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Adenocarcinoma of the Ovary

Ovary Adenocarcinoma


Presentation

  • Two women presented with pleural or cervical lymph node metastases respectively 2 and 13 years before the primary pelvic tumour was discovered.[ncbi.nlm.nih.gov]
  • Fifty percent of clear cell patients presented in Stage I versus 31% of serous patients.[ncbi.nlm.nih.gov]
  • Foci of high-grade squamous neoplastic proliferation, inflammation, and a paratubal cyst were also present on the pathology specimen.[ncbi.nlm.nih.gov]
  • A 51-year-old woman, with complete remission after optimal maximal debulking and chemotherapy for an International Federation of Gynecology and Obstetrics IIIc primary ovarian carcinoma, presented with nausea, vomiting, vertigo and headache 18 months[ncbi.nlm.nih.gov]
  • We report a case of a 68-year-old woman who presented with symptoms of cerebellar degeneration which initiated a suspicion of underlying malignancy.[ncbi.nlm.nih.gov]
Pleural Effusion
  • There was mild ascites along with mild bilateral pleural effusion. The levels of serum cancer antigen 125 (CA-125), serum lactate dehydrogenase (LDH), and alpha fetoprotein were 179.4 U/ml, 715.9 IU/L, and 0.96 ng/ml, respectively.[ccij-online.org]
  • Pleural effusion must have positive cytology for MI/stage IV.[emedicine.medscape.com]
  • In advanced stages, the size and growth of the tumor can lead to: Abdominal pain and ascites Cancer cachexia Possible disruption of menstrual cycle Dyspnea due to malignant pleural effusion Abdominal or pelvic mass Complication: tumor can cause ovarian[amboss.com]
  • Complications of advanced disease: malnutrition, electrolyte imbalance, small and large bowel obstruction, infection, ascites, pleural effusion.[patient.info]
Weight Loss
  • They are considered to be of mucinous type, based on their appearance under a microscope Mucinous Adenocarcinoma of Ovary usually presents with sign and symptoms, such as abdominal pain, weight loss, vaginal bleeding, and increased abdominal girth.[dovemed.com]
  • Signs and symptoms of ovarian cancer may include: Abdominal bloating or swelling Quickly feeling full when eating Weight loss Discomfort in the pelvis area Changes in bowel habits, such as constipation A frequent need to urinate When to see a doctor Make[mayoclinic.org]
  • Also consider testing women who present with unexplained fatigue, weight loss or change in bowel habit.[patient.info]
  • loss Unexplained abdominal pain An ovarian mass is more likely to be cancer in older women.[merckmanuals.com]
  • Advanced ovarian cancer often results in blockage of the intestines, causing severe nausea, vomiting, pain and weight loss. DIAGNOSIS Physical Examination A careful pelvic exam is performed with attention to the ovaries, uterus, bladder and rectum.[womenscancercenter.com]
Abdominal Pain
  • The patient, a 64-year-old, nulliparous postmenopausal Greek woman presented with a complaint of abdominal pain and abnormal uterine bleeding.[ncbi.nlm.nih.gov]
  • They are considered to be of mucinous type, based on their appearance under a microscope Mucinous Adenocarcinoma of Ovary usually presents with sign and symptoms, such as abdominal pain, weight loss, vaginal bleeding, and increased abdominal girth.[dovemed.com]
  • The most common signs and symptoms of HCO are abdominal distension, abdominal pain and pelvic mass.[spandidos-publications.com]
  • In these cases symptoms may include: Abdominal pain Trouble urinating or frequent urination Low back pain Pain with sexual intercourse Bad cramps with a woman’s periods Feeling full quickly after eating, or no appetite Nausea or vomiting.[cancer.coloradowomenshealth.com]
  • In advanced stages, the size and growth of the tumor can lead to: Abdominal pain and ascites Cancer cachexia Possible disruption of menstrual cycle Dyspnea due to malignant pleural effusion Abdominal or pelvic mass Complication: tumor can cause ovarian[amboss.com]
