A borderline serous ovarian tumor (serous borderline tumor of low malignant potential) is resected in a 28-year-old wishing to preserve fertility. Which feature, if found in the specimen, would MOST increase the risk of relapse and potentially indicate the need for staging surgery?

• A Micropapillary architecture (noninvasive)
• B Presence of psammoma bodies
• C Peritoneal implants — invasive type ✓
• D Stromal microinvasion <5 mm

Explanation

Invasive peritoneal implants in serous borderline ovarian tumors are the single most important adverse prognostic factor, significantly increasing the risk of recurrence and progression to low-grade serous carcinoma; they effectively upstage the disease and indicate the need for comprehensive staging. Micropapillary architecture is associated with higher recurrence rates but carries lower risk than invasive implants. Stromal microinvasion <5 mm and psammoma bodies do not independently worsen prognosis.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.