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Ovarian Neoplasm


Presentation

  • Only two other cases of ovarian carcinoma with this presentation have been reported in the literature. Gynecologic processes that can present as bleeding gastrointestinal lesions are reviewed.[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]
  • View Article PubMed Google Scholar Outwater EK, Marchetto B, Wagner BJ: Virilizing tumors of the ovary: imaging features. Ultrasound Obstet Gynecol. 2000, 15: 365-371. 10.1046/j.1469-0705.2000.00123.x.[bmcendocrdisord.biomedcentral.com]
  • 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]
Abdominal Mass
  • Our patient is a 68-year-old woman who presented with an asymptomatic abdominal mass and uterine prolapse. Ultrasound revealed a right-sided, cystic and solid pelvic mass.[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]
  • 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]
Increased Abdominal Girth
  • abdominal girth -epithelial tumor -simple or septate thin walled multiocular cysts with varying degrees of echogenicity caused by mucoid material ascites with punctuate echoes and septations -second most common benign ovarian tumor (after dermoid cysts[quizlet.com]
  • abdominal girth Tiredness or low energy Changes in menstruation Ovarian cysts, masses or tumors A pelvic mass may represent either benign (not cancerous) or malignant (cancerous) conditions.[cancercenter.com]
  • abdominal girth or clothes fitting tighter around your waist A persistent lack of energy In ovarian cancer, symptoms tend to last longer and worsen over time.[livescience.com]
  • Symptoms The most common signs and symptoms of ovarian cancer include abdominal swelling and bloating; increased abdominal girth; pelvic discomfort, pain, pressure, or heaviness; abnormal bleeding or discharge; indigestion, gas, or nausea; constipation[fortherecordmag.com]
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]
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]
  • Now that we’ve equipped you with an understanding of the morphologic building blocks of adnexal masses, and how those masses are assessed using ultrasonography (US) (described in Part 2 of this four-part series), you can apply your skills of discernment[obgmanagement.com]
  • 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
  • A woman with abdominal or pelvic pain, vaginal bleeding, and positive pregnancy test may have an ectopic pregnancy.[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]
  • Symptoms of ovarian cysts, masses or tumors may include: Pelvic pain Nausea or vomiting Pain shortly before or after the start of your period Pressure, swelling or pain in the abdomen A dull ache in the lower back and thighs Difficulty emptying your bladder[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]
  • 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]
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]
Metrorrhagia
  • ., menorrhagia, metrorrhagia), or a blood dyscrasia. In a postmenopausal woman, a low hematocrit may be caused by colon cancer or anemia of chronic disease.[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]
  • Routine laboratory workup revealed the following: leukocytosis (11.2   10 9 /L) with neutrophilia (76.6%), hypokalemia (3.3 mmol/L) and elevated fasting glucose (6.4 mmol/L). Hormonal assays were not conducted.[bmcendocrdisord.biomedcentral.com]
  • 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]

Treatment

  • There was a 7% increase in survival for paclitaxel-based treatment (2-year increase from 50% to 57%; P 0.02) and a 10% increase in progression-free survival (1-year increase from 40% to 50% in favor of paclitaxel-based treatment; P 0.0004).[ncbi.nlm.nih.gov]
  • Alternative treatment The term alternative therapy refers to therapy utilized instead of conventional treatment.[medical-dictionary.thefreedictionary.com]

Prognosis

  • 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]
  • The prognosis for early stage cancer of the ovary is generally good, the earlier the better. Unfortunately, not many Stage IA ovarian cancers are detected and treated.[brooksidepress.org]

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]
  • Inhaltsverzeichnis (30 Kapitel) Inhaltsverzeichnis (30 Kapitel) Epidemiology of Epithelial Ovarian Carcinoma Paoletti, Anna Maria (et al.) Seiten 3-12 Histopathology Parodo, Giuseppina, MD (et al.)[springer.com]
Sex distribution
Age distribution

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 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]

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]

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