Detection of malignant ovarian neoplasms: a review of the literature. I. Detection of the patient at risk; clinical, radiological and cytological detection.
Risk factors for epithelial ovarian cancer are summarized in Table 1. Calculation of ovulation-years appears to be a potentially useful and practical method for identification of the high-risk individual. Risk factors for nonepithelial ovarian cancer are largely unknown, and consequently clinical diagnosis is stressed in the early detection of these tumors. Patients with Peutz-Jeghers syndrome or ovarian dysgenesis are significantly at risk and require at least regular pelvic examination. Of course, individuals with sexual precocity are at high risk for sex cord/stromal or germ cell malignancies. Individuals with a family history of Sertoli-Leydig cell tumors and benign thyroid disease also deserve close observation. Early clinical detection requires a sensitivity to presenting symptomatology (e.g., diffuse abdominopelvic complaints) as well as the skill and knowledge needed to recognize and appropriately manage adnexal masses. Harbingers of ovarian malignancy in the elderly woman, including unexplained hypercalcemia, new onset dermatomyositis, and cerebellar degeneration, should motivate thorough gynecologic evaluation. While radionuclide ovarian imaging for detection of early epithelial cancers of the ovary may become more generally available in the future, ultrasound imaging of the postmenopausal ovary, and peritoneal cytology may be of immediate value in screening high-risk women.
D000367:Age Factors; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D010053:Ovary / Q000473:pathology; D010298:Parity; D011247:Pregnancy; D012306:Risk; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014626:Vaginal Smears