We report a case of DSRCT with involvement of the ovary and omentum as well as an elevated CA-125 level at presentation. A 23-year-old female presented to another institution with a pelvic mass and a CA-125 level of 140 U/ml. [ncbi.nlm.nih.gov]

Patients can also present with stigmata of hormonal excess. [clinicaladvisor.com]

• Asymptomatic

  Conclusions and Recommendation The USPSTF recommends against screening for ovarian cancer in asymptomatic women. (D recommendation) This recommendation applies to asymptomatic women who are not known to have a high-risk hereditary cancer syndrome. [doi.org]

  Most patients are asymptomatic, with the ovarian enlargement being incidentally discovered at the time of cesarean section. It can simulate a neoplasm on clinical, gross and sometimes microscopic examination. [ncbi.nlm.nih.gov]

• Virilization

  Achard- Thiers syndrome 0 *Virilism *Ovarian Neoplasms *Diabetes Complications. TCEAL7 protein, human 0 *Nuclear Proteins Ovarian Neoplasms. [reference.md]

  Sex cord-stromal tumor, including estrogen -producing granulosa cell tumor and virilizing Sertoli-Leydig cell tumor or arrhenoblastoma, accounts for 8% of ovarian cancers. [en.wikipedia.org]

  Hirsutism, virilism and apparent virilism and their gonadal relationship. II. J Endocrinol 1967;38:203-27. 9. de Oliveira Franzin CM, Kraft ML, Faundes D, Zeferino LC, Alvarenga M, Marussi EF. [sjmms.net]

  Sex cord tumors► Androgen- secreting tumors- Androblastoma,Sertoli-leydig,Gynandroblastoma- Cause virilization• Fibroma- solid tumor- May be associated with meigs’ syndrome- Tend to have long pedicle 35. FIBROMA 36. THECOMA 37. [slideshare.net]

  If a patient with a Sertoli-Leydig tumor presents with virilization, testosterone can be used as a tumor marker, but only 40% of patients have signs of androgen excess. [clinicaladvisor.com]

• Abdominal Pain

  Abdominal pain and swelling were the symptoms most frequently experienced in patients with benign ovarian neoplasms. [ncbi.nlm.nih.gov]

  This can cause lower tummy (abdominal) pain, back pain, passing urine more often than usual, constipation, pain during sex, or a swollen abdomen. Women may also have irregular periods or bleeding after the menopause. [web.archive.org]

• Abdominal Mass

  A 63-yr-old, gravida 2, para 1, woman was referred to us with an abdominal mass. Pelvic examination revealed normal postmenopausal uterus and a fetal head-sized movable hard mass in the lower abdomen. [ncbi.nlm.nih.gov]

  Investigations [ 4, 14 ] In primary care Refer urgently any woman with ascites and/or a pelvic or abdominal mass not obviously fibroids. [patient.info]

  A pelvic examination may reveal an ovarian or abdominal mass. A CA-125 blood test is not considered a good screening test for ovarian cancer. [nlm.nih.gov]

• Abdominal Distension

  Case report of a 61-year-old female who presented with two months of abdominal pain, progressive lower abdominal distension and a 10-15 pound weight gain accompanied by one week of urinary hesitancy and frequency. [ncbi.nlm.nih.gov]

  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]

  distension (often misdiagnosed as “middle-aged spread”) increasing tumour size results in pressure effects causing chronic abdominal, pelvic or back pain, urinary frequency/urgency (pressure on bladder), constipation/altered bowel habit/bowel obstruction [geekymedics.com]

  Symptoms that come later include the following: Pelvic pain or pressure Pain with intercourse Abdominal swelling and bloating Urinary frequency Constipation Ascites : Collection of fluid in the abdomen, contributing to abdominal distension and shortness [emedicinehealth.com]

• Abdominal Bloating

  Common symptoms may include: Abdominal bloating, indigestion or nausea Changes in appetite, such as a loss of appetite or feeling full sooner Pressure in the pelvis or lower back A more frequent or urgent need to urinate and/or constipation Changes in [cancercenter.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]

  Symptoms of ovarian cancer Symptoms of ovarian cancer can include: abdominal or pelvic pain, pressure or discomfort increased abdominal size persistent abdominal bloating excessive fatigue or lethargy needing to urinate often or urgently changed bowel [health.qld.gov.au]

  Ovarian cancer symptoms There are often no obvious signs of ovarian cancer, however you may have one or more of the following symptoms: abdominal bloating difficulty eating or feeling full quickly frequent or urgent urination back, abdominal or pelvic [cancer.org.au]

• Dyspepsia

  […] most common adverse reactions occurring in at least 10% of patients receiving niraparib were thrombocytopenia, anemia, neutropenia, leukopenia, palpitations, nausea, constipation, vomiting, abdominal pain/distention, mucositis/stomatitis, diarrhea, dyspepsia [fda.gov]

  Common side effects of Lynparza included nausea, fatigue, vomiting, diarrhea, distorted taste (dysgeusia), indigestion (dyspepsia), headache, decreased appetite, common cold-like symptoms (nasopharyngitis), cough, joint paint (arthralgia), musculoskeletal [web.archive.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]

