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. 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.
History and exam
Justin C. Chura, MD, MBA, FACS
Gynecologic Oncology and Robotic Surgery
Cancer Treatment Centers of America
Eastern Regional Medical Center
JCC declares that he has no competing interests.
Dr Justin C. Chura would like to gratefully acknowledge Dr Allison E. Axtell, the previous contributor to this monograph. AEA declares that she has no competing interests.
Michael P. Hopkins, MD, MEd
Obstetrics and Gynecology
Northeast Ohio Universities of Medicine (NEOMED)
MPH declares that he has no competing interests.
Ritu Salani, MD
Gynecologic Oncology Fellow
Johns Hopkins Medical Institutions
RS declares that she has no competing interests.
Susan A. Davidson, MD
Chief, Gynecologic Oncology
Department of Obstetrics & Gynecology (UCD)
University of Colorado Cancer Center
SAD declares that she has no competing interests.
Khadra Galaal, MBChB, MPH, MRCOG
Consultant Gynaecological Oncologist
Northern Gynaecological Oncology Centre
Queen Elizabeth Hospital
KG is co-author of a systematic review (in print) of follow-up strategies after primary treatment in ovarian cancer. This is not referenced in this monograph.
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