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management of borderline endometrioid tumors?

I am a 36 year old woman who was discovered to have two cysts on the right ovary. I had a CA-125 of 40.  My mother passed away of cancer of the fallopian tube, so my gynecologist wanted to perform surgery to be sure about the nature of the cysts.

He removed the right ovary along with the cysts and the right fallopian tube. During the surgery he made an initial diagnosis of endometriosis and burned off some of the implants that he found. (He showed me the pictures).  One of the cysts ruptured during removal.

The pathology came back as atypical proliferative borderline endometrioid tumor, and a consult with Johns Hopkins pathology confirmed the diagnosis.  

I have an appointment with a gyn-oncologist, but I would like to do as much research as possible before.  

What would the the appropriate course of treatment based on the diagnosis?  Is it significant that my surgery was not performed by a gynecological oncologist?  How do I know that those implants were not also borderline (or malignant tumors)...my gynecologist would not answer that question.

I understand that borderline endometrioid tumors are quite rare, with the majority of them being malignant.

I would really appreciate any thought you could give to my case.  
Thank you so much
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Avatar universal
Thank you for your answer, Dr. Goodman!   I feel more prepared for the visit.

My gynecologist said that the oncologist will most likely want to do a procedure to explore the abdomen and nodes for evidence of disease.  Do you think that is likely to happen?


Thankimh you, Laura
Helpful - 0
242604 tn?1328121225
MEDICAL PROFESSIONAL
Hi There, thank you so  much for  your question.

Borderline tumors of the ovary are a category of ovarian tumor that comes from the lining of the ovarian which is called epithelial ovarian neoplasms (EOM)

the three broad categories of EOM are benign, borderline, and invasive carcinomas.
In each category, there are various cell types: serous, mucinous, endometrioid
there are other cell types that are only seen in invasive cancers: clear cell and undifferentiated.

So you have an endometrioid borderline tumor and you have clinical evidence of enodmetriosis.

Your doctor did absolutely the right thing for you.
Now with these findings these are the things to discuss with the gyn oncologist that you will be seeing:

Should you undergo a full hysterectomy and removal of your other ovary and fallopian?
Should you undergo genetic testing with BRCA 1/2?

My own thoughts are that you should consider both these interventions.
best wishes
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