Synonyms in a broader sense
Medical: Ovarian carcinoma
- Ovarian tumor
- Ovarian tumor
Definition
Ovarian cancer is a malignant tumor of the ovaries that can occur on one or both sides. The type of ovarian cancer is distinguished by its histological image. Thus, tumors are divided into epithelial tumors are tumors that originate from the cells on the surface of the ovaries.
They account for approximately 60% of all malignant ovarian tumors. The germ cell tumors originating from the germ cells of embryonic development (body fruit development) account for about 20% of all malignant ovarian tumors. Stromal tumors are tumors that develop from the ovarian tissue and account for about 5% of all malignant ovarian tumors.
Furthermore, about 20% of all malignant ovarian tumors are metastases, i.e. cells that have migrated from a tumor that was originally located elsewhere. The metastases usually occur on both sides and originate from uterine cancer (uterus carcinoma) in about 30% and from breast cancer (breast cancer) or cancer of the gastrointestinal tract (gastrointestinal carcinoma) in about 20%.
- Epihelial tumors
- Germ cell tumors and
- Germ line – and current tumors.
Diagnosis
Diagnostic measures include
- Anamnesis (medical history)
- Physical (clinical)/gynecological examination
- Sonography
- Laboratory valuesTumor markers
- ImagingX-ray image
The process of confirming the diagnosis begins with the patient interview (anamnesis), in which the doctor makes an assumption based on the symptoms presented by the patient and can draw conclusions about a possible ovarian cancer. In order to clarify whether it really is ovarian cancer or whether something else is hidden behind the symptoms, the doctor must arrange for further examinations. Using ultrasound sonography, changes in the ovaries (ovaries), the uterus and the lymph nodes in the vicinity can be examined for abnormalities.
On the other hand, the treating physician should take a look at the surrounding organs in order not to overlook any existing cancer cell metastases. The bowel (colon) (as far as possible), liver (hepar), spleen (splen) and kidney (ren) should also be sonicated. This should be supplemented by an ultrasound examination through the vagina (transvaginal sonography).
A special ultrasound probe is inserted into the vagina for this purpose. Since the ovaries are located on both sides of the uterus, this ultrasound probe can be used to look at the ovaries. The vagina and the uterus are of course also evaluated.
The function of the organs (liver, kidney, etc.) can be assessed with the help of the laboratory blood values. Furthermore, a statement about an inflammation in the body can be made on the basis of inflammation values.
Of particular interest in ovarian cancer are also so-called tumor markers for ovarian cancer. These are special laboratory values that are elevated in some patients in the course of the tumor disease. However, it is not possible to draw conclusions about the size or even the malignancy of the tumor from the level of these values.
The tumor markers are not important until the course of the disease is observed, since changes in the value can then be used to make a statement about the behavior of the tumor. Increases in the values indicate further growth (proliferation) of the tumor; decreases in the values indicate that the tumor is getting smaller. If tumor marker values remain constant, one can speculate that the tumor neither grows nor shrinks.
The most common tumor marker for ovarian cancer is CA 125, which is elevated particularly in serous ovarian cancer. However, CA 125 may also be elevated in benign ovarian tumors or in inflammation within the abdominal cavity (intra-abdominal). Other tumor markers that can be detected are CEA, CA 19-9 and CA 72-4, but these tumor markers are also elevated in other tumors such as colon cancer or inflammation in the abdominal cavity.
They therefore only give an indication of the presence of ovarian cancer. Other pathological processes in the body must be excluded.AFP (alpha-fetoprotein) is a very specific tumor marker that is elevated in yolk sac tumors. hCG (human chorionic gonadotropin), a hormone that is normally produced by the fetus during pregnancy and thus elevated in the blood, is also elevated in chorionic carcinoma, which is derived from embryonic cells.
Summary of laboratory valuesTumor markers that may be elevated in ovarian cancer:
- CA 125
- CEA
- CA 19-9
- CA 72-4
- AFP
- HCG
If an X-ray of the lung is taken, cancer cell metastases can be detected. Computer tomography is a radiological representation of the body in which the organism can be viewed in different layers. However, these examinations are not always necessary.
After evaluating the data previously obtained, the treating physician must consider whether one of these two imaging procedures can still provide new insights and is useful. Magnetic resonance imaging also depicts the organism in several layers, but here magnetic fields are used instead of X-rays. Using computed tomography and magnetic resonance imaging, the physician can assess even more precisely whether ovarian cancer is present and in which organs cancer cell metastases may be present.
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