An RPCI Cancer Talk reader inquired recently about the treatment and prognosis of borderline mucinous epithelial carcinoma. Because this is a diagnosis that may be unfamiliar to many, I would like to share my response here on Cancer Talk to help others understand what it is. Many thanks to the reader for submitting the question!
A "carcinoma" is a word used to describe any cancer that begins in the skin or in tissues that line or cover internal organs, such as the ovaries. Epithelial carcinoma of the ovary is one of the more common gynecologic carcinomas, arising from the "epithelial" cells of the ovary. Epithelial cells are cells that line hollow organs and glands and those that make up the outer surface of the body. Borderline tumors of the ovary, more frequently termed "low malignant potential ovarian tumors," are not actually considered carcinomas because the cells do not appear to be invasive under the microscope, as we would see with an ovarian cancer.
One way to think of this is to imagine ovarian tumors along a spectrum, with a benign ovarian tumor on one end and an actual ovarian cancer on the other end of the spectrum. Low malignant potential ovarian tumors are in the middle, with some clinical and microscopic characteristics appearing more aggressive than a benign cyst, but with no evidence of actual cancer.
Prognosis and Treatment
Overall, these tumors have an excellent prognosis with surgery alone, particularly if the tumor was confined to the ovary (stage I). The prognosis is much better than ovarian cancer, and the overall survival for stage I disease is likely better than 97%. Chemotherapy is rarely used, and only if there are certain microscopic features that might predict a higher risk of recurrence. For that reason, it may be a good idea for the pathology to be reviewed by a pathologist with experience in gynecologic tumors, such as the pathologists at Roswell Park. Although the recurrence risk is low, many experts would also recommend removing the other ovary, along with a hysterectomy (removal of the uterus), when future fertility is no longer desired.
One resource that I have found helpful is the website of the National Cancer Institute (NCI) to help patients learn more about low malignant potential ovarian tumors.