Ovarian Neoplasms OB-GYN 101 Facts Card ©2003 Brookside Press

Ovarian neoplasms may benign or  Dysgerminoma (malignant, Fertility-enhancing may increase the malignant. Some produce hormones. but usually good prognosis) risk of ovarian cancer. A family history of breast or ovarian cancer Mixed Primarily Cystic increases the patient's. BRCA1 or  Dermoid (teratoma, usually  Mucinous cystadenoma BRCA2 gene increases the lifetime benign, may produce thyroid (benign, sometimes grow quite risk to about 1/3. hormone) large)  Clear cell carcinoma  Serous cystadenoma The incidence of ovarian cancer (usually malignant) (benign) steadily increases with age, peaking  Adneocarcinoma  Adenocarcinoma in the mid-60s. Ovarian cancer (malignant) (malignant) among younger women is rare. Prior  Endometrioid Carcinoma to age 30, the incidence is Primarily Solid (malignant) 5/100,000.  Fibroma (benign) Dermoid tumors contain dermal  Brenner tumor (usually element, incl. teeth, hair, sebaceous Detection benign) glands, and thyroid cells. Usually Ovarian cancer can be difficult to  Granulosa Cell tumor benign, occasionally malignant. detect. Unlike uterine cancer (that (malignant, produces estrogen) Bilaterality is common. tends to cause visible bleeding at a  Thecoma (benign, relatively early stage), ovarian produces estrogen, occasionally Ovarian Cancer cancer usually remains symptomless androgens) The life-time risk is about 1%. OCPs until fairly late in the disease  Sertoli-Leydig Cell tumors decreases the, as does pregnancy, process. Symptoms associated with (Generally benign, may produce tubal ligation or hysterectomy. ovarian cancer include pelvic androgens and/or estrogen) discomfort and bloating. Unfortunately, these symptoms are so mixed cystic and solid enlargement of  Stage II (Growth beyond non-specific as to be nearly useless in the ovaries, and thick-walled or the ovaries, but limited to the evaluating a patient for possible complex ovarian cysts. By the time the pelvis. Stage II is further ovarian cancer. Further, by the time a macroscopic changes of ovarian subdivided into IIA, IIB, and IIC.) patient develops these symptoms, the cancer are detectable by ultrasound,  Stage III (Growth out of ovarian cancer has frequently spread most ovarian cancers are well beyond the pelvis, but still within the to distant sites. the early stage of the disease. Also, epithelial surfaces of the most abnormalities seen by ultrasound abdominal cavity. This is Blood tests are of limited value. Serum are not, in fact, cancer, but are benign subdivided into IIIA, IIIB, and CA-125 increases in the presence of findings that require no treatment. IIIC.) most ovarian epithelial cancers.  Stage IV (Distant Unfortunately, it also increases in the That said, using CA-125 and metastases outside the confines presence of anything that irritates the ultrasound (and CT scanning or MR of the abdominal cavity or within peritoneal surface, including infection, imaging) to evaluate an adnexal mass the liver parenchyma). endometriosis, ovulation, and trauma. can be helpful. Simple ovarian cysts Further limiting its usefulness has been are virtually never malignant, and The prognosis for early stage cancer the observation that by the time the observing more complex masses over of the ovary is generally good, the serum CA-125 levels increase in time can distinguish between the many earlier the better. response to ovarian cancer, it is no that are benign (corpus luteum cysts, longer in its early stages. for example), and the few that are Surgical treatment options include malignant and growing. local excision, TAH/BSO, and such Transvaginal ultrasound scanning has debulking procedures as been used, with some success, to (FIGO). Stages include: omentectomy and bowel resection. identify ovarian cancer. Ultrasonic Even if the entire tumor cannot findings that can be suspicious for  Stage I (Growth limited to safely be removed surgically, ovarian cancer include unusually large the ovaries, and subdivided into reducing its bulk by at least 90% will amounts of free fluid in the abdominal Stage IA, IB, and IC.) often result in improved survival. cavity, solid ovarian enlargement, Radiotherapy and/or chemotherapy can also be used with good results.