Summary
Definition
History and exam
Key diagnostic factors
- pelvic mass
- ascites
- pleural effusion
Other diagnostic factors
- gastrointestinal symptoms
- urinary urgency or frequency
- symptom duration >3 months
- abdominal distention
- pelvic/abdominal pain or pressure
Risk factors
- BRCA1 mutation
- BRCA2 mutation
- increasing age
- family history of ovarian cancer
- family history of breast cancer
- never used combined oral contraceptives
- Lynch syndrome
- nulliparity
- obesity
- hormone therapy
- endometriosis
Diagnostic investigations
1st investigations to order
- pelvic ultrasound
- CA-125
- histopathology
Investigations to consider
- PET or PET-CT scan
- MRI
- CT scan
- OVA1 assay
Treatment algorithm
surgical candidate, intraoperative histology confirmed disease
poor surgical candidate, biopsy confirmed disease
platinum-sensitive recurrent disease
platinum-resistant recurrent or refractory disease
Contributors
Authors
Sareena Singh, MD
Gynecologic Oncologist
Aultman Medical Group
Northeast Ohio Medical University
Canton
OH
Disclosures
SS declares that she has no competing interests.
Acknowledgements
Dr Sareena Singh would like to gratefully acknowledge Dr Justin C. Chura and Dr Allison E. Axtell, previous contributors to this topic.
Disclosures
JCC and AEA declare that they have no competing interests.
Peer reviewers
Michael P. Hopkins, MD, MEd
Chairman
Obstetrics and Gynecology
Northeast Ohio Universities of Medicine (NEOMED)
Rootstown
OH
Disclosures
MPH declares that he has no competing interests.
Ritu Salani, MD
Gynecologic Oncology Fellow
Johns Hopkins Medical Institutions
Baltimore
MD
Disclosures
RS declares that she has no competing interests.
Susan A. Davidson, MD
Associate Professor
Chief, Gynecologic Oncology
Department of Obstetrics & Gynecology (UCD)
University of Colorado Cancer Center
Aurora
CO
Disclosures
SAD declares that she has no competing interests.
Khadra Galaal, MBChB, MPH, MRCOG
Consultant Gynaecological Oncologist
Northern Gynaecological Oncology Centre
Queen Elizabeth Hospital
Gateshead
UK
Disclosures
KG is co-author of a systematic review of follow-up strategies after primary treatment in ovarian cancer. This is not referenced in this topic.
Differentials
- Irritable bowel syndrome (IBS)
- Metastases to the ovary
- Endometriosis
More DifferentialsGuidelines
- Ovarian epithelial, fallopian tube, and primary peritoneal cancer treatment
- Updated treatment recommendations for newly diagnosed epithelial ovarian carcinoma from the ESMO clinical practice guidelines
More GuidelinesPatient leaflets
Ovarian cancer: what is it?
Ovarian cancer: what treatments work?
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