OVARIANCANCERINTRODUCTIONI.HistologicClassificationi.coelomicepitheliumoriginatingtumoraccountsfor50-70%ofprimalovariantumor,85-90%ofovarianmalignace.developedfromgerminalepithelium→primalcoelomicepithelium→variousmuller,sepithelium→tubalepithelium,cervicalmucosaepithelium,endometriumthecoelomicepithelialtumorsinclude(i).seroustumor(ii).mucinoustumor(iii).endometrioidtumor(iv).clearcelltumor(v).Brennertumor/transitionalcelltumor(vi).mixedepithelialtumor(vii).undifferentiatedcarcinomaii.germcelltumoraccountsfor20-40%ofovariantumor.germcellsoriginatefromendogermtissues.inthecourseofitsorigination,transformationanddevelopmentthecellularheterogeneitymayoccurandformvarioustumorsgermcelltumorsinclude(i).dysgerminoma(ii).endodermalsinustumor(iii).embryoniccarcinoma(iv).polyembryonictumor(v).choriocarcinoma(vi).teratomai).immaturetypeii).maturetype(a).solidteratoma(b).cysticteratomaa).dermoidcystb).malignantchangeofdermoidcyst(c).monodermalandhighlyspecializedtumorsa).strumaovariib).carcinoid(vii).mixedtypeiii.ovariangonadalsexcordstromaltumoraccountsfor5%ofovariantumor.sexcordstromaoriginatesfrommesenchymaltissuesofprimalcoelomfemaleandmaledifferentiation→epitheliumdifferentiation→granulosa,Sertoliccelltumorfunctionaltumorstromaldifferentiation→thecacell,Leydigcelltumorsexcordstromalcellstumorincludes(i).granulosacell-stromaltumori).granulosacelltumorii).thecacelltumor,fibroma(ii).Sertolic-Leydigcelltumori).androblastoma(iii).gynandroblastomaiv.metastasizedtumorII.Highriskfactorsofovariantumorsi.hereditaryandfamilyfactorsabout20-25%malignantovariantumorshavefamilyhistoryii.environmentalfactorsthemobidityofovariancancerishighinindustrydevelopedcountrys,thismaybebecauseofhighcholesteroldietinthesecountrysiii.endocrinicfactorsmobidityinlesspregnantorinfertilewomenishigh(why),functionalcancersmayeasilycomplicatedwithmammaryandendometrialcancerIII.pathologyi.epithelialovariantumorsage:30-60;classification:benigh,borderline,malignantborderlinetumormeans:(i).serouscystadenomamobidity:accountsfor25%benightumorsmacroexamination:unilateral,globular,differentsize,smoothsurface,cystic,thinwallandfilledbyclearlight-yellowfluidsection:simpletype,monocystic,smoothwall;papillarytype,multicystic,intracysticpapillamicroscopicexanination:tumorwalliscomposedoffibro-connectivetissuesandlinedbyasinglelayerofcuboidorcolumnarepitheliumborderlineserouscystadenomamacroexamination:moderatesizebilateral,moreextracysticpapillamicroscopicexamination:thinpapillarybranch,epithelium≤3layers,slightcellularatypia,nuclearmitosis1/HP,nostromainvasion5yearsurvivalrate:over90%serouscystadenocarcinomamorbidity:mostcommonmalignantovariantumor,40-50%macroexamination:bilateral,relativelylarge,semisolid,nodularorlobular,smoothsurface,graywhitecolor,papillaryproliferationsection:multicystic,filledbypapilla,brittle,bleeding,necrosis,blurredcysticfluidmicroscopicexamination:obviousepithelialproliferation,4-5layers,cuboidorcolumnarcancercells,obviouscellularatypia,stromalinvasion5yearsurvivalrate:20-30%(ii).mucinouscystadenomamorbidity:20%ofbenigntumormacroexamination:unilateral,roundorelliptic,smoothsurface,graywhite,largeorgiantsection:multicystic,filledbytremellosemucus,lessintracysticpapillamicroscopicexamination:fibroconectivetissueswall,linedasinglelayerofhighcolumnarepithelium,malignantchangerate5-10%peritonealmyxoma:2-5%ofmucinouscystadenomasmaydevelop,formation,histologyborderlinemucinouscystadenomamacroexamination:relativelarge,moreunilateral,smoothsurface,multicysticsection:thickwalll,solidarea,tinysoftpapillamicroscopicexamination:epithelium≤3layers,slightcellularheterogeneous,largedarkstainednucleus,lessmitosis,proliferatedepitheliumprotrudeintocavityandformpapilla,nostromalinvasionmucinouscystadenocarcinomamorbidity:10%ofmalignanttumorsmacroexamination:unilateral,largesize,papillaryorsolidareasection:semicysticandsemisolid,blurredorbloodyfluidmicroscopicexamination:densegland,lessstroma,glandularepithelium3layers,obviouscellularatypia,stromalinvasion5yearsurvivalrate:40-50%,prognosisisbetterthanserouscystadenocarcinoma(iii).endometrioidtumormorbidity:lessencountered,benignmacroexamination:moreunilateral,smoothsurfacemicroscopicexamination:surfaceisasinglelayerofcolumnarepitheliumwhichverylikeendometrialglandepithelium,cavityislinedbypavementepitheliumborderline:rareendometrioidcarcinomamorbidity:10-24%ofprimarymalignanttumormacroexamination:moreunilateral,moderatesizesection:cysticorsolid,papilla,bloodyfluidmicroscopicexamination:verysimilartoendometrialcancer,moreadenocarcinomaoradenoacanthoma,oftencomplicatedwithendometrialcarcinoma5yearsurvivalrate:40-50%ii.ovariangermcelltumorsagroupofovariantumorsoriginatedfromprimalgermcells,itsmorbidityissecondarytotheepithelialtumors,mostoccursinchildhoodandadolescence,morbiditybeforeadolescenceaccountsfor60-90%,whileaftermenopauseitonlyaccounts4%(i).teratomamatureteratoma:alsocalleddermoidcystmorbidity:themostcommonbenignovariantumor,10-20%ofovariantumors,85-97%ofgermcelltumors,over95%ofteratomaage:occu