Ovarian Cancer

Question 1

What are risk factors for Ovarian Cancer?

Answer 1

FH- mutation of BRCA 1/2 gene
Early menarche/ late menopause
Nulliparity

Question 2

What are symptoms?

Answer 2

Abdominal Distension/ Bloating
Abdo/Pelvic pain
Early satiety
Urinary symptoms e.g. urgency
Diarrhoea
Commonly affects women >50

Question 3

What investigations are required?

Answer 3

Examine for ascites/mass- refer 2WW
1) Measure Ca125
2) If Ca125 >35 urgent US abdo/pelvis

Normally diagnosed via laparotomy

Question 4

What is the management of ovarian cancer?

Answer 4

Combination of surgery and platinum based chemotherapy

Question 5

What are physiological ovarian cysts?

Answer 5

Follicular cyst
- most common cyst
- due to non rupture of dominant follicle
- regresses after multiple cycles

Corpus Luteum cyst
- fail of corpus luteum to break down instead forms cyst
- more like to present with intra-peritoneal bleeding

Question 6

What are benign germ cell tumours?

Answer 6

Dermoid cyst
-mature cystic teratomas
- contain things like skin/hair/teeth
- most common benign ovarian tumour
- usually asymptomatic

Question 7

What are benign epithelial tumours

Answer 7

Serous cystadenoma
- most common, bilateral in around 20%

Mucinous cystadenoma
- second most common
- larger and can become massive
- if ruptures can cause pseudomyxoma peritonei

Question 8

What is the investigation for ovarian cyst?

Answer 8

US
If older (post menopausal) should be referred to gynae for assessment due to risk of cancer

Management depends on symptoms