These tumors are also called LMP tumors, atypical proliferating tumors, or borderline tumors. When seen on ultrasound and CT scan, these tumors look the same as invasive epithelial ovarian cancers. To know for certain that the tumor isn’t an invasive epithelial ovarian cancer, a biopsy must be done. A biopsy sample is usually taken during surgery. Surgery for LMP tumors is similar to the surgery for invasive ovarian cancer, with the goals of removing the tumor along with full staging and debulking (see the section about surgery for details).
For women who have finished having children, the uterus, both fallopian tubes, and both ovaries are removed. Surgical staging is done to see if the tumor has spread outside the ovary or pelvis. This means removing the omentum and some lymph nodes, and doing washings of the abdomen and pelvis. If the patient wants to be able to become pregnant in the future, only the ovary with the tumor and the fallopian tube on that side is removed. Rarely, just the part of the ovary containing the ovarian cyst with the tumor is removed (ovarian cystectomy). These patients still should have surgical staging to see if the tumor has spread. If the tumor is only in one ovary, the patient is usually observed without further treatment. Experts recommend follow-up visits at least every 6 months for the first 5 years after diagnosis. Chemotherapy (chemo) and radiation therapy are not generally the first treatments used for tumors that haven’t spread outside the ovary.
If the tumor has spread outside the ovary when it is first diagnosed, the surgeon will remove as much of it as possible (debulk it). Treatment after surgery depends on something called invasion (when one kind of cell grows into organs or tissues where it doesn't belong). Part of what makes a cancer cell dangerous is its ability to invade other tissues. When LMP tumors spread, they can form tumor implants (deposits) on the lining of the abdomen (the peritoneum) and on the surface of organs in the abdomen and pelvis. Most often, these implants are non-invasive, meaning they haven't grown into the abdominal lining or organs. When they are growing into the peritoneum or the organs, they are said to be invasive.
Patients with non-invasive spread from an LMP tumor are usually observed without further treatment after debulking surgery. If the tumor implants are invasive, chemo may be offered. The chemo given is usually the same as that used for invasive ovarian cancer. Observation is often recommended for LMP tumors because they grow very slowly and even when they spread they are rarely fatal.
If the tumor comes back after initial surgery, further debulking surgery may be considered. Chemo and, rarely, radiation therapy are also options for recurrent LMP tumors.
Last Revised: 02/04/2016