28) Malignant Ovarian Tumors - Dx, Tx. Ovarian Cancer

Question 1

What are Malignant Ovarian Tumors?

Answer 1

• They’re mainly EPITHELIAL Ovarian Cancers
• Also the BENIGN NEOPLASTIC Tumors which also end up metastasising
• Present with non-specific signs –> becomes large
• CFs = Abdominal Distension, Lower Abdominal Pain, Weight loss, and pelvic mass

Question 2

Explain the STAGING

Answer 2

• Stage 1 = Confined to ovaries / tubes
• Stage 2 = extends BEYOND ovaries / tubes —> pelvic extension
• Stage 3 = extends to–> abdomen/ lymph nodes
• Stage 4 = metastasis to LUNGS

Question 3

What are Benign Neoplastic Tumors?

Answer 3

Epithelial

• Serous Cystadenoma
• Papillary Cystadenoma
• Mucinous Cystadenoma

Germ Cell - mature teratoma / dermoid cyst

Sex Cord Stroma - Fibromas

Question 4

Describe the Epithelial Tumors

Answer 4

(a) SEROUS - Filled with translucent fluid; is 5 - 15cm

(b) PAPILLARY - Found in 40 - 60 Year Olds; is 5 - 30cm

(c) MUCINOUS - LARGEST Tumor, 50cm; A *Multi-Chamber Cystic Formation

Question 5

Describe the Germ Cell - mature teratoma / dermoid cyst

Answer 5

• Found anteriorly to Uterus
• Lined with keratinised squamous epithelium, containing sebaceous + sweat glands
• Smooth + Rounded

Question 6

What are the RISK FACTORS for Malignancy?

Answer 6

• Family History
• Mutations of BRCA-1, BRCA-2
• Low Parity + Infertility

Question 7

What is the DIAGNOSIS / TREATMENT

Answer 7

DIAGNOSIS

• Bimanual Pelvic Examination
• Increased Levels of Ca-125
• Pelvic Ultrasound

TREATMENT

1) Surgery

• Laparotomy
• Excision of Pelvic + Para-aortic Lymph Nodes
• Omentectomy

2) Chemotherapy

• Taxare
• Platinum