Ovarian malignancy

1. Big picture

Ovarian malignancy is a silent but dangerous gynaecological cancer because early disease causes vague symptoms, while many patients present late with ascites, omental spread, abdominal distension, early satiety, pelvic mass, or bowel/urinary symptoms.

For the final exam, the examiner wants you to know:

1. Most malignant ovarian cancers in adults are epithelial ovarian cancers.
2. Most epithelial ovarian cancers present late because symptoms are nonspecific.
3. Transvaginal ultrasound + CA-125 are key first investigations, but CA-125 alone is not diagnostic.
4. Suspicious masses must be managed by a gynaecological oncologist, not casually aspirated or removed without staging.
5. Main treatment is surgical staging/cytoreduction + platinum-based chemotherapy.
6. In young women, think of germ-cell tumours, tumour markers, and fertility-sparing surgery.

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