) had a seromucinous histotype. Seromucinous borderline ovarian tumors were more commonly left-sided, unilateral unilocular or multilocular solid cysts, with ground-glass content, showing moderate vascularization at color Doppler examination (Color Score 3) of papillary projections/solid component. Moreover, they had higher preoperative levels of carbohydrate antigen 19.9 compared to other histotypes (p < 0.001). Endometriosis was detected in 26% of all study women but was significantly more frequent (70%) in women with seromucinous borderline ovarian tumors (p < 0.001).
conclusionsCompared to other histotypes, seromucinous borderline ovarian tumors appeared more commonly as left unilateral unilocular or multilocular solid cysts, with ground-glass content, showing moderate vascularization of papillary projections/solid component. Moreover, they showed a higher increase in serum carbohydrate antigen 19.9 and were associated with endometriosis in most cases.
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