Ovarian cancer

Incidence of epithelial ovarian cancer is relatively low when compared with that of breast, colon, and lung cancer.

Patients often present with vague, nonspecific symptoms such as abdominal bloating, early satiety, and dyspepsia (suggestive of upper abdominal disease). Other symptoms are more suggestive of pelvic disease, such as pelvic pain, pressure, low back pain, and urinary urgency.

When a suspicious pelvic mass is identified, referral to a gynecologic oncologist is recommended.

When an ovarian mass is detected, biopsy is not routinely recommended as this can disseminate tumor cells in the peritoneal cavity. In addition, biopsy is prone to sampling error and potential bleeding complications.

Surgery is typically required for definitive diagnosis.

Epithelial ovarian cancer is a relatively uncommon gynecologic cancer occurring when there is malignant transformation of the ovarian capsule epithelium.[1]Fleming GF, Ronette BM, Seidman J, et al. Epithelial ovarian cancer. In: Barakat RR, Markman M, Randall ME, eds. Principles and practice of gynecologic oncology. 5th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2009. The epithelium covering the ovary consists of the same epithelial cells that line the peritoneal cavity. Thus, epithelial ovarian cancer and primary peritoneal cancer occur via the same pathophysiology and are treated with the same basic principles. Subtypes of ovarian cancer include epithelial, germ cell, and sex-cord stromal tumors. The primary focus of this monograph will be the epithelial ovarian subtype.