Ovarian cancer
Alerts and Notices
Synopsis
In the United States, ovarian cancer is the deadliest gynecologic malignancy, resulting in more deaths than uterine and cervical cancers combined. It is the second most common gynecologic malignancy.
Ovarian cancer can develop at any age, although it is most common in postmenopausal women, with an average age at diagnosis in the mid-60s. Women of Northern European descent are more likely to develop ovarian cancer, although women of African descent are more likely to die of the disease. The prognosis for women with stage III or IV mucinous ovarian cancer, a rare subtype of ovarian carcinoma, is poorer than the prognosis for women with other subtypes.
Risk factors for ovarian cancer are usually related to frequency and duration of ovulation. Early menarche, late menopause, and nulliparity have been associated with increased risk for ovarian cancer. Factors that decrease the risk of ovarian cancer are those that provide a respite in continuous ovulation, such as pregnancy, breastfeeding, and use of oral contraceptives.
Patients may have a genetic predisposition to development of ovarian cancer. For example, patients with a mutation in the BRCA1 gene have up to a 46% risk of ovarian cancer by age 70, while those with a mutation in the BRCA2 gene have up to a 27% risk. Lynch syndrome (hereditary nonpolyposis colorectal cancer) is an autosomal-dominant syndrome that increases the risk of ovarian cancer, in addition to being associated with endometrial, colorectal, intestinal, or renal cancers.
Patients with ovarian cancer are usually diagnosed with advanced disease, as the symptoms are often dismissed or overlooked by the patient and/or provider.
Codes
ICD10CM:C56.9 – Malignant neoplasm of unspecified ovary
SNOMEDCT:
363443007 – Malignant tumor of ovary
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
The differential diagnosis depends greatly on the patient's presenting symptoms.An adnexal mass could represent a benign or malignant lesion of the fallopian tube or ovary, but could also represent an infectious process, such as a tubo-ovarian abscess, and could likewise represent a diverticular abscess.
Ascites or pleural effusion, both of which are seen with advanced ovarian cancer, can be caused by multiple other medical conditions.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:09/28/2017
Last Updated:01/25/2022
Last Updated:01/25/2022
Ovarian cancer