A 35-year-old woman has bilateral ovarian masses. Histology shows epithelial proliferation with nuclear atypia but no destructive stromal invasion. The diagnosis is:

• A Low-grade serous ovarian carcinoma
• B High-grade serous carcinoma
• C Serous cystadenoma
• D Borderline ovarian tumor (ovarian tumor of low malignant potential) ✓

Explanation

Borderline ovarian tumors (tumors of low malignant potential) are defined histologically by epithelial proliferation with nuclear atypia and increased mitotic activity but WITHOUT destructive stromal invasion — the key distinguishing feature from invasive carcinoma. They occur in younger women and have an excellent prognosis (5-year survival >95% for stage I). Low-grade serous carcinoma shows invasive implants and destructive invasion. Serous cystadenoma lacks atypia. Fertility-sparing surgery (cystectomy or unilateral salpingo-oophorectomy) is appropriate for stage I borderline tumors.

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

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