Clinical Presentation

Clinical features related to ovarian pathology are often non-specific and, in general with ovarian neoplasia, symptoms occur late in the course of the disease when the tumour has often spread beyond the ovary. Symptoms related to ovarian tumours include swelling or a feeling of fullness in the abdomen or pelvis, the presence of an abdominal mass, irregular uterine bleeding and abdominal or pelvic pain. There may be associated ascites, especially with ovarian malignancies, but also with some benign neoplasms such as fibromas. With ovarian endometriosis, pain and swelling may fluctuate depending on the stage of the menstrual cycle. In younger patients, ovarian pathology may be discovered during the course of investigations for infertility. Ovarian pathology may also be discovered incidentally during abdominal or pelvic imaging or as a result of an

Glands Fibroma Ovary

Figure 21.1. Overview of gynaecological anatomy. Based on Hermanek P, Hutter RVP, Sobin LH, Wagner G, Wittekind Ch (eds.). TNM Atlas: illustrated guide to the TNM/pTNM classification of malignant tumours, 4th edition. Springer-Verlag: Berlin and Heidelberg, 1997.

1. Ovarian ligament

2. Round ligament

Figure 21.1. Overview of gynaecological anatomy. Based on Hermanek P, Hutter RVP, Sobin LH, Wagner G, Wittekind Ch (eds.). TNM Atlas: illustrated guide to the TNM/pTNM classification of malignant tumours, 4th edition. Springer-Verlag: Berlin and Heidelberg, 1997.

increased serum CA-125. Serum CA-125 measurements and abdominal ultrasound are currently being evaluated in screening programmes for ovarian cancer.

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