Ovarian Carcinoma Flashcards
OUTLINE THE CLASSIFICATION OF OVARIAN TUMOURS (3 most important types of ovarian tumours)
Primary Ovarian Tumours
- Epithelial tumours
-about 90% of ovarian tumours are epithelial types
-tumour originates from surface epithelium tissue of the ovary
-common in older post menopausal
-90% chances of survival if detected early stage, majority 75-80% are dx at stages 2 to4
-ie serous, endometroid, transitional & undifferentiated subtypes - Germ Cell Tumours
-About 5% of ovarian cancers
-originate from primordial germ cells of the ovary
-common in young people under 30
- Ie dysgerminomas, yolk sac or endodermal sinus tumours, embryonal carcinomas & non-gestational choriocarcinomas of the ovary.
-germ cell carcinomas often contain more than one histological type - Sex Cord Stromal Tumours
-8% of ovarian tumours
-affects all age groups
-originate from stromal connective tissue of the ovary
-many produce hormones eg oestrogen, inhibit, progesterone and testosterone
-common types: sertoli leydig cell tumours, adult granulosa cell tumours, juvenile granulosa cell tumours
-May present with virilisation
List some of the risk factors for ovarian cancer (4)
Family history
Uninterrupted ovulation
Low parity
Increasing age
Diet
Smoking ?
List some of the symptoms of ovarian cancer (4/5)
PMB
Pelvic pain
Weight loss
Vague:Change in bowel habits
Abdominal distension and fullness after meals
Give a list of investigations you would do for a pt you suspect has overran cancer
Hb
Preg test in younger
Pap smear
Endometrial sampling (hysteroscopy?)
Metastatic screen
UEC, LFTs
X-RAY
CT of abdomen and Pelvis
Mammogram
Tumour markers: CA 125, AFP, LDH, bHCG
Outline the staging of ovarian cancer (4)
Stage 1: tumour confined to one or both ovaries
Stage 2: involves one or both ovaries and extends to other pelvic organs
Stage 3: tumours has extended to adjacent structures ie bowel lining, abdominal peritoneum or lymph nodes
Stage 4: tumour metastasised to distant organs eg liver or chest
Descuss the management of ovarian cancer
Surgery is good standard
-TAH(total abdominal hysterectomy)
-BSO (bilateral salpingo-oophorectomy)
-Omentectomy (thin fold of tissue encasing the abdo organs ei intestines&stomach and contains lymph nodes and vessels)
What is the management of germ cell tumours (1)
Multiple Agent Chemotherapy
What is the management of sex cord stromal tumours (1)
Surgical