  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]

• Hirsutism

  In addition, the patient also presented with hirsutism, which might result from hyperandrogenemia rather than hypercortisolemia. Routine screening for Cushing syndrome in women presented with hirsutism is a controversial issue. [bmcendocrdisord.biomedcentral.com]

  Case report A 21-year-old nulliparous female presented with complaints of pelvic pain, acne, hirsutism, hoarseness of voice and oligomenorrhea for the last 6 months. [sjmms.net]

  It’s also appropriate to code any functional activity, such as one of the following: • other ovarian dysfunction (256.8); • hirsutism (704.1); • hyperestrogenism (256.0); • other ovarian hyperfunction (256.1); • precocious sexual development and puberty [fortherecordmag.com]

  Often, these patients present with symptoms of rapidly virilizing clinical signs of elevated testosterone, such as male-pattern baldness, voice deepening, clitoromegaly, and increased hirsutism. [emedicine.medscape.com]

  Patients with embryonal carcinoma, nongestational choriocarcinoma, granulosa cell tumor, and Sertoli-Leydig tumor may have precocious puberty, primary or secondary amenorrhea, irregular vaginal bleeding, postmenopausal bleeding, and hirsutism, depending [clinicaladvisor.com]

• Lethargy

  She had excuses for tiredness and lethargy: she was busy preparing to move from New Zealand back to Australia to help look after her grandchildren. She says, “I was working 10 hour shifts and preparing to move. [health.qld.gov.au]

  Persistent abdominal bloating, indigestion or nausea Changes in appetite, typically a loss of appetite or feeling full sooner Pressure in the pelvis or lower back Urge to urinate more frequently Changes in bowel movements Increased abdominal girth Lethargy [cancercenter.com]

  Additional signs may include a loss of appetite, lethargy, and lower back pain. Since there is no standard testing procedure to determine the presence of ovarian cancer, a variety of screening and preliminary tests may be conducted. [wisegeekhealth.com]

• Adnexal Mass

  A 58-year-old woman is noted to have bilateral adnexal masses on physical examination. Which of the following is most suggestive of these adnexal masses being malignant? A. CT imaging revealing that they are primarily cystic B. [medicalgeek.com]

  Adnexal masses are frequently found in both symptomatic and asymptomatic women. [aafp.org]

  · Fallopian Tube Masses · Evaluation of an Adnexal Mass · Military Significance Introduction Adnexal masses may be encountered during a routine examination of an asymptomatic patient. [brooksidepress.org]

  Based on our review, the Risk of Malignancy Index should be the prediction model of choice in the preoperative assessment of the adnexal mass. [ncbi.nlm.nih.gov]

• Pelvic Pain

  She also had lower pelvic pain, but nothing extreme. “It was more of a niggle,” Sandra says. “I didn’t realise it was a symptom.” [health.qld.gov.au]

  pain Abdominal or adnexal tenderness CBC Transvaginal ultrasonography Pelvic inflammatory disease Fever; lower abdominal or pelvic pain; nausea; vaginal discharge; vomiting Abdominal or adnexal tenderness; cervical motion; fever; tenderness; vaginal [aafp.org]

  Approximately 90% of women with pain associated with endometriosis will experience relief of their chronic pelvic pain. After definitive surgery, consider adjuvant therapy. [emedicine.medscape.com]

  Pain during sex Abnormal bleeding See your doctor for an evaluation if you suspect you have a pelvic mass. [cancercenter.com]

  pain constipation or diarrhoea menstrual irregularities fatigue indigestion pain during sexual intercourse. unexplained weight loss or weight gain These symptoms can be caused by other conditions but if you are experiencing any of these symptoms, contact [cancer.org.au]

• Dyspareunia

  Clinical Presentation and Diagnostic Approach [ edit ] Presentation of the Adenexal Mass [ edit ] Women may present with Most cases are discovered incidentally and present with vague symptoms Postmenopausal bleeding Dyspareunia Acute pain in pelvis and [en.wikibooks.org]

  Patients with dyspareunia and pain worsening with menses may have an endometrioma. Dysmenorrhea and menorrhagia may indicate a leiomyoma rather than an ovarian mass. [aafp.org]

  Dyspareunia. Swollen abdomen, with palpable mass arising out of the pelvis, which is dull to percussion and does not disappear if the bladder is emptied. [patient.info]

  The commonly reported symptoms of TOAs are dyspareunia and rectal discomfort, partial intestinal obstruction, dysuria, urinary frequency, and sterility. Occasionally, fever with the symptoms of pelvic peritonitis develops. [emedicine.medscape.com]

• Oligomenorrhea

  Case report A 21-year-old nulliparous female presented with complaints of pelvic pain, acne, hirsutism, hoarseness of voice and oligomenorrhea for the last 6 months. [sjmms.net]

  Polycystic ovaries (multiple small cysts, often around the periphery of the ovary—the classic “string of pearls” appearance) Signs of androgen excess (eg, acne, hirsutism, temporal balding, male pattern hair loss, or clitoromegaly) Menstrual irregularities (oligomenorrhea [emedicine.medscape.com]