Pelvic Mass
  • CT scan of the abdomen and pelvis revealed bilateral pelvic masses. A laparotomy revealed a papillary serous adenocarcinoma of ovarian primary and an infarcted spleen with capsular tumor metastases.[ncbi.nlm.nih.gov]
  • Patients with clear cell carcinoma presented more often with pelvic masses (84% vs 65%) and had larger (diameter greater than 10 cm) primary tumors (73% vs 29%).[ncbi.nlm.nih.gov]
  • A 39-year-old gravida 3 para 2 woman was diagnosed in October 2000 with a large pelvic mass. She underwent an exploratory laparotomy and a left salpingo-oophorectomy with multiple abdominal and pelvic biopsies.[ncbi.nlm.nih.gov]
  • In advanced stages, the size and growth of the tumor can lead to: Abdominal pain and ascites Cancer cachexia Possible disruption of menstrual cycle Dyspnea due to malignant pleural effusion Abdominal or pelvic mass Complication: tumor can cause ovarian[amboss.com]
  • Women with a pelvic mass and an increased CA-125 level will go straight to surgery, and women with a pelvic mass and other symptoms suggestive of cancer (like having fluid collect in their abdomen) may also go directly to surgery.[oncolink.org]
Abdominal Mass
  • On physical examination, a large abdominal mass was palpable predominantly on left side extending above the umbilical region. Ultrasound (USG) examination shows ovarian mass (12.5 cm 11 cm 7 cm) with both solid and cystic components.[ccij-online.org]
  • Investigations [ 4 , 14 ] In primary care Refer urgently any woman with ascites and/or a pelvic or abdominal mass not obviously fibroids.[patient.info]
  • Presenting symptoms are usually related to an enlarging abdominal mass. Clear cell carcinoma is the most common epithelial ovarian neoplasm to be associated with paraneoplastic hypercalcemia, and rarely hypercalcemia may be a presenting symptom.[path.upmc.edu]
  • mass Inguinal lymphadenopathy Pelvic or adnexal mass Sister Mary Joseph nodule* Table 6 History and Examination Findings Associated with Ovarian Cancer Family history Bilateral breast cancer Early-onset breast cancer (younger than 50 years) Male breast[aafp.org]
  • The patient may feel an abdominal mass. Most cases are diagnosed in an advanced stage.[emedicine.medscape.com]
Increased Abdominal Girth
  • They are considered to be of mucinous type, based on their appearance under a microscope Mucinous Adenocarcinoma of Ovary usually presents with sign and symptoms, such as abdominal pain, weight loss, vaginal bleeding, and increased abdominal girth.[dovemed.com]
  • abdominal girth (clothes no longer fit at the waist)![amboss.com]
  • abdominal girth over the past month.[medbullets.com]
  • Here, we report a case of a 55‑year‑old female who presented to the Second Xiangya Hospital, Changsha, China, with lower abdominal pain, abdominal distention and increasing abdominal girth.[spandidos-publications.com]
  • abdominal girth, an abdominal mass, abdominal pain, abnormal uterine bleeding, urinary symptoms, and gastrointestinal symptoms.[emedicine.medscape.com]
Abdominal Distension
  • Case report An 11-year-old premenopausal girl presented with 3 months history of abdominal distension and respiratory distress.[ccij-online.org]
  • Early symptoms are often vague, such as abdominal discomfort, abdominal distension or bloating, urinary frequency or dyspepsia. Constitutional symptoms include fatigue, weight loss, anorexia and depression.[patient.info]
  • The most common signs and symptoms of HCO are abdominal distension, abdominal pain and pelvic mass.[spandidos-publications.com]
  • The mass may lead to acute pain due to torsion, rupture, or hemorrhage, or, patients may have abdominal distension, vaginal bleeding, or fever. Most are stage I and confined to the ovary at the time of diagnosis.[emedicine.medscape.com]
  • The typical symptoms of an LMP tumor can include abdominal distension or pelvic pain.[en.wikipedia.org]
