K Uma Devi, N Purushotham, N Jayashree1. 1. Department of Gynaec Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka State, India.
Abstract
BACKGROUND: Ovarian Cancer is a broad spectrum of diseases comprising several subtypes. Three major categories in younger women are germ cell tumor, sex cord stromal tumor and epithelial ovarian neoplasia. OBJECTIVE: literature search was for an update on management of ovarian cancer in young women. CONTEXT: Germ cell tumor is suspected in young girls presenting with solid ovarian neoplasm as abdominal mass, discomfort, dyspnea or pain abdomen. Preoperative evaluation should include thorough clinical examination with biochemical profile tumor markers and imaging techniques. When prepubertal girls present with precocious puberty, clitoromegaly, development of secondary sexual character, one should suspect juvenile granulosa theca cell tumor. Often serum beta inhibin is elevated in these cases. Young women are not immune to other tumors. Surgery should be fertility sparing, salphingo -oopherectomy, omentectomy, peritoneal cytology, retro peritoneal lymphadenectomy whenever indicated. Except Stage I A puredysgerminoma, Stage IA grade 1 immature teratoma, Stage IA /B grade 1 epithelial ovarian carcinoma, all other histopathological types irrespective of the stage of the disease require adjuvant chemotherapy. CONCLUSION: Girls, young women can have ovarian cancer conservative therapy. However treatment needs to be individualized. Except stage IA disease all other patient require adjuvant chemotherapy apart from fertility sparing surgery.
BACKGROUND:Ovarian Cancer is a broad spectrum of diseases comprising several subtypes. Three major categories in younger women are germ cell tumor, sex cord stromal tumor and epithelial ovarian neoplasia. OBJECTIVE: literature search was for an update on management of ovarian cancer in young women. CONTEXT: Germ cell tumor is suspected in young girls presenting with solid ovarian neoplasm as abdominal mass, discomfort, dyspnea or pain abdomen. Preoperative evaluation should include thorough clinical examination with biochemical profile tumor markers and imaging techniques. When prepubertal girls present with precocious puberty, clitoromegaly, development of secondary sexual character, one should suspect juvenile granulosa theca cell tumor. Often serum beta inhibin is elevated in these cases. Young women are not immune to other tumors. Surgery should be fertility sparing, salphingo -oopherectomy, omentectomy, peritoneal cytology, retro peritoneal lymphadenectomy whenever indicated. Except Stage I A puredysgerminoma, Stage IA grade 1 immature teratoma, Stage IA /B grade 1 epithelial ovarian carcinoma, all other histopathological types irrespective of the stage of the disease require adjuvant chemotherapy. CONCLUSION:Girls, young women can have ovarian cancer conservative therapy. However treatment needs to be individualized. Except stage IA disease all other patient require adjuvant chemotherapy apart from fertility sparing surgery.