Ovarian cancer

3 cell types make up the normal ovary: Surface epithelial cells (multipotential); sex cord/stromal cells (multipotential); germ cells (totipotential).

Risk factors: Nulliparity and Fx. OCP reduces the risk :)

Genetics: 5-10% of all ovarian cancers are familial. Most are caused by mutations in BRCA1 and BRCA2. The average lifetime risk for ovarian cancer approximates 30% for BRCA1 carriers; somewhat lower in BRCA2 carriers.

Sporadic cancers:

• BRCA1 and BRCA2 mutations are seen in only 10% of sporadic ovarian cancers.
• HER2/NEU is overexpressed in 35%, and is associated with a poor prognosis.
• K-RAS protein is overexpressed in up to 30%, mostly mucinous cystadenocarcinomas.
• p53 is mutated in about 50% as with other cancers.

Surface epithelial cells

• Serous
• Mucinous
• Endometrioid
• Clear cell
• Brenner
• Cystadenofibroma

Germ cell

• Teratoma
• Dysgerminoma
• Endodermal sinus tumour
• Choriocarinoma

Sex cord-stroma

• Fibroma
• Cranulosa-theca cell tumour
• Sertoli-Leydig cell tumour