OVARIAN CANCER

Question 0

Risk factors? Protective factors?

Answer 0

Increased number of ovulations

• PCOS
• early menarche, late menopause
• nulliparity

THEREFORE OCP, PREG OR LACTATION ARE PROTECTIVE

Family history of breast, colon, endometrial or ovarian cancer BRCA HNPCC

infertility
smoking

Question 1

Types of ovarian cancer?

Answer 1

Ovaries are like GEMS!

Germ cell
Epithelial (majority)
Metastatic
Sex-cord stromal

Question 2

Signs?

Answer 2

Adnexal mass MC
Pelvic pain 
GI symptoms
- bloating mc
- early satiety ABDO pain 

Acute symptoms usually from advanced disease

• bowel obstruction
• pleural effusion SOB
• hypercoagulable state VTE
• ascites
• ovarian torsion

Hirsuitism from testosterone secretion
THYROTOXICOSIS from struma ovarii

Question 3

Investigations? Diagnosis?

Answer 3

Lab
Ca-125 marker

Rad
US transvaginal
CT/MRI abdomen for metastasis, CXR for pleural effusion

Diagnosis is made by peritoneal fluid cytology or histopathology

Question 4

Management?

Answer 4

Surgical
- radical hysterectomy with bilateral salpingo-oopherectomy

Ajuvant chemotherapy