Types of ovarian cancer

Question 1

What is the most common type of ovarian cancer?

Answer 1

Epithelial cell tumours (tumours arising from the epithelial cells of the ovary) are the most common type.

Question 2

What is ovarian cancer?

Answer 2

Ovarian cancer is a malignancy originating from various cell types found within the ovary.

Question 3

What are the subtypes of epithelial ovarian tumours?

Answer 3

Serous tumours (the most common)
Endometrioid carcinomas
Clear cell tumours
Mucinous tumours
Undifferentiated tumours

Question 4

What are the 3 main classifications of ovarian tumours?

Answer 4

Epithelial ovarian tumours

Germ cell tumours

Sex cord stromal tumours

Question 5

Epithelial tumours are partially cystic, and the cysts can contain fluid. True/false?

Answer 5

True

Question 6

Around what % of ovarian cancers are epithelial?

Answer 6

90%

Question 7

Where do germ cell tumours arise from?

Answer 7

Originate from the germ cells in the embryonic gonad.

Question 8

What is the primary route of spread for ovarian germ cell tumours?

Answer 8

Spreads mainly via the lymphatic route

Question 9

What women do ovarian germ cell tumours typically arise in?

Answer 9

Most commonly arise in young women, which is atypical for most cases of ovarian cancer

Question 10

Main tumour markers for ovarian germ cell tumours?

Answer 10

Tumour markers include alpha-fetoprotein and sometimes beta human chorionic gonadotrophin (B-HCG).

Question 11

Where do ovarian sex cord stromal tumours originate from?

Answer 11

Originates from connective tissue

Question 12

Ovarian sex cord stromal tumours are common occurrences. True/false?

Answer 12

False

They are rare, making up less than 5% of all ovarian tumours. They are malignant tumours, but are much less aggressive than epithelial tumours

Question 13

Ovarian cancer can be secondary to another cancer elsewhere, which has metastasised to the ovary. What is an example of this?

Answer 13

A Krukenberg tumour refers to a “signet ring” sub-type of tumour, typically gastrointestinal in origin, which has metastasised to the ovary.

Question 14

Risk factors for ovarian cancer?

Answer 14

Advanced age

Smoking

Increased number of ovulations (early menarche, late menopause)

Obesity

Hormone replacement therapy (HRT)

Genetic predisposition (BRCA 1 and 2 genes)

Question 15

Protective factors against ovarian cancer?

Answer 15

Childbearing (parity)

Breastfeeding

Early menopause

Use of combined oral contraceptive pill (COCP)

Question 16

Typical clinical features of ovarian cancer?

Answer 16

Abdominal discomfort

Bloating

Early satiety

Urinary frequency or change in bowel habits

Question 17

What can be features of the late stages of ovarian cancer?

Answer 17

Ascites (due to vascular growth factors increasing vessel permeability)

Pelvic, back and abdominal pain

Palpable abdominal or pelvic mass

Question 18

What are the 3 main investigations to check for risk of malignancy index in ovarian cancer?

Answer 18

Blood test for CA-125

Confirm menopausal status

Abdominal and pelvic ultrasound

Question 19

Further investigations for ovarian cancer?

Answer 19

CT scans for staging

AFP and beta-hCG tests for younger women who may have germ cell cancers

Laparotomy for tissue biopsy

Question 20

2 main management types for ovarian cancer?

Answer 20

Surgical

Chemotherapy

Question 21

Surgical management for ovarian cancer?

Answer 21

If early disease surgery can include removal of the uterus, ovaries, Fallopian tubes and infracolic omentectomy

In advanced disease debulking surgery can be performed.

Question 22

Chemotherapy management for ovarian cancer?

Answer 22

Adjuvant chemotherapy in combination with surgery

Intraperitoneal chemotherapy may be performed at the time of operation