卵巢癌 Ovarian Cancer－狄文.ppt

2006-11-1 七年制 Ovarian Cancer Ovarian Cancer Risk Factors Family history Ovarian cancer Breast cancer Colon cancer Genetic factors Older age Caucasian More menstrual circles during lifetime (Ovulation induction) Incidence Nearly 25% of all ovarian neoplasm are malignant. Approximately 80％ of them are primary growths of the ovary. The remainder being secondary，usually carcinomata. symptoms Lack of any specific symptoms, ovarian tumors are often large by the time the doctor is consulted. Menstrual function is seldom upset, and any irregularity is attributed to the patient’s ‘time of life’. symptoms Increased abdominal size symptoms Pressure symptoms Gastro-intestinal symptoms (Bloating) Urge to urinate plevic pain (a dull pain in the lower abdomen) Very large tumors may cause respiratory embarrassment and edema or varicosities in the legs, and a characteristic ‘ ovarian cachexia’ develops. General Rule  An experienced examiner will recognize an ovarian tumor mainly because ovarian tumor is, in the circumstances, the most likely diagnosis. All abdominal swellings should be subjected to ultrasound and X-ray examination. ASCITES A fluid thrill may be elicited from an ovarian cyst, and ascites and tumor may coexist; but as a rule the distinction should be easily made. Uterine Fibroids A large midline intramural fibroid may be impossible to distinguish from a solid ovarian tumor until the abdomen is opened and an entirely different surgical problem encountered. Histological Classification Most tumors arise from the ovarian stroma and germinal epithelium. The embryonic coelom from which that epithelium develops also gives rise to the Mullerian duct from which develop the structures of the genital tract, and it is this common origin which explains the great variety of epithelial patterns which are met with. Primary Epithelial Tumor Mucinous cystadenoma or cystadencarcinoma (of. Cervical epithelium). Serous cystadenoma or cystadenocarcinoma