Which histologic findings are characteristic of borderline ovarian cancer?

Updated: Mar 18, 2019
  • Author: Andrew E Green, MD; Chief Editor: Warner K Huh, MD  more...
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According to Dietel and Hauptmann, the histology of borderline tumors is characterized by the following features:

  • Epithelial multilayering of more than 4 cell layers

  • Not more than 4 mitoses per 10 high-power field (HPF)

  • Mild nuclear atypia

  • Increase in nuclear/cytoplasmic ratio

  • Slight to complex branching of epithelial papillae and pseudopapillae

  • Epithelial budding and cell detachment into the lumen

  • No destructive stromal invasion - A major component in differentiating malignant from borderline tumors

Mucinous tumors look grossly similar to their benign counterparts, having large, multilocular cysts with smooth surfaces. The epithelial layer is characterized by stratification of 2-3 layers. Nuclear atypia, enlarged nuclei, and mitotic figures are observed.

Approximately 25% of borderline tumors have cell proliferations on the outer surface of the lesion, with no evidence of growth from the inner surface. Of these, approximately 90% develop peritoneal implants. Only 4% of cases with peritoneal implants do not have surface proliferation.

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