Borderline ovarian serous cystadenomas lie in the intermediate range in the spectrum of ovarian serous tumors and represent approximately 15% of all serous tumors. They present at a younger age group than the more malignant serous cystadenocarcinoma with a peak age of presentation of ~45 years.

The tumors are often clinically silent until they achieve an advanced size or stage. The most frequent initial manifestations were abdominal pain, increasing abdominal girth or distension, or as an abdominal mass.

In the presence of abundant papillary projections especially in a young patient, low-grade malignancy should be considered. ​Low-grade malignancy represents about 15% of all ovarian serous tumors.