Ovarian cancer is the fifth most common malignancy in females and the leading cause of gynaecological cancers.

The peak age of incidence is 60 years and it generally carries a poor prognosis due to late diagnosis.

Types

Epithelial ovarian tumours

• most common type - mostly occur in post-menopausal women
• Originate from the epithelium which lines the fimbria of the fallopian tubes or the ovaries
• Epithelial tumours are partially cystic, and the cysts can contain fluid
• The initial metastatic spread typically involves the peritoneal cavity, with seeding particularly affecting the bladder, paracolic gutters and the diaphragm
• Around 90% of ovarian cancers are epithelial ovarian tumours.

Germ cell tumours features

• Originate from the germ cells in the embryonic gonad
• These tumours typically grow rapidly and spread predominantly via the lymphatic route
• Germ cell tumours most commonly arise in young women, which is atypical for most cases of ovarian cancer
• Tumour markers include alpha-fetoprotein and sometimes beta human chorionic gonadotrophin (B-HCG).

Sex cord stromal tumours

• Originate from connective tissue
• They are rare, making up less than 5% of all ovarian tumours. They are malignant tumours, but are much less aggressive than epithelial tumours
• Additionally, ovarian cancer can be secondary to another cancer elsewhere, which has metastasised to the ovary. A Krukenberg tumour refers to a "signet ring" sub-type of tumour, typically gastrointestinal in origin, which has metastasised to the ovary.