Borderline endometrioid tumors are extremely rare. More often they are an integral part of endometrioid cancer and are associated with transitional variants. These tumors are often unilateral, occur in the foci of endometriosis. The frequency of malignancy of endometriosis varies from 1 to 11.4%. The morphogenetic mechanisms of the occurrence of malignant tumors in endometriosis have been little studied. A borderline type Brenner tumor is extremely rare. Treatment of borderline tumors. In practice, one cannot limit oneself to the diagnosis of a borderline tumor only by equipping the study of the primary lesion and searching for the initial signs of invasive growth. A microscopic examination of the omentum and the most common sections of the peritoneum for disseminates is necessary. The method of DNA cytometry allows you to distinguish between diploid, aneuploid or polyploid types of tumors. In the first case, the prognosis is favorable, the latter is characterized by the same clinical course as with ovarian cancer. Staging with borderline tumors is carried out, as with ovarian cancer. The nature of the disseminates and the type of stromal reaction around the tumor cells make it possible to get the most accurate picture of the prognosis of the disease. There are no clear recommendations when planning treatment of patients with borderline tumors. Considering that stage 75 of the disease is diagnosed in 75% of patients with borderline tumors, women of reproductive age are recommended to perform unilateral removal of tumor-modified uterine appendages, resection of the contralateral ovary, removal of the greater omentum and multiple peritoneum biopsy. It is advisable for elderly patients to perform uterine extirpation with appendages, removal of the greater omentum, and a peritoneal biopsy. In cases of complete excision of the tumor in patients with stage I disease, chemotherapy or radiation therapy is not indicated. At present, no convincing data have been obtained that in the early stages of borderline ovarian tumors, additional drug, radiation, and hormone therapy improves treatment outcomes. In a common process (stage II-III), uterine extirpation with appendages, omentectomy, revision of the abdominal organs, and peritoneal biopsy are performed. Further treatment is carried out, as with ovarian cancer. 5-year survival in borderline stage I tumors is 100%, in II -75%.
Tecoma (tecablastoma, a cell-cell, feminizing tumor) accounts for up to 5% of all ovarian tumors. It develops from spindle-shaped cells of the inner shell of the follicle tire, which produce estrogens, and with their luteinization – progesterone. As a result, premature puberty (8-10 years) or late extinction of menstrual function (55-60 years) (early or late feminizing syndrome) is possible. In childhood, secondary sexual characteristics appear prematurely (mammary glands develop, cyclic or acyclic spotting from the uterus appears, hair growth on the pubis). In women of childbearing age, the menstrual cycle is disrupted (menorrhagia, metrorrhagia, amenorrhea), infertility or a tendency to miscarriage are noted . During menopause, menstruation resumes or acyclic spotting appears, the uterus increases due to hypertrophy and hyperplasia of the myometrial cells, the mammary glands increase, hyperplasia of the mucous membrane of the vagina and cervix, as well as the endometrium, sexual desire increases. Tecoma often develops in women after 40 years of age, a unilateral tumor of a dense or tight elastic consistency, can reach large sizes. On the section, the tissue is yellow, sometimes with patches of small cysts containing opacifying follicular fluid of a yellowish color Tekoma is often accompanied by menstrual irregularities such as menometrorrhagia, hemorrhagic metropathy, and infertility. Diagnosis of tecoma is difficult. The diagnosis is usually made on the operating table macroscopically or by biopsy. Surgical treatment – removal of the affected ovary. After the operation (with the second ovary preserved), the menstrual cycle is restored and infertility is eliminated.