These slides will provide you a basic info about Ovarian cancer. Too much text and info is not added in slides to avoid the distraction of students from what the presenter is saying.

1. OVARIAN CANCER
BY:
SHEHZINA NAWAL
FINAL YEAR M.B.B.S
CMH MEDICAL COLLEGE
LAHORE

2. INTRODUCTION:
• Ovarian cancer is the second most common gynecological
malignancy.
• Major cause of death as it presents late.
• Mean age of presentation is 64 years.

3. FACTS:

4. AETIOLOGY:
 Age
 Marital Status
 Smoking
 Infections
 Contraception
 Immunosuppression
 BRCA 1 and BRCA 2 mutation
 Nulliparity
 Endometriosis

5. PATHOPHYSIOLOGY:
Incessant Ovulation Theory
• Continuous ovulation leads to repeated trauma leading to
formation of cancer
Excess Gonadotropin secretion
• It promotes high levels of estrogen leading to epithelial
proliferation

6. SIGNS AND SYMPTOMS:

7. CLASSIFICATION:
• Dysgerminoma
• Yolk sac tumor
• Teratoma
• Choriocarcinoma
• Krukenberg tumor
• Granulosa Cell
• Sertoli-Leydig cell
• Serous
• Mucinous
• Endometroid
• Clear cell
EPITHELIAL
TUMORS
SEX CORD
STROMAL
TUMORS
GERM CELL
TUMOR
METASTATIC

9. FIGO STAGING:

10. INVESTIGATION:
• Bimanual Pelvic Examination
• Ultrasound
• Tumor markers
• CT/MRI
• Ascitic fluid aspirate for cytology
• Staging laparotomy
• Biopsy

11. RMI:
• Value of CA-125, menopausal status and USG findings are combined
for scoring.
•
• RMI=UxMxCA-125
• For premenopausal, score is 1 and for post menopausal score is 3.
• For USG, 1 score is given for each of the following findings
 Multilocular cyst Metastasis
 Solid area Ascites
 Bilateral lesion

12. HOW TO PROCEED IF OVARIAN MASS IS
DETECTED?

13. TREATMENT:
• Treatment of choice is total hysterectomy, bilateral salpingo-
oophorectomy and omentectomy for stage 1 disease.
• Unilateral salpingo-oophorectomy is indicated in patients who are
young and fertility is to be conserved.
• Chemotherapy is given for stage 2 and beyond after surgery.Platin
derivatives are used as first line.
• Radiotherapy is used in patients with stage 1b to 111b.
• Hormonal therapy and immunotherapy may also be used.

14. PROGNOSIS:
0% 10% 20% 30% 40% 50% 60% 70%
STAGE 1
STAGE 2
STAGE 3
STAGE 4
5 YEAR SURVIVAL
5 YEAR SURVIVAL

15. FOLLOW UP:
• Clinical Examination
• CT Scan
• CA -125
• If it reoccurs, palliative treatment is given.

16. SUMMARY: