CA OVARY

Alfiya Mulla
3rd BHMS
03
• SPREAD
• CLINICAL FEATURES
• DIAGNOSIS
SPREAD
• Natural path of spread:- spread along the peritoneal surface to
involve ovarian, parietal and intestinal peritoneal surfaces as well as
diaphragm particularly right side.
• Modes of spread:-
1. Transcelomic
2. Lymphatic
3. Direct
4. Hematogenous
• Transcelomic spread
Implantation of malignant cells occurs by:
• Direct exfoliation of cells as in papillary cyst adenocarcinoma
• Penetration of tumor capsule
• Rupture of the capsule.
Lymphatics:-
• It is draining lymph nodes namely paraaortic and superior
gastric nodes.
• Left supraclavicular nodes are enlarged due to obstruction of
efferent lymphatic channel of nodes by tumor emboli.
• Lateral lymphatic spread through broad ligament to pelvic
nodes occur.
• Retrograde lymphatic spread in advance disease occur to
inguinal nodes through round ligament.
• Direct
After capsule is broken, spread occurs directly to the adjacent
organs like tubes broad ligament, intestine, omentum and
uterus.
• Hematogenous
The blood stream metastasis lately and involve organs such as
lungs, liver parenchyma, brain and Bones, etc.
Clinical features
• Although there is no immune to ovarian malignancy
but about 60% in postmenopausal and 20% in
premenopausal women are malignant.
• Increased association of nulliparity and with a family
history.
SYMPTOMS
Early stage- asymptomatic.
Presenting complaints – short duration and insidious
onset.
Feeling of abdominal distension and vague discomfort.
Dyspepsia, flatulence, eructation and pelvic pain.
Loss of appetite with sensation of bloating after meals.
In pre existing tumor-
1. dull aching pain and tenderness at one area.
2. rapid enlargement of tumor.
• Later stages
Abdominal swelling –maybe rapid
Dull abdominal pain.
Sudden loss of weight.
Respiratory distress – due to ascites or pleural effusion.
SIGNS:-