Ovarian Cancer

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Krukenberg Tumor of Ovary

'Ovarian cancer' [1] are superficial epithelial tumors (90%). From the group of germinal cell tumors' (2-3% of cancers), the most common cancer is' dysgerminoma '. Other cancers are from the group of tumors' 'of stromal cells and' 'germline' . The ovaries metastasize Uterine tumors, Mamma carcinoma, Malignant lymphomas and GIT tumors ( Krukenberg's tumor).

Searchtool right.svg For more information see Ovarian Tumors.

Epithelial tumors spread mainly 'by implantation' and lymphogenically [2]. Dysgerminomas metastasize mainly lymphogenically , rarely by implantation [1].

Epidemiology[edit | edit source]

Ovarian malignancies have an annual incidence of about 11 / 100,000 women [3].

Diagnostics[edit | edit source]

Epithelial tumors are usually asymptomatic and occur as an accidental ultrasound scan. Biochemical examination of the tumor marker CA-125 is also important. In the late stages, they may present with tactile resistance, ' ascites' , cachexia (facies ovarica), cycle disorders, and bleeding are present. There may be painful torsion of the ovary to infarction or subtotal cyst.

In germ cell tumors, detection of α-fetoprotein (AFP), hCG and carcinoembryonic antigen (CEA) is possible.

Sertoli-Leydig tumor (androblastoma) produces androgens, which corresponds to the clinical manifestations. Estrogenically active granulosa tumor may manifest as premature pseudopuberty, irregular menstrual bleeding, and under [estrogenic influence] may develop endometrial cancer with its manifestations.

The basis is ultrasound examination, biochemical examination tumor markers , diagnostic and surgical laparoscopy with prevention of malignant spread after the peritoneum ( endo-bag ) and subsequent histological examination.

Metastasis[edit | edit source]

  • lymphogenically: pelvic and paraaortic lymph nodes,
  • hematogenously: lungs, liver, bones, CNS.

Staging[edit | edit source]

The TNM classification or the FIGO classification is used for staging:

  • T1, FIGO I - tumor bounded to the ovary ( 1a one ovary, 1b both ovaries, 1c rupture of the capsule and malignant cells in ascites / cytology of the peritoneum) ,
  • T2, FIGO II - pelvic tumor only ( 2a uterus / tube, 2b other tissues, 2c malignant cells in ascites / cytology of the peritoneum),
  • T3, FIGO III - tumor outside the pelvis, metastases on the peritoneum ( N1 lymph nodes, 3a micrometastases, 3b meta <2 cm, 3c meta> 2 cm),
  • M1, FIGO IV - distant metastases.

Treatment[edit | edit source]

Treatment varies according to the histological type. Epithelial and non-epithelial tumors, with the exception of dysgerminoma, are treated "surgically", often with very extensive procedures to achieve zero macroscopic residue (R0). 'Chemotherapy' is used adjuvantly (epithelial tumors paclitaxel + carboplatin 6-8 cycles with an interval of 21 days between cycles) [4].

Radiotherapy is not used in epithelial tumors.

Dysgerminomas are very chemosensitive and radiosensitive. Bleomycin, etoposide, cisplatin (BEP) chemotherapy is preferred for minor late complications [1].

Summary video[edit | edit source]


Video in English, definition, pathogenesis, symptoms, complications, treatment.


Links[edit | edit source]

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Related Articles[edit | edit source]

External links[edit | edit source]

Reference[edit | edit source]

  1. a b c ROB, Luke – MARTAN, Alois – CITTERBART, Karel. Gynecology. 2. edition. Prague : Galen, 2008. 390 pp. pp. 206-211. ISBN 978-80-7262-501-7.
  2. ONION, David. Management of malignant gynecological tumors - surgical treatment [lecture for subject Gynecology and obstetrics pre-state internship, specialization General medicine, 1st Faculty of Medicine Charles University in Prague]. Prague. 14.2.2014. 
  3. Web portal - Epidemiology of cancer in the Czech Republic. Diagnosis report: C56 - ZN of ovary [online]. ©2015 (data for 2012). [cit. 2015-11-11]. <http://www.svod.cz/report.php?diag=C56>.
  4. FREITAG, Pavel. Management of malignant gynecological tumors [lecture for subject Gynecology and obstetrics pre-state internship, specialization General medicine, 1st Faculty of Medicine Charles University in Prague]. Prague. 14.2.2014.