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Condition/Disorder Synonyms

  • Extraovarian primary peritoneal carcinoma (EOPPC)

  • Germ cell tumor (in egg cells)

ICD-9-CM Codes

  • 183 Malignant neoplasm of ovary and other uterine adnexa1

  • 183.0 Malignant neoplasm of ovary1

  • 198.6 Secondary malignant neoplasm of ovary2

ICD-10-CM Codes

  • C56.9 Malignant neoplasm of unspecified ovary

  • C79.60 Secondary malignant neoplasm of unspecified ovary

Preferred Practice Patterns

Key Features


  • Either EOPPC or germ cell tumor (in egg cells)

  • Second-most common female urogenital cancer

  • EOPCC is the most lethal of ovarian cancers

  • Epithelial tumors make up 90% of cases

Essentials of Diagnosis

  • Diagnosis is difficult and most women present with metastasis at time of diagnosis

  • Most primary malignant ovarian neoplasms are either carcinomas (serous, mucinous, or endometrioid adenocarcinomas) or malignant germ cell tumors1

  • Metastatic malignant neoplasms to the ovary include carcinomas, lymphomas, and melanomas1

  • This may be from a primary ovarian cancer involving the opposite ovary, or from a cancer at a distant site2

General Considerations

  • Most symptoms are common with non-cancer diagnoses, and therefore are overlooked (e.g., abdominal/pelvic pain)


  • Occurs in women

  • Incidence peaks in women during their 5th and 6th decade of life

  • White and Hawaiian women have the highest incidence of ovarian cancer in the United States

Clinical Findings

Signs and Symptoms

  • Typically asymptomatic or vague symptoms

    • Abdominal bloating

    • Flatulence

    • Fatigue and malaise

    • Gastritis

    • General abdominal discomfort

    • Antalgic gait

    • Postural abnormality

    • Abdominal/back pain

  • Less common symptoms

    • Abnormal vaginal bleeding

    • Leg pain

    • Pelvic mass

    • Low back pain

    • Local pelvic pain (occurs late in the disease)

  • Symptoms associated with metastasis

    • Unexplained weight loss

    • Weakness

    • Pleurisy

    • Ascites

    • Cachexia

  • Paraneoplastic cerebellar degeneration (PCD): primarily affects women with gynecologic cancers

    • Ataxic gait

    • Truncal and appendicular ataxia

    • Nystagmus

    • Speech impairment (dysarthria)

  • Radiation side effects

    • Fatigue

    • Secondary neoplasm

    • Integumentary compromise (burns)

    • Radiation fibrosis

  • Chemotherapy side effects

    • Nausea

    • Vomiting

    • Diarrhea

    • Alopecia

    • Mouth sores

    • Conjunctivitis

    • Ulcers

    • Leukopenia

    • Anemia

    • Thrombocytopenia

    • Headaches

    • Dizziness

    • Menstrual irregularities

    • Infertility

    • Peripheral neuropathies

Functional Implications

  • Decreased endurance

  • Postural muscle imbalance

  • Pain with mobility (guarded pelvic/hip movements)

  • Self care/ADL deficits

  • Antalgic gait

  • Postural abnormality

Possible Contributing Causes

  • Etiology unknown

  • Risk factors include

    • Hormonal factors

    • Environmental factors

    • Genetic factors

      • Family history of ovarian or breast cancer

      • First-degree relative with ovarian cancer or who has the BRCA1 mutation has a 45% lifetime chance of developing ovarian cancer

    • Nulliparous women

Differential Diagnoses

  • Malignant gastric tumors

  • Adnexal tumors

  • Appendicitis (acute); appendiceal tumors

  • Ascites

  • Bladder distention/urinary retention

  • Borderline ovarian cancer

  • Bowel adhesions

  • Cervicitis


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