Ovarian Cancer

Ovarian cancer is a malignant tumor arising from the ovarian tissue, most commonly from the epithelial cells, leading to peritoneal spread, ascites, and potentially life-threatening complications if untreated.

Definition

Ovarian cancer is a malignant tumor arising from the ovarian tissue, most commonly from the epithelial cells, leading to peritoneal spread, ascites, and potentially life-threatening complications if untreated.

Epidemiology

7th most common cancer in women worldwide
Incidence higher in postmenopausal women (median age ~63 years)
More common in developed countries
Risk factors: family history, BRCA1/BRCA2 mutations, nulliparity
Often diagnosed at an advanced stage due to nonspecific early symptoms

Etiology

Genetic mutations: BRCA1, BRCA2, TP53, RAD51, mismatch repair genes
Hormonal factors: increased ovulatory cycles (nulliparity, early menarche, late menopause)
Endometriosis increases risk of certain subtypes (clear cell, endometrioid)
Family history of ovarian or breast cancer
Environmental and lifestyle factors: obesity, smoking, infertility treatments

Pathophysiology

Malignant transformation of ovarian surface epithelium, germ cells, or stromal cells
Epithelial ovarian cancers spread via peritoneal fluid, direct invasion, and lymphatics
Tumor microenvironment promotes angiogenesis and immune evasion
Ascites formation due to peritoneal spread and vascular permeability
Advanced disease may involve omentum, bowel, and liver surface