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Ovarian Tumor Overview and Management

This document discusses ovarian cancer, including: - Ovarian cancer can occur at any age and there are different types depending on age. Epithelial ovarian cancer has a poor prognosis. - Symptoms of benign ovarian tumors include abdominal bloating if the tumor is medium-sized, or a mass may be found during gynecological exam. Symptoms of ovarian cancer appear at later stages and include abdominal bloating and mass. - Diagnosis involves ultrasound, CT, MRI, tumor markers like CA125, and laparoscopy. Staging is determined by the FIGO system and guides treatment, which includes surgery to confirm diagnosis and remove tumor, chemotherapy, and follow-up due to

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Ilham Harsya
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23 views16 pages

Ovarian Tumor Overview and Management

This document discusses ovarian cancer, including: - Ovarian cancer can occur at any age and there are different types depending on age. Epithelial ovarian cancer has a poor prognosis. - Symptoms of benign ovarian tumors include abdominal bloating if the tumor is medium-sized, or a mass may be found during gynecological exam. Symptoms of ovarian cancer appear at later stages and include abdominal bloating and mass. - Diagnosis involves ultrasound, CT, MRI, tumor markers like CA125, and laparoscopy. Staging is determined by the FIGO system and guides treatment, which includes surgery to confirm diagnosis and remove tumor, chemotherapy, and follow-up due to

Uploaded by

Ilham Harsya
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

KANKER OVARIUM

Dr. Dino Rinaldy, [Link](K)Onk


RSUD Dr. H. Abdul Moeloek
Ovarian tumor
 Sering terjadi
 Semua usia
 Jenis berbeda sesuai usia
 Jenis epiteliel mempunyai prognosis jelek
Pendahuluan

 Klasifikasi WHO tahun 1973


Jenis histologi
 Ovarain epithelial tumor
 Germ cell tumor
 Sex-cord stromal cell tumor
 Lipid (lipoid) cell tumor
 Gonadal blastoma
 Non-specific ovarian soft tissue tumor
 Unclassified tumor
 Metastatic tumor
 Tumor-like lesions
Gejala dan tanda
 Tumor jinak
 Jika kecil tak bergejala

 Pembesaran perut dan adanya masa pelvik


jika tumor ukuran menengah
 Pemeriksaan ginekologi dijumpai massa
disamping uterus
Gejala dan tanda
 Kanker ovarium
 Stadium dini
asimtomatik, ditemukan tidak disengaja
 Stadium lanjut
Pembesaran perut, massa abdominal, asites
 Pemeriksaan transvagina-rectnum
massa solid or semi-solid, terfiksir
Complications
 Rupture
 Frequency about 3%
 Traumatic and spontaneous
 Symptom
lower abdominal pain
related to the size of rupture
the quality and quantity of cyst fluid
 Signs
abdominal tenderness
muscle intensity
ascites
 Treatment
emergency surgery
Diagnosis
 Benign tumors
No specific symptoms
A mass found occasionally by physical examination
 Ovarian cancer
No specific symptoms
Gynecological examination
bilateral pelvic mass, solid , poor movability, with ascites,
uterus rectum nest nodules
Diagnosis

Pencitraan
Ultrasonografi ：
diagnosis lesi primer, akurasi > 90%
Radiologi (X-Ray, CT, MRI)
untuk lesi metastasis
Ultrasonografi kanker ovarium
Diagnosis
 Penanda tumor
§CA125
meningkat pada 80% kanker epitelial, monitoring dan prognosis
§AFP
meningkat pada endodermal sinus tumor
§hCG
choriacarcinoma ovarium
§Sex hormone
sex-cord stromal cell tumor
Laparoscopy
Ascitic cytology
Metastatic pathway
 Gambaran
 Penyebaran luas pada rongga abdomen
 Subclinical metastasis
 Cara menyebar
 langsung
 aliran getah bening
 melalui aliran darah
Clinical surgical-pathology staging (2000，FIGO)
Stage
I Growth limited to ovaries
Growth limited to one side ovaries; no ascites. No
IA
tumor on external surface; capsules intact
Growth limited to both ovaries; no ascites. No
IB
tumor on external surface; capsules intact
Tumor either IA or IB but with tumor on surface
of one or both ovaries;or with capsule ruptured; or
IC
with ascites containing malignant cells, or with
positive peritoneal washings
II Growth involving one or both ovaries with pelvic extension.
Extension and/or metastasis to the uterus and/or
IIA
tubes.
IIB Extension to other pelvic tissues.
Tumor either Stage IIA or IIB, but with tumor on
surface of one or both ovaries; or with capsule
IIC
ruptured; or with ascites containing malignant
cells, or with positive peritoneal washings.
Tumor involving one or both ovaries with peritoneal implants outside pelvis and/or positive
III
retroperitoneal or inguinal nodes. Superficial liver metastasis equals Stage III.
Tumor grossly limited to true pelvis with negative
nodes, but with histologically confirmed
IIIA
microscopic seeding of abdominal peritoneal
surfaces.
Tumor of one or both ovaries with histologically
confirmed implants to abdominal peritoneal
IIIB
surfaces, none exceeding 2 cm in diameter Nodes
are negative.
Abdominal implants >2 cm in diameter and/or
IIIC
positive retroperitoneal or inguinal nodes.
Growth involving one or both ovaries with distant metastasis. If pleural effusion present, must be
IV
positive cytology to assign a case to Stage IV. Parenchymal live metastasis equals Stage IV.
Terapi
 Pembedahan
Tujuan
 Konfirmasi diagnosis
 Reseksi tumor
 Penentuan stadium
 Kemotherapi
 follow-up
Mudah berulang
Thank you !

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