Ovarian cancer ( a rare cancer condition)

1. Erbil Health And Medical Technical College
Histopathology- Practical
3rd Stage
Ovarian Cancer

2. Introduction
• Ovarian cancer is a growth of cells that forms in
the ovaries. The cells multiply quickly and can
invade and destroy healthy body tissue.
• The female reproductive system contains two
ovaries, one on each side of the uterus. The
ovaries — each about the size of an almond —
produce eggs (ova) as well as the hormones
estrogen and progesterone.
• It accounts for 3-4% cancer in women
• It’s the second most common gynecologic
cancer after endometrial cancer.
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3. Types of ovarian cancer
 Epithelial tumors
 Germ cell tumors
 Sex cord Stromal tumors
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4. Epithelial Ovarian Tumors
 Epithelial ovarian cancer is the most common type of ovarian
cancer.
 This cancer develops in the epithelial tissue, a thin lining that covers the
outside of an ovary.
 There are various types of epithelial ovarian cancers:
- Serous:
Serous epithelial ovarian cancer is the most common type. Your doctor
examines the cancer under the microscope. They grade your cancer depending
on how much the tumour cells look like normal tissue.
The doctor describes it as either;
-high grade serous ovarian cancer
-low grade serous ovarian cancer
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5.  Endometrioid:
Endometrioid ovarian cancer is the 2nd most common type of epithelial ovarian cancer. It
can be linked to endometriosis. Most cases of endometrioid ovarian cancer are diagnosed
at an early stage and are low grade.
 Clear cell:
Clear cell ovarian cancer is rare. It can be linked to endometriosis. The treatment is the
same as for high grade serous ovarian cancer. But chemotherapy doesn’t tend to work as
well as it does for other types of epithelial ovarian cancer.
 Mucinous:
Mucinous ovarian cancer is rare. It can be difficult to diagnose. The doctor does tests to
check if the cancer started to grow in the ovary. Or if it spread there from somewhere else
in your digestive system. Mucinous tumours can be non-cancerous (benign), borderline or
cancerous (malignant).
 Undifferentiated or unclassifiable:
Some epithelial ovarian cancers are undifferentiated or unclassifiable. These cancers have
cells that are very undeveloped. So it is not possible to tell which type of cell the cancer
started from.
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6. signs and symptoms of epithelial ovarian cancer:
Signs and symptoms may include the following:
 Pain, swelling, or a feeling of pressure in the abdomen or pelvis.
 Sudden or frequent urge to urinate.
 Trouble eating or feeling full.
 A lump in the pelvic area.
 Gastrointestinal problems, such as gas, bloating, or constipation.
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epithelial ovarian tumor cancer stages:
 Stage 1: Cancer is in one ovary or one fallopian tube.
 Stage 2: Cancer has spread to your uterus or your peritoneal cavity.
 Stage 3: Cancer has spread outside of your pelvis to other organs, lymph nodes or
both.
 Stage 4 ovarian cancer is classed as advanced (metastatic) cancer. This means the
cancer has spread away from the ovary to other body organs, such as the liver or lungs.

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Germ cell tumors
• Ovarian germ cell tumor is a disease in which
malignant (cancer) cells form in the germ (egg) cells of
the ovary.
• Ovarian germ cell tumors usually occur in teenage girls
or young women and most often affect just one ovary.
• The mature cystic teratoma, also called dermoid cyst is
by far the most common subtype.
• It accounts for 95% of all germ cell tumors and is
clinically benign

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signs and symptoms of Germ cell tumors:
Germ cell tumors:
Ovarian germ cell tumors can be hard to diagnose (find) early.
Often there are no symptoms in the early stages, but tumors may
be found during regular gynecologic exams (checkups)

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Germ cell tumors ovarian cancer stages:
• Stage 1 germ cell tumor means the cancer has not spread beyond the
ovaries, fallopian tubes or abdomen.
• Higher stages (stages 2 to 4) mean that the cancer is more advanced
and the tumor is larger. It has spread (metastasized) to other parts of
the body.

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Sex cord Stromal tumors:
• Ovarian sex cord-stromal tumors (SCSTs), are a group of benign and malignant
neoplasms that develop from:
1. The sex cord (eg, Sertoli cell tumor, granulosa cell tumor)
2. Stromal cells (eg, fibroma, thecoma, Leydig cell tumor)
3. Both (eg, Sertoli-Leydig cell tumor).
• The stroma and the sex cords are tissues that support the ovary. And from which
different cells develop.
• Most pure stromal tumours are non cancerous (benign). Sertoli-leydig tumours can be
either benign or cancerous.
• The most common type of SCST are granulosa cell tumours which are cancerous
(malignant).

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Sex cord stromal tumor signs and symptoms:
Functioning tumours that produce hormones can cause hormone related
symptoms including:
• changes to your periods such as irregular or heavy bleeding
• post menopausal vaginal bleeding
• breast tenderness or changes

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Risk factors of ovarian cancer:
• Older aged
• Family history
• Overweighted persons
• Taking hormone replacement therapy
• Endometriosis
• Never got pregnant
• Genetic mutation

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Ovarian cancer overall signs and symptoms:

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Diagnosis of ovarian cancer:

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Ovarian cancer treatment
There are basically 3 forms of treatment for ovarian cancer:
• The primary treatment: surgery at which time the cancer is removed
from the ovary and from as many other sites as possible.
• Second important treatment :Chemotherapy
• Radiation treatment which is used in only certain instances. It utilizes
high energy x-rays to kill cancer cells.

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Prevention of ovarian cancer:
There is no known way to prevent ovarian cancer, but these
things are associated with a lower chance of getting ovarian
cancer:
• Having used birth control pills for five or more years.
• Having had a tubal ligation (getting your tubes tied)
• both ovaries removed
• hysterectomy (an operation in which the uterus sometimes the
cervix, is removed).
• Having given birth.
• Breastfeeding.

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References
 Cancerresearchuk.com
 American cancer society, treatment for epithelial tumors of low malignant potential
 Desai A, Xu J, Aysola K, et al. epithelial ovarian cancer: an overview
 CDC institute, ovarian cancer ovcerview.
 Overian cancer research alliance. Types of ovarian cancer.

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