Malignant Ovarian Tumors

OVARIAN CANCER  Malignant ovarian cancer is a leading cause death among the reproductive malignancies, mainly because of late detection.  No early screening mechanism is available at present.  However, 6-monthly pelvic examination with transvaginal ultrasound may aid early detection, especially in case of family history of breast or ovarian cancer.  The cancer may be primary or as a result of metastasis of other cancers. Its common in women between 50 and 59 years and the incidence is high in developed countries.  Survival rate depends on the stage at the time of diagnosis. OVARIAN CANCER: RISK FACTORS Age above 40 years. Risk of ovarian cancer increases with age. Family history of ovarian or breast cancer Family history of non-polyposis colorectal cancer Nulliparity History of infertility History of dysmenorrhea Use of ovulation stimulating medications High dietary fat intake Mumps before menarche OVARIAN CANCER: FACTORS REDUCING THE RISK Factors that interrupt or reduce the number of ovulatory cycles reduce the risk of ovarian cancer. These include; Pregnancy Multiparity Oral contraceptives Breastfeeding Bilateral oophorectomy OVARIAN CANCER: PATHOPHYSIOLOGY  Most of the ovarian cancers arise from the ovarian epithelium (carcinoma), although a few are adenocarcinomas.  The tumor grow and spread silently, and gradually spread via direct invasion and local seeding to the adjacent organs namely fallopian tubes, uterus, ligaments, omentum, intestines, liver and other abdominal pelvic organs.  Distant metastasis occur through the Hematogenous and lymphatic spread.  The cancer is asymptomatic in early stages.  The symptoms occur when the tumor is large enough