ovarian cancer-radiographic diagnosis and staging

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1、IleanaHowardGillianLieberman,MDJuly2002OvarianCancerOvarianCancer--RadiographicRadiographicDiagnosisandStagingDiagnosisandStagingIleanaHoward,HarvardMedicalSchoolYearIIIIleanaHoward,HarvardMedicalSchoolYearIIIGillianLieberman,MDGillianLieberman,MDIleanaHowardGillianL

2、ieberman,MDPatient#1:Ms.SPatient#1:Ms.S5151y.oy.o.female,G0P0.female,G0P0PresentedtoE.D.withabdominalPresentedtoE.D.withabdominaldistensiondistensionLiverenzymesnormalLiverenzymesnormal4.5L4.5Lasciticasciticfluidremovedfromabdomen,fluidremovedfromabdomen,testingp

3、ositiveformalignantcells!testingpositiveformalignantcells!CTscanofabdomenperformedCTscanofabdomenperformed2IleanaHowardGillianLieberman,MDMs.S,continuedMs.S,continuedCTrevealed10x13cmCTrevealed10x13cmmassinRmassinRadenexaadenexaTumorsurgicallyTumorsurgicallyremove

4、dremoveddeterminedtobedeterminedtobestageIIclearcellstageIIclearcellcarcinomacarcinomaCourtesy:ChadBrecher,MD.BIDMC3IleanaHowardGillianLieberman,MDOvarianCancerOvarianCancer--backgroundbackgroundEpidemiology:Symptoms:Approx.1/100womendieofabdominaldistensionando

5、variancancerpain,dyspepsia,anorexia,Leadingcauseofdeathweightloss,backache,bladderSxfromgynecologicalmalignancyinU.S.Riskfactors:MoredeathsthanfromNulliparitycervicalandendometrialfamilyhx(attributedin~5-cancerscombined!10%ofcases)Of25,400newcasessupressionofo

6、vulationdiagnosedeachyearinU.S.-appearstobeprotective70%alreadyinadvanced(pregnancy,oralcontraceptivestages(III/IV)usage)Averageageatdiagnosis:63Conversely,inductionofovulationwithclomiphenehasbeensuggestedtoincreaseriskofovariancancer4IleanaHowardGillianLieberman,

7、MDPrimaryOvarianTumorsPrimaryOvarianTumors--evaluationevaluationTumorclassification:90%epithelial(serous,mucinous,endometrioid5%malignantmetastasis,mostcommonlyfrombreast,colon,gastric,lymphomaSignetcellmetastasisfromG.I.=KrukenbergtumorScreening:Currentlynotre

8、commended,asthepositivepredictivevalueoftestsavailablenotsufficientlyhighRadiologicmethodsofprimarytumorevaluation:UltrasoundCT