Balancing Oncologic Safety and Fertility: A Case of Borderline Ovarian Tumor

Borderline ovarian tumors (BOTs) are epithelial neoplasms that mostly affect women of reproductive age; management requires a balance between oncological safety and fertility preservation. The aim of this case is to illustrate the importance of intraoperative decision-making, patient-centered care, and fertility-sparing management. We present a case of a 31-year-old woman whose right ovarian mass was initially diagnosed as a dermoid cyst by ultrasound. Intraoperatively, a borderline tumor was suspected, and biopsy of both ovaries, omental sampling, and peritoneal lavage for cytology were done. Histopathological examination confirmed a borderline tumor of serous type in the right ovary and a corpus luteum cyst in the left ovary. In the subsequent stage, a right salpingo-oophorectomy, a repeat biopsy of the left ovary, pelvic lavage, omentectomy, and appendectomy were performed using a laparoscopic approach. This case highlights the importance of individualized, stepwise surgical management, ensuring both oncological safety and fertility preservation.