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]

• 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]

  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 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]

  Ovarian cysts are fluid-filled sacs that usually dissolve after ovulation and can cause pain, but most often go away on their own. [childrenshospital.org]

  The most common signs and symptoms of HCO are abdominal distension, abdominal pain and pelvic mass. [spandidos-publications.com]

• 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]

  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]

  loss and malaise and increased urinary urgency or frequency, very few patients (around3%) complain chest pain or breathing problems. [intechopen.com]

• Pleural Effusion

  Pleural effusion must have positive cytology for MI/stage IV. [emedicine.medscape.com]

  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]

  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]

• 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]

  The most common signs and symptoms of HCO are abdominal distension, abdominal pain and pelvic mass. [spandidos-publications.com]

  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]

  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]

  Changes in bowel movements Increased abdominal girth Lethargy, fatigue or lack of energy Abdominal pain or swelling Elevated levels of the protein CA-125 According to the Ovarian Cancer National Alliance, most patients diagnosed with ovarian cancer develop [cancercenter.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]

  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

  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]

  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]

  […] fullness Back pain Constipation Diarrhea Early satiety Fatigue Nausea Pelvic pain Urinary symptoms Physical findings Abdominal mass Inguinal lymphadenopathy Pelvic or adnexal mass Sister Mary Joseph nodule* Another study examined the presenting symptoms [aafp.org]

  […] 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]

  Often these masses are large enough to cause bloating, abdominal distension, constipation, and changes in bladder habits. In the more uncommon ovarian types (stromal and germ cell tumors), symptoms are similar. [medicinenet.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]

• Abdominal Fullness

  At the primary hospital, the woman had complained of abdominal fullness. A cervical pap smear was negative for both intraepithelial lesions and malignancy. [ovarianresearch.biomedcentral.com]

  fullness Back pain Constipation Diarrhea Early satiety Fatigue Nausea Pelvic pain Urinary symptoms Physical findings Abdominal mass Inguinal lymphadenopathy Pelvic or adnexal mass Sister Mary Joseph nodule* Another study examined the presenting symptoms [aafp.org]

  Symptoms can include: abdominal enlargement or swelling, abdominal fullness, early satiety (feeling full early), changes in bowel or bladder habits, or clothes not fitting well. [medicinenet.com]

• Adnexal Mass

  IMAGING Doppler transvaginal ultrasonography is used in the initial evaluation of adnexal masses. [aafp.org]

  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]

  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 abdominal [merckmanuals.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]

  Management of adnexal masses. Obstet Gynecol. 2007 Jul. 110 (1):201-14. [Medline]. Suh-Burgmann E, Kinney W. Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses. Am J Obstet Gynecol. 2015 Dec. 213 (6):816.e1-4. [emedicine.medscape.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]

  Constipation Diarrhea Early satiety Fatigue Nausea Pelvic pain Urinary symptoms Physical findings Abdominal mass Inguinal lymphadenopathy Pelvic or adnexal mass Sister Mary Joseph nodule* Another study examined the presenting symptoms in women older [aafp.org]

  Most women with advanced cancer present with nonspecific symptoms (eg, dyspepsia, bloating, early satiety, gas pains, backache). Later, pelvic pain, anemia, cachexia, and abdominal swelling due to ovarian enlargement or ascites usually occur. [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]

• 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]

  These tumors cause abnormalities in menstruation (excessive bleeding, infrequent menstruation, or no menstruation) or postmenopausal bleeding. [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

  In general, sex cord-stromal tumors are associated with hormonal effects such as virilization, the development of male secondary sex characteristics (e.g., a low voice, facial hair); precocious puberty, early sexual maturity; amenorrhea, absence/stopping [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]

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]

[…] used 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]

  […] malignant lesions: Ovarian carcinoma with a partly cystic mass and lymphe node metastasis Ovaries malignant lesions: Ovarian carcinoma with a cystic ovarian mass, omental metastases and ascites Ovaries malignant lesions: Ovarian carcinoma with a mainly [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

  Pleural effusion must have positive cytology for MI/stage IV. [emedicine.medscape.com]

  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]

  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]

Maytansine thus appears inactive in the treatment of adenocarcinoma of the ovary at the dose and schedule tested. [ncbi.nlm.nih.gov]

Treatment The type of treatment depends on the stage of the disease. First-line treatment is surgical management, followed by chemotherapy then radiotherapy. Surgical management Surgical management is done by open surgery. [myvmc.com]

Mucinous epithelial ovarian cancer: A separate entity requiring specific treatment. J Clin Oncol 2004;22:1040-4. 6. Guruprasad B, Jacob LA. Mucinous cystadenocarcinoma of ovary: Changing treatment paradigms. World J Obstet Gynecol 2012;10:42-5. 7. [ccij-online.org]

CONCLUSIONS: 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]

Prognosis and Treatment Overall, these tumors have an excellent prognosis with surgery alone, particularly if the tumor is confined to the ovary ( stage I ). [roswellpark.org]

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 Risk factors Genetic predisposition BRCA1 / BRCA2 mutation HNPCC syndrome Peutz-Jeghers syndrome Hormonal imbalance and menstrual cycle Elevated number of lifetime ovulations (the contraceptive pill appears to have a protective effect) Infertility [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]

(Etiology) The exact cause of Mucinous Adenocarcinoma of Ovary is unknown in many cases. [dovemed.com]

(See Etiology.) Ovarian cancer is the most common cause of cancer death from gynecologic tumors in the United States. [emedicine.medscape.com]

Surveillance, Epidemiology, and End Results Program. Statistical summaries: cancer stat fact sheets (ovary) Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. [revistamedicasinergia.com]

References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

*SEER = Surveillance, Epidemiology, and End Results [cancer.org]

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]

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]

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]

Preventive Services Task Force. Screening for ovarian cancer: recommendation statement. U.S. Preventive Services Task Force. Am Fam Physician. 2005;71(4):759-762. 12. Moslehi R, Chu W, Karlan B, et al. [aafp.org]

Preventive Services Task Force Reaffirmation Recommendation Statement. USPSTF [On-line information].Available online at http://www.uspreventiveservicestaskforce.org/uspstf12/ovarian/ovarartaddend.htm.Accessed October 2012. [labtestsonline.it]