  Patients presenting with oligomenorrhea, amenorrhea, or menorrhagia associated with obesity and hirsutism may have polycystic ovary syndrome. Midcycle pain suggests ovulation or mittelschmerz. [aafp.org]

• Ovarian Disorder

  RUNOWICZ, Early Diagnosis and Screening for Ovarian Cancer, Diagnosis and Management of Ovarian Disorders, 10.1016/B978-012053642-9/50023-5, (219-229), (2003). [dx.doi.org]

Patient underwent a diagnostic workup for an ovarian neoplasm, but was found at surgery to have mesentric fibromatosis. [ncbi.nlm.nih.gov]

CT scanning (MRI rarely used for this purpose) Ca-125 measurement (if required equipment) CBC + differential: if anemic, thorough workup should be completed for a gastrointestinal pathology. Creatinine Laparotomy and biopsy. [en.wikibooks.org]

A 17 Serum CA 125 levels should not be routinely used during the diagnostic workup of an adnexal mass in a premenopausal patient. B 20 Serum CA 125 levels should be drawn in postmenopausal patients with adnexal masses to guide treatment options. [aafp.org]

See Workup for more detail. Management Standard treatment for women with ovarian cancer involves aggressive debulking surgery and chemotherapy. [emedicine.com]

• Ovarian Mass

  We describe the case of a 50-year-old woman who presented with a complex right ovarian mass. [ncbi.nlm.nih.gov]

  The presence of ascites and ovarian masses is strongly associated with ovarian cancer. Other features of malignancy include solid ovarian masses, bilaterality, and lymphadenopathy. [/HIDE] -- [medicalgeek.com]

  Several ovarian and/or adnexal masses have specific ultrasound features. [appliedradiology.com]

When clinical trials show that a new treatment is better than the treatment currently used as standard treatment, the new treatment may become the standard treatment. [cancer.gov]

The main treatments The main treatments for ovarian cancer are: surgery chemotherapy Some women with advanced ovarian cancer have targeted drug treatment, hormone treatment or radiotherapy. Surgery Almost all women with ovarian cancer need surgery. [cancerresearchuk.org]

Your doctor can work with you to create a treatment plan. Types of Treatment Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy. Surgery: Doctors remove cancer tissue in an operation. [web.archive.org]

Questions to ask about treatment To make the decisions that are right for you, ask your healthcare team questions about treatment. [cancer.ca]

( endodermal sinus tumor ) tends to have a poor prognosis. [en.wikipedia.org]

Dysgerminoma is the most common type and has an excellent prognosis for Stage I tumours. [patient.info]

The utility of genetic testing of this tumor and additional reporting of alterations detected is needed to verify pathogenicity of variants detected, as well as their potential roles with prognosis, behavior, and therapeutic targets. [ncbi.nlm.nih.gov]

So estimation of Estrogen and Progesterone receptor status may help to select the women with ovarian malignancy for hormonal therapy, which is more likely to improve the response rate as well as prognosis. [scopemed.org]

Although the etiology of ovarian cancer is not clear, certain factors are implicated in the etiology of this disease, such as ovulation, gonadotropic and steroid hormones, germ cell depletion, oncogenes and tumor suppressor genes, growth factors, cytokines [doi.org]

Etiology and Risk Factors [ edit ] Possible etiologies of the adenexal mass: Gastrointestinal tract: bowel cancer, constipation, bowel abscess Urinary tract: full bladder Obstetrical/Gynecological: pregnancy, hydrosalpinx, tubal cancer, fibroids, ovarian [en.wikibooks.org]

Possible etiologies of the present case are discussed and additional literature investigated. [ncbi.nlm.nih.gov]

Physical Examination A complete physical examination concentrating on signs of infection or neoplasm is necessary to determine the etiology of a pelvic mass. [aafp.org]

Age at menarche and risk of ovarian cancer: A meta‐analysis of epidemiological studies Qi‐Jun Wu Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China [doi.org]

[PUBMED Abstract] Collaborative Group on Epidemiological Studies of Ovarian Cancer: Ovarian cancer and body size: individual participant meta-analysis including 25,157 women with ovarian cancer from 47 epidemiological studies. [cancer.gov]

Pathology and pathophysiology of uterine smooth-muscle tumors. Environ Health Perspect. 2000;108:779S–84S. 3. Murase E, Siegelman ES, Outwater EK, Perez-Jaffe LA, Tureck RW. [cogprints.org]

Pathophysiology The definitive pathophysiology associated with the development of ovarian cancer remains to be defined. The absence of a clearly-defined pre-malignant state, such as documented in cervix cancer, has hindered efforts in this arena. [cancertherapyadvisor.com]

Pathophysiology. Elsevier Health Sciences. pp. 660–. ISBN 978-0-323-29317-4. ^ Farage MA, Neill S, MacLean AB (2009). "Physiological changes associated with the menstrual cycle: a review". [en.wikipedia.org]

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.com]

[…] help prevent cancer. [cancer.gov]

Cancer prevention clinical trials are used to study ways to prevent cancer. Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. [web.archive.org]

Corresponding Author Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Control, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, GA, USA Correspondence to: Centers [doi.org]