Dysarthria
  • The patient presented with progressive ataxia and dysarthria and after excluding primary cerebellar pathology, paraneoplastic syndrome was suspected and she was investigated for a malignancy.[ncbi.nlm.nih.gov]
Adnexal Mass
  • IMAGING Doppler transvaginal ultrasonography is used in the initial evaluation of adnexal masses.[aafp.org]
  • Diagnosis and management of the adnexal mass. Am Fam Physician . May 15 1998;57(10):2471-6, 2479-80. Lin HW, Tu YY, Lin SY, et al. Risk of ovarian cancer in women with pelvic inflammatory disease: a population-based study. Lancet Oncol .[dovemed.com]
  • Differential Diagnoses A mass that is felt in the region of the ovary and fallopian tube on an exam or on imaging tests is referred to as an adnexal mass .[verywell.com]
  • Ultrasound Transvaginal ultrasound is well known to be an effective primary screening imaging technique in patients with adnexal masses to distinguish benign from malignant conditions.[intechopen.com]
  • Diagnosis Ultrasonography (for suspected early cancers) or CT or MRI (for suspected advanced cancers) Tumor markers (eg, cancer antigen [CA] 125) Surgical staging Ovarian cancer is suspected in women with the following: Unexplained adnexal masses Unexplained[merckmanuals.com]
Pelvic Pain
  • In such cases, the signs and symptoms associated with the accompanying syndrome may exist Following are the common signs and symptoms associated with this tumor type: Abdominal pain (the pain is usually a pelvic pain) Abdominal swelling due to the mass[dovemed.com]
  • pain, abdominal pain, increased abdominal size, bloating, difficulty eating, and early satiety), occurring more than 12 days per month for less than one year, has a 56.7 percent sensitivity for early-stage ovarian cancer and a 79.5 percent sensitivity[aafp.org]
  • Later, pelvic pain, anemia, cachexia, and abdominal swelling due to ovarian enlargement or ascites usually occur. Germ cell or stromal tumors may have functional effects (eg, hyperthyroidism, feminization, virilization).[merckmanuals.com]
  • The most common symptoms complained by patients at the moment of diagnosis were abdominal-or pelvic pain and discomfort. The tumor diameter ranged between 0.5 and 10 cm and 5.4% of patients presented ascites at the time of diagnosis.[intechopen.com]
  • The typical symptoms of an LMP tumor can include abdominal distension or pelvic pain.[en.wikipedia.org]
Dyspareunia
  • […] such as constipation Feeling full soon after eating less (having a feeling of satiety after eating less) Loss of appetite Weight loss Fatigue, feeling tired easily Frequent urination (polyuria) and difficulty while urinating Frequent pain during sex (dyspareunia[dovemed.com]
  • […] increased abdominal size, discomfort, tense abdomen; 10-35% of these patients complain of gastrointestinal symptomatology like changes in bowel habits, nausea or constipation; 15% complain of gynaecological symptoms like abnormal vaginal bleeding and dyspareunia[intechopen.com]
Amenorrhea
  • ., a low voice, facial hair); precocious puberty, early sexual maturity; amenorrhea, absence/stopping of the menstrual period; or postmenopausal bleeding. Publication Review By: Stanley J. Swierzewski, III, M.D.[healthcommunities.com]
  • Adolescents with sex cord-stromal tumors may experience amenorrhea . As the cancer becomes more advanced, it can cause an accumulation of fluid in the abdomen.[en.wikipedia.org]
Irregular Menstruation
  • They occur in about 50 percent of women with irregular menstruation and in about 30 percent of women with regular menstruation.[cancer.coloradowomenshealth.com]
  • Particularly large masses tend to be benign or borderline. [19] [16] The most typical symptoms of ovarian cancer include bloating , abdominal or pelvic pain or discomfort, back pain, irregular menstruation or postmenopausal vaginal bleeding, pain or bleeding[en.wikipedia.org]

