A low malignant potential tumor of the ovary is often called an LMP tumor, or a borderline tumor. LMP tumors makeup approximately 15% of ovarian cancer. This type of ovary cancer occurs most often between age 15-30. If a young patient develops ovarian cancer it is more likely to be an LMP tumor. The names reflect the microscopic appearance that has some features of aggressive cancers and some features of benign tumors. The borderline name also describes an uncertain future behavior which is sometimes more benign and sometimes identical to aggressive ovarian cancers. Expert pathology interpretation is crucial for proper management of these tumors. Treatment is different for a low malignant potential tumor compared to a high-grade aggressive ovarian cancer. Treatment is primarily surgery. An LMP ovarian cancer may be cured with surgery. If an LMP ovarian cancer does recur, then it may changes its appearance and its behavior and often has evolved into a low-grade serous ovarian cancer. That type is more aggressive and more invasive and even more prone to metastatic disease.
This type of cancer will most often present with a pelvic pressure or pain, and sometimes with urinary frequency or constipation and abdominal bloating. Further evaluation with an exam may reveal a pelvic mass.
Additional studies are usually done to explain patient's symptoms or an abnormal exam. Ultrasound or CT scan would reveal an ovarian cyst/tumor or mass caused by an ovarian cancer. Suspicion of cancer is often based on exam and ultrasound findings. Surgery is initially recommended because a concerning ovarian cyst or tumor has been found. Prior to surgery it is difficult to confirm cancer when no spread is seen on x-rays or ultrasounds. If an ovarian tumor is not a simple cyst and is involved with complex features, then ovarian cancer including the LMP cancer is a more likely cause for the patient's abnormal ultrasound.
The exact diagnosis of low malignant potential ovary cancer is not made until surgery. Most low malignant potential ovarian cancers do not have metastatic spread. Approximately 30% of low malignant potential cancers do have spread of either visible or microscopic about. Immediate pathology review during the surgery is required to confirm a diagnosis. This is called a frozen section pathology study. If the findings at surgery confirm visible spread of cancer, then surgery to remove all the spread is crucial. If there is no visible spread then a staging procedure may be done to hunt for microscopic spread. A specialist in treating ovarian cancers would commonly carry out “staging procedures,” and this may include surface biopsies and lymph node biopsies. Dr. Martin is very experienced in completing those procedures. A second surgery would likely be needed to complete the ideal surgery if an ovarian tumor is removed by a doctor that does not specialize in cancer treatment.
Surgical removal of the tumor, and surgical staging to identify spread of disease are the most important treatments available for low malignant potential cancer of the ovary. The specialist managing a malignant ovarian tumor must make careful recommendations regarding extent of surgery to recommend and whether chemotherapy would be needed. A gynecologic oncologist is uniquely trained for that management with the skills to carry out various surgeries needed and familiar with the statistics regarding different tumors and their behavior. Younger patients may also have desire to preserve fertility. Dr. Martin is a board certified gynecologic oncologist and his familiarity with the behavior and treatment statistics for each type of tumor will allow him to provide the best possible care for a very complicated and potentially dangerous disease.
Dr. Martin has helped patients with the surgery and the counseling regarding care of these tumors on many occasions.