Ovarian Cancer

Krukenberg Tumor of Ovary

'Ovarian cancer' 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).

 For more information see Ovarian Tumors.

Epithelial tumors spread mainly 'by implantation' and lymphogenically . Dysgerminomas metastasize mainly lymphogenically , rarely by implantation .

Epidemiology

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

Diagnostics

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

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

Staging

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

 For more information see Surgical treatment of gynecological malignancies , Non-surgical treatment of gynecological malignancies.

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) .

Radiotherapy is not used in epithelial tumors.

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

Summary video

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

Links

==source=-

• ws:Zhoubné nádory ovária

Related Articles

• Ovarian tumors
• Gynecological malignancies

External links

• www.onkogyn.cz (eg current 'TNM classification' , this is the Oncogynecological Center of the General Hospital website)
• Template:Mefanet