Recurrence of borderline ovarian tumor during pregnancy – is wait-and-see approach a possible strategy? Case report and literature review

Borderline ovarian tumors (BOT) are neoplasms with low malignant potential, which are characterized by atypical epithelial proliferation without destructive stromal invasion. They account for 15–20 % of all epithelial ovarian tumors, with serous and mucinous BOT being the most common. The incidence of BOT ranges from 1.5 to 4.8 cases per 100,000 women, with at least one-third of patients being younger than 40 years at the time of diagnosis. Therefore, one of the most critical aspects of treatment is fertility preservation. The “gold standard” for organ-sparing treatment is resection of the affected ovary or adnexectomy, accompanied by mandatory surgical staging. Most BOT are diagnosed at early stages (FIGO I), ensuring a favorable prognosis with a 5-year survival rate of 95 % and a 10-year survival rate of 90 %. Recurrences occur in 5–34 % of cases, most often as borderline tumors and less frequently as invasive ones. Although conservative treatment is considered one of the risk factors for subsequent recurrences, its impact on overall survival has not been proven. We describe a clinical case of fertility-sparing treatment for a recurrent during second pregnancy BOT, initially diagnosed in a young woman during the first trimester of her first pregnancy.