Workup

  • Despite a previous negative cancer workup, a transvaginal ultrasound scan, performed for antral follicle count as part of the initial ovarian reserve assessment, revealed a synchronous ovarian adenocarcinoma.[ncbi.nlm.nih.gov]
  • See Workup for more detail. Management Standard treatment for women with ovarian cancer involves aggressive debulking surgery and chemotherapy.[emedicine.medscape.com]
  • The problem is that many patients without ovarian cancer will have elevated CA-125 levels and then have unnecessary further workup (called a false positive).[oncolink.org]
  • […] to determine the extent of its spread (which is a form of tumor staging ). [16] Risk scoring [ edit ] A widely recognized method of estimating the risk of malignant ovarian cancer is the risk of malignancy index (RMI), calculated based on an initial workup[en.wikipedia.org]
Ovarian Mass
  • CT scan of the pelvis showed a left-sided ovarian mass later diagnosed as serous adenocarcinoma of the ovary. She underwent surgery and histology of the mass showed poorly-differentiated serous adenocarcinoma.[ncbi.nlm.nih.gov]
  • Figure 1: Above (a) intraoperative picture of ovarian mass. (b) Postoperative ovarian mass and excised omentum. (c) Ultrasound shows ovarian mass with both solid, cystic components and loculations with thin-walled septa.[ccij-online.org]
  • There is a large ovarian mass in a patient with multiple metastases probably of an upper digestive tract tumor. Biopsy pro ...[ultrasoundcases.info]
  • The initial assessment demonstrates that the patient has a right-sided hydrothorax, ascites, and a large ovarian mass. Surgery is performed to remove the ovarian mass, and the patient's ascites and pleural effusion resolve promptly.[medbullets.com]
  • mass, she will be treated by the Division of Gynecology at Boston Children's Hospital.[childrenshospital.org]
Pleural Effusion
  • There was mild ascites along with mild bilateral pleural effusion. The levels of serum cancer antigen 125 (CA-125), serum lactate dehydrogenase (LDH), and alpha fetoprotein were 179.4 U/ml, 715.9 IU/L, and 0.96 ng/ml, respectively.[ccij-online.org]
  • Pleural effusion must have positive cytology for MI/stage IV.[emedicine.medscape.com]
  • In advanced stages, the size and growth of the tumor can lead to: Abdominal pain and ascites Cancer cachexia Possible disruption of menstrual cycle Dyspnea due to malignant pleural effusion Abdominal or pelvic mass Complication: tumor can cause ovarian[amboss.com]
  • Complications of advanced disease: malnutrition, electrolyte imbalance, small and large bowel obstruction, infection, ascites, pleural effusion.[patient.info]

Treatment

  • Maytansine thus appears inactive in the treatment of adenocarcinoma of the ovary at the dose and schedule tested.[ncbi.nlm.nih.gov]
  • Progression-free survival (PFS) showed no significant difference between the 2 treatment groups.[ncbi.nlm.nih.gov]
  • Two hundred twenty-five patients were diagnosed with mucinous adenocarcinoma at individual institutes and underwent primary treatment between 1998 and 2003.[ncbi.nlm.nih.gov]
  • Thus, radiotherapy may be effective for treatment of clear cell adenocarcinoma of the ovary.[ncbi.nlm.nih.gov]
  • This article reports the case of a 33-year-old woman diagnosed with breast cancer and referred for oncofertility counseling before her treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Univariate analysis suggests that metastatic disease to the appendix and failure to perform complete staging including appendectomy are related to a worsened prognosis.[ncbi.nlm.nih.gov]
  • Adenosine triphosphate-binding cassette superfamily F2 protein was highly expressed in CCC of the ovary, but expression was not related to age, clinical stage, chemoresponse, or prognosis.[ncbi.nlm.nih.gov]
  • In contrast, patients with mucinous invasive adenocarcinoma receiving suboptimal operation showed a significantly worse prognosis (survival rate: 27.8% vs. 61.5%).[ncbi.nlm.nih.gov]
  • Advanced clear cell adenocarcinoma of the ovary is a histologic type with an extremely poor prognosis. No reports have been published concerning useful drugs for salvage chemotherapy for this type of cancer.[ncbi.nlm.nih.gov]
  • The lesions arising from endometriomas tended to be the cystic type on MRI and have a good prognosis. Preexisting endometrioma in this entity rarely showed "shading" on T2-weighted images.[ncbi.nlm.nih.gov]

