Any role for adjuvant chemotherapy in advanced-stage borderline ovarian tumors? A case report and review of the literature

Background Borderline ovarian tumors (BOTs) typically affect young women; therefore, fertility preservation is a major concern in their management. Fertility-sparing surgery (FSS) is considered the standard of care for BOTs, regardless of disease stage. However, its oncologic safety remains debated, and the role of chemotherapy in this setting is still unclear. Case presentation We present the case of a 37-year-old woman diagnosed with a FIGO stage IIIB micropapillary borderline ovarian tumor involving both ovaries, with invasive implants on the surface of the right ovary and fallopian tube, as well as diffuse non-invasive desmoplastic implants at other peritoneal sites. The patient underwent debulking fertility-sparing surgery (FSS), resulting in pelvic residual disease (RD). Given the advanced stage, histopathologic features, and the patient’s reproductive goals, six cycles of adjuvant carboplatin chemotherapy were administered. After the patient decided not to pursue further fertility preservation, completion surgery was performed, revealing a complete pathological response with no microscopic RD. Conclusions This case illustrates an advanced-stage micropapillary serous BOT in which complete pathological response was obtained after upfront FSS and adjuvant carboplatin chemotherapy. This outcome is noteworthy and hypothesis-generating, as the benefit of chemotherapy in this setting remains controversial in the literature.