Medical terminology of Ovarian cancer symptoms:
Ovarian cancer risk factor:
1. low parity.
2. decreased fertility.
3. delayed child bearing.
4. family history.
5. colon, breast cancer and endometrial carcinoma are associated with ovarian cancer.
6. genetic 1% malignant ovarian tomour involves BRCA-1 gene.
7. age-risk increase with age up to 70 year.
8. mumps prior to menarche.
9. high dietary fat intake.
10. environomental factor, industrial pollution. Multiparity, breastfeeding ,ocp are protective.
Type:
1. epithelial ovarian cancer.
2. non epithelial cancer.
Epithelial cancer:
Serous histological type:
75% Mucinous 20% endometrial
brennar tumor clear cell ca.
Undiff.Cancer
10-20% of these tumour are borderline tumour. They have low malignant potential
remains confine to ovary for long. Predominant in age group 30-50 year.
Diagnose by epithelial proliferation with papilly formation and pseudostratification.,nuclear atypia and inareased mitotic activity, absence of true stromal inuasiom.
2. non epithelial malignancy
Germ cell malignancy are derived from priamary germ cell.
eg, dysgerminoma, teratoma, endodermal sinus tumour, embryonal carcinoma..
- Endodermal sinus tumour:
Second most common tumour of germ cell origin. Rich in AFP and alpha fetoprotein.
Usually child or young women presenting with abdominal pain, pelvis mass which grow rapidly.
Respond to chemotherapy with good surviaval rate.
Choriocarcinoma
Part of mixed germ cell tomour.
Origin as teratoma can be confirmed in pre pubertal girl., when the possibility of gastetional origin can be excluded. it is very vascular tumour. it secret large quanty of hCG, a good tumour marker. it is highly malignant.
Embryonic cell carcinoma
Seen in pubertal girl.it secrete alpha fetoprotein.
SymptomsPrecocious peberty and menstrual irregularities.
Sex cord stromal tumour
Consist of female and male cells.
Secondaries ovarian tumor
Krukenberg tumour
Bilateral, smooth surface, freely movable in pelvis.
Clinical featues of ovarian cancer
Age:
Adolescent, menopausal or post menopausal of low parity, initially asymptomatic, later on abdominal discomfort, pain, lump and abnormal or postmenopeusal bleeding..
p/v:
Fixed nodule in pouc of douglas apart from adnexal mass felt separate from uterus.
Investigation
CT, MRI, for extent growth.
Tissue marker like hCG, AFI, AAT.
Barium meal, enema.
Breast examination if metastatic tumour is suspected.
FIGO staging:
Stage1, tumour restricted to overies.
1A, 1 overy is invole only.
1B, both overy involve.
1C, Capsule ruptured/malignant ascites.
Stage 2, pelvic extension also
2A, Metastasis to uterus n/pelvic extension tube.
2B, extension to other pelvic organ
2C-above plus surface growth ,rupture capsule,malignant ascietes.
Stage 3A, microscopic seeding of peritoneum.
3B, abd peritoneal implant