Ovarian and Fallopian Tube Tumors Flashcards
What is the 5 year survival for ovarian cancer and why is it so low?
25-45%
No effective screening method for ovarian cancer
Where are ovarian tumors most likely to arise?
65-90% from surface epithelium on the ovarian capsule
Germ cells, stroma are less common
Where are metastatic tumors to the ovary likely to come from?
GI tract - Krukenberg tumors
Breast, endometrium
How does ovarian cancer spread?
Direct exfoliation of cells from the ovary
What can occur in the GI tract with advanced ovarian disease?
Carcinomatous ileus - intraperitoneal tumor spread causes ascites and encasement of bowel with tumor
Leads to malnutrition, starvation, cachexia, death
How is ovarian cancer thought to arise?
Malignant transformation of ovarian tissue after prolonged periods of chronic uninterrupted ovulation
What is the new theory on how ovarian cancer arises?
Thought that it arises from the fallopian tube
What are the odds of developing ovarian cancer with BRCA 1 and 2?
BRCA1 - 30-50%
BRCA2 - 25%
What are risk factors for ovarian cancer?
Uninterrupted ovulation, increasing age
What are protective factors for ovarian cancer?
Ovulation suppression - OCPs, breast feeding, multiparity, chronic anovulation
Tubal ligation and hysterectomy* - thought to be due to decreased migration of carcinogens from lower GI tract up to ovaries
What are the signs and symptoms of ovarian cancer?
Asymptomatic Vague, nonspecific complaints Lower abdominal pain Early satiety Fatigue Urinary frequency N/V Ascites/SOB
What can you see on physical exam with ovarian tumor?
Solid, fixed, irregular pelvic mass
Mets to the umbilicus can result in Sister Mary Joseph nodule
How is ovarian cancer diagnosed?
Pelvic US
CT/MRI for spread of disease
Barium enema and IVP to rule out primary sources
What should not be done for evaluation of ovarian cancer?
Paracentesis and cyst aspiration because it spreads through direct exfoliation
What are tumor markers for ovarian cancer?
CA-125, AFP, LDH, and hCG