Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Extraovarian primary peritoneal carcinoma (EOPPC)Germ cell tumor (in egg cells) ++ 183 Malignant neoplasm of ovary and other uterine adnexa1183.0 Malignant neoplasm of ovary1198.6 Secondary malignant neoplasm of ovary2 ++ C56.9 Malignant neoplasm of unspecified ovaryC79.60 Secondary malignant neoplasm of unspecified ovary ++ 4C: Impaired muscle performance6B: Impaired aerobic capacity/endurance associated with deconditioning +++ Description ++ Either EOPPC or germ cell tumor (in egg cells)Second-most common female urogenital cancerEOPCC is the most lethal of ovarian cancersEpithelial tumors make up 90% of cases +++ Essentials of Diagnosis ++ Diagnosis is difficult and most women present with metastasis at time of diagnosisMost primary malignant ovarian neoplasms are either carcinomas (serous, mucinous, or endometrioid adenocarcinomas) or malignant germ cell tumors1Metastatic malignant neoplasms to the ovary include carcinomas, lymphomas, and melanomas1This 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) +++ Demographics ++ Occurs in womenIncidence peaks in women during their 5th and 6th decade of lifeWhite and Hawaiian women have the highest incidence of ovarian cancer in the United States +++ Signs and Symptoms ++ Typically asymptomatic or vague symptomsAbdominal bloatingFlatulenceFatigue and malaiseGastritisGeneral abdominal discomfortAntalgic gaitPostural abnormalityAbdominal/back painLess common symptomsAbnormal vaginal bleedingLeg painPelvic massLow back painLocal pelvic pain (occurs late in the disease)Symptoms associated with metastasisUnexplained weight lossWeaknessPleurisyAscitesCachexiaParaneoplastic cerebellar degeneration (PCD): primarily affects women with gynecologic cancersAtaxic gaitTruncal and appendicular ataxiaNystagmusSpeech impairment (dysarthria)Radiation side effectsFatigueSecondary neoplasmIntegumentary compromise (burns)Radiation fibrosisChemotherapy side effectsNauseaVomitingDiarrheaAlopeciaMouth soresConjunctivitisUlcersLeukopeniaAnemiaThrombocytopeniaHeadachesDizzinessMenstrual irregularitiesInfertilityPeripheral neuropathies +++ Functional Implications ++ Decreased endurancePostural muscle imbalancePain with mobility (guarded pelvic/hip movements)Self care/ADL deficitsAntalgic gaitPostural abnormality +++ Possible Contributing Causes ++ Etiology unknownRisk factors includeHormonal factorsEnvironmental factorsGenetic factorsFamily history of ovarian or breast cancerFirst-degree relative with ovarian cancer or who has the BRCA1 mutation has a 45% lifetime chance of developing ovarian cancerNulliparous women +++ Differential Diagnoses ++ Malignant gastric tumorsAdnexal tumorsAppendicitis (acute); appendiceal tumorsAscitesBladder distention/urinary retentionBorderline ovarian cancerBowel adhesionsCervicitisColon cancer (adenocarcinoma)Colonic obstructionEctopic pregnancyEmbryologic remnantsEndometriosisFecal impactionGastric cancer (gastric adenocarcinoma)Hydrosalpinx/pyosalpinxIrritable bowel syndrome (IBS)Low-lying cecumMetastatic gastrointestinal carcinomaOvarian cysts; torsion... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.