Ovarian cancer affects predominantly perimenopausal and postmenopausal women. Etiology and Pathology Incidence is higher in industrialized countries in which dietary fat intake is high. A history of nulliparity, infertility, late childbearing, and delayed menopause increases risk. Use of oral contraceptives significantly decreases risk. A personal or family history of endometrial, breast, or colon cancer increases risk.
Ovarian tumors are the most histologically diverse group of tumors.
Others include mucinous, endometroid, transitional cell, Brenner, clear cell, and unclassified carcinomas. Malignant germ cell tumors include dysgerminomas, immature teratomas, endodermal sinus tumors, embryonal carcinomas, choriocarcinoma, and polyembryomas. Ovarian cancer spreads by direct extension, by intraperitoneal implantation via exfoliation of cells into the peritoneal cavity, by lymphatic dissemination in the pelvis and para-aortic region, and, less commonly, hematogenously to the liver or lungs. The most common early finding is an adnexal mass, which is often solid, irregular, and fixed. A patient may be asymptomatic until an abdominal mass is discovered during routine pelvic examination or until the disease is advanced.