A case report of second fertility-preserving surgical management for early recurrence of young woman with borderline ovarian tumors

Abstract

Abstract Background Borderline ovarian tumors (BOTs) have low malignant potential and favorable prognoses. The group most affected By BOTs are women of childbearing age; therefore, fertility-sparing surgery is considered the first choice for young patients. Several studies have reported that conservation treatment is associated with a higher recurrence rate; however, data on treatment and clinical management after relapse are scarce. Case presentation: A 19-year-old woman was admitted to our hospital for two weeks due to unexplained abdominal distension. Palpation of the uterus was unsatisfactory, and an ultrasound examination revealed abdominal effusion and a cystic solid mass in front of the uterus. The patient required fertility and underwent fertility-sparing procedures, including abdominal right adnexectomy and excision of the left ovarian mass. Histological examination confirmed stage III serous BOTs. The patient had normal menstruation after surgery. After 20 months, the patient experienced a recurrence of serous stage IIIC BOTs, and a second fertility-sparing surgery was performed. Currently, there was no disease recurrence until the last follow-up, but the patient had stopped menstruating for six months and had not yet completed childbirth. Conclusion In young women diagnosed with BOTs, fertility preservation surgery may be associated with a higher risk of recurrence, especially in advanced patients. Clinically, pregnancy should be recommended as early as possible after surgery, and long-term follow-up is required.