Presentation
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]
Entire Body System
- 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]
Gastrointestinal
- 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 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]
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]
Skin
- 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]
Urogenital
- 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]
· 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]
Adnexal masses are frequently found in both symptomatic and asymptomatic women. [aafp.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
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]
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 during sex Abnormal bleeding See your doctor for an evaluation if you suspect you have a pelvic mass. [cancercenter.com]
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]
They found that the combination of abdominal pain, pelvic pain, bloating, constipation and increased abdominal size were significantly more severe in women with ovarian cancer. [livescience.com]
- 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]
- 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]
- Metrorrhagia
A low hematocrit in a premenopausal woman could indicate an ectopic pregnancy, abnormal uterine bleeding (e.g., menorrhagia, metrorrhagia), or a blood dyscrasia. [aafp.org]
Workup
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]
Laboratory tests showed elevated serum testosterone 27.6 ng/mL (normal range: 0.2-1.2 ng/mL) and dehydroepiandrosterone of 16.3 ng/mL (normal range: 0.8-3.2 ng/mL), and normal CA-125 of 22 U/mL (normal range The patient was referred to imaging workup [sjmms.net]
See Workup for more detail. Management Standard treatment for women with ovarian cancer involves aggressive debulking surgery and chemotherapy. [emedicine.medscape.com]
Ultrasound
- 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]
Treatment
Abstract Substantial progress has been made since the early 1990s regarding the treatment of patients with ovarian cancer. [ncbi.nlm.nih.gov]
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]
Questions to ask about treatment To make the decisions that are right for you, ask your healthcare team questions about treatment. [cancer.ca]
Prognosis
( endodermal sinus tumor ) tends to have a poor prognosis. [en.wikipedia.org]
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]
Dysgerminoma is the most common type and has an excellent prognosis for Stage I tumours. [patient.info]
Etiology
Possible etiologies of the present case are discussed and additional literature investigated. [ncbi.nlm.nih.gov]
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]
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]
Epidemiology
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]
OVARIAN CANCER OF EPITHELIAL ORIGIN Epidemiology and Pathogenesis A female has approximately a 1 in 72 lifetime risk (1.6%) of developing ovarian cancer, with the majority of affected women developing epithelial tumors. [accessmedicine.mhmedical.com]
Pathophysiology
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.medscape.com]
Prevention
[…] 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]
Further research is also needed on primary prevention of ovarian cancer. [doi.org]