A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) [cachexia; virilization signs (masculinization)] Skin and mucous membranes Abdominal wall and inguinal region (groin area). Auscultation (listening) of the heart. Auscultation of the lungs Percussion of the abdominal wall … Ovarian Cancer: Examination
Laboratory parameters 1st order – obligatory laboratory tests: For suspected genetic predisposition to ovarian (or breast) carcinoma: BRCA mutation analysis/BRCA gene status* (BRCA1* * , BRCA2* * , BRCA3/RAD51C gene); performed on formalin-fixed, paraffin-embedded (“FFPE”) tumor tissue; performed within a few days. * For women with a BRCA mutation, the risk of developing breast cancer … Ovarian Cancer: Test and Diagnosis
Therapeutic target Improvement of symptoms Therapy recommendations Therapy recommendations include the following groups: Epithelial ovarian cancer. Borderline tumors Malignant germline tumors Malignant germ cell tumors See also under “Further therapy“. Agents (main indication) Chemotherapeutic agents Epithelial ovarian cancer [S3 guideline] Early “Epithelial Ovarian Carcinoma.” Adjuvant therapy (therapy that follows surgical resection of a tumor): Patients … Ovarian Cancer: Drug Therapy
Mandatory medical device diagnostics. Vaginal sonography (transvaginal sonography; ultrasound examination by means of an ultrasound probe inserted into the vagina), if necessary also an abdominal sonography – for basic diagnostics [see below checklist for differentiation of ovarian cancer and benign masses]. X-ray of the thorax (X-ray thorax / chest), in two planes, or lungs – … Ovarian Cancer: Diagnostic Tests
Epithelial ovarian cancer [S3 guideline] Patients with genetic predisposition (healthy mutation carriers) to ovarian cancer. Prophylactic bilateral salpingo-ovarectomy (PBSO; removal of the fallopian tube and ovary) after completed family planning results in an 80% to >90% risk reduction of developing ovarian cancer. Indication: women with a mutation in the BRCA1/2 gene and proven mutations in … Ovarian Cancer: Surgical Therapy
To prevent ovarian cancer (ovarian cancer), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – see Prevention with micronutrients. Overweight (BMI ≥ 25; obesity) (+ 10%). Medication Hormone therapy (HT) after menopause (the time of the last spontaneous menstrual period in a woman’s lifetime) – regardless … Ovarian Cancer: Prevention
Ovarian cancer (ovarian cancer) usually does not cause early symptoms. In advanced stages, the following symptoms and discomfort may occur: Abdominal tightness1 Ascites (abdominal dropsy) Increase in the circumference of the abdomen (abdominal circumference increase). Loss of appetite* Unintentional weight loss1 Cachexia Meteorism2 (bloated abdomen) Micturition discomfort (discomfort during urination); increase in micturition frequency (frequency … Ovarian Cancer: Symptoms, Complaints, Signs
Pathogenesis (disease development) The pathogenesis of ovarian cancer is not yet fully understood. To date, ovarian cancer is thought to have a dual genesis: Type 1 (“low grade”) carcinomas arise from defined precursor lesions such as borderline tumors Type 2 (“high grade”; aggressive) carcinomas often arise from intraepithelial lesions (damage located within the epithelial layer) … Ovarian Cancer: Causes
General measures Aim for or maintain normal weight!Determine BMI (body mass index, body mass index) or body composition using electrical impedance analysis. BMI ≥ 25 → participation in a medically supervised weight loss program. Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age … Ovarian Cancer: Treatment
The following entities are distinguished according to histologic criteria: Borderline and epithelial tumors (60-80% of all ovarian cancers, age-dependent: Increase with increasing age) Endometrioid carcinoma De-differentiated carcinoma Mixed carcinoma Clear cell carcinoma Mucinous carcinoma Squamous epithelial Low-grade serous carcinoma – when low-grade serous carcinoma (LGSC) is indicated, additional subclassification should be made between carcinoma and … Ovarian Cancer: Classification
Medical history (history of illness) is an important component in the diagnosis of ovarian cancer (ovarian cancer). Family history Are there any tumor cases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current … Ovarian Cancer: Medical History
Neoplasms – Tumor Diseases (C00-D48). Ovarian metastases – daughter tumors arising from an ovarian cancer. Ovarian tumors originating from the germinal stroma such as granulosa theca cell tumors or Sertoli-Leydig cell tumors Ovarian tumors that arise from the germ cells such as teratoma, dysgerminoma, sinus tumors, or chorionic carcinoma Ovarian tumors originating from surface epithelial … Ovarian Cancer: Or something else? Differential Diagnosis