Etiology

  • The etiology and pathogenesis of this phenomenon remains unclear. The authors' aim was to present a case of synchronous squamous cell carcinoma of the endometrium and endometrioid adenocarcinoma of the ovary and review current literature.[ncbi.nlm.nih.gov]
  • (Etiology) The exact cause of Mucinous Adenocarcinoma of Ovary is unknown in many cases.[dovemed.com]
  • Etiology Risk factors Genetic predisposition Hormonal imbalance and menstrual cycle Elevated number of lifetime ovulations (the contraceptive pill appears to have a protective effect) Infertility /low number of pregnancies Early menarche and late menopause[amboss.com]
  • While the etiology of this phenomenon remains unclear, it has been postulated that embryologically similar tissues of the female genital tract, when simultaneously subjected to carcinogen may develop synchronous neoplasm.[casereports.in]
  • (See Etiology.) Ovarian cancer is the most common cause of cancer death from gynecologic tumors in the United States.[emedicine.medscape.com]

Epidemiology

  • References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology About 7% of all ovarian tumours are metastatic, predominantly from the gastrointestinal tract. Conversely, about 3.4% of women with colorectal carcinoma develop ovarian metastases 2 .[e-immunohistochemistry.info]
  • Ovarian preservation in young patients with stage I cervical adenocarcinoma: a surveillance, epidemiology, and end results study. International Journal of Gynecological Cancer. 24(8):1513-20, 2014 Oct. Abstract .[rcog.org.uk]
  • Below is the relative five-year survival rate for epithelial ovarian cancer: Below is the relative five-year survival rate for ovarian stromal tumors: Below is the relative five-year survival rate for ovarian germ cell tumors: The Surveillance, Epidemiology[healthline.com]
  • (See Epidemiology.) Early disease causes minimal, nonspecific, or no symptoms. Therefore, most cases are diagnosed in an advanced stage.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Historically, most theories of the pathophysiology of ovarian cancer included the concept that it begins with the dedifferentiation of the cells overlying the ovary.[emedicine.medscape.com]
  • […] though research is still ongoing in this area. [24] Higher caffeine intake and consumption of more than two cups of tea a day have both been associated with lower ovarian cancer risk. [21] Smoking tobacco is protective for sex cord-stromal tumors. [22] Pathophysiology[en.wikipedia.org]

Prevention

  • In an atypical presentation in patients with metastatic ovarian carcinoma, thorough investigations should be done to rule out or confirm brain metastasis, which can be aggressively managed to prevent serious consequences and improve outcome.[ncbi.nlm.nih.gov]
  • How can Mucinous Adenocarcinoma of Ovary be Prevented? The cause of Mucinous Adenocarcinoma of Ovary is unknown. Hence, there are no known methods to prevent the tumor occurrence.[dovemed.com]
  • Strategies for ovarian cancer prevention. Obstet Gynecol Clin North Am . 2007;34(4):667-86. [ Abstract ] Salehi F, Dunfield L, Phillips KP, et al . Risk factors for ovarian cancer: An overview with emphasis on hormonal factors.[myvmc.com]
  • Prevention There's no sure way to prevent ovarian cancer. But there may be ways to reduce your risk: Consider taking birth control pills. Ask your doctor whether birth control pills may be right for you.[mayoclinic.org]
  • Preventive Services Task Force Reaffirmation Recommendation Statement. USPSTF [On-line information].Available online at October 2012.[labtestsonline.it]

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