Adenocarcinoma of the ovary

Adenocarcinoma of the ovary is a cancer of the glandular tissue of the ovary. This disease is also called a glandular cancer.

Adenocarcinoma of the ovary is one of the varieties of epithelial ovarian cancer, that is, a cancer in which tumor development occurs when cells of different kinds of epithelium grow.

The degree of malignancy depends on the level of differentiation of cells. That is, the degree to which these cells, by their structure, form, composition, are different from healthy cells of a given area of the body, tissue, organ.

[1], [2], [3], [4], [5]

Causes of adenocarcinoma of the ovary

To date, there is no single and unequivocal opinion on the causes of ovarian adenocarcinoma. But some of the risk factors are important in this prediction.

These factors include obesity, the use of a number of drugs to treat infertility. Indirect risk factors can also include the use of loose powder cosmetic products, such as talc or powder of some types.

In addition, there is an opinion that there is a link between the duration of the reproductive period and ovarian cancer. So, it is believed that the more reproductive period is longer (the beginning of the menstrual cycle is earlier, and the climax comes late), the higher the probability of development of various types of ovarian cancer, including adenocarcinoma. Although there is no scientifically proven link between these processes.

You can not exclude such a common risk factor as genetic predisposition. In particular, those women who have mutations of such genes as BRCA1 or BRCA2 are more prone to ovarian adenocarcinoma.

There are a number of presumed risk factors, but they have very little impact on the possibility of ovarian adenocarcinoma. These include surgery to remove the ovary, bilateral pipetting, the use of oral contraceptives.

There are also common risk factors that actively influence the occurrence of any type of cancer, namely radiation, carcinogenic food, the ecological situation, air and water quality.

[6], [7], [8]

Symptoms of adenocarcinoma of the ovary

Diagnosing ovarian adenocarcinoma, as well as other types of ovarian cancer is quite difficult. In the early stages of the disease is asymptomatic. And with its further development, the symptoms are often indirect and it is difficult to recognize cancer in them.

In particular, at first glandular cancer manifests itself in an irregular monthly cycle. But this disease is more common in women of pre-menopausal age, because this symptom doctors, and the patients themselves, often write off the approaching menopause.

Also, uncomfortable symptoms in the development of adenocarcinoma of the ovary are discomfort and unexpressed pain in the lower abdomen, changes in the work of the intestine, such as a feeling of early satiety with food intake, bloating, functional digestive disorders. In the later stages, one can already detect a change in the size and shape of the ovary during palpation. Also, there may be intestinal obstruction or difficulty breathing. This is due to the pressure of the tumor on the internal organs. In rare cases, pain can occur during intercourse.

In the late stages of the disease, changes in the size of the abdomen, severe dyspnea, an increase in inguinal lymph nodes with possible metastases can already be observed.

In the diagnosis of ovarian adenocarcinoma, the definition of oncomarkers is important. But their specificity is rather low. Therefore, the occurrence of so-called false positive results. Most often it occurs with such concomitant diseases as endometriosis, adenomyosis, fibroids of the uterus, benign cysts, menstruation period, inflammatory processes of the pelvic organs.

The most important symptom is the emergence of specific data for hardware diagnostic methods, such as ultrasound, multimodal screening.

The evaluation of symptoms with ovarian cancer suspected should be treated in a comprehensive manner, since most of the symptoms are not those that directly indicate the problem.

But often, ovarian cancer is detected accidentally, with any cavitary surgical interventions, as part of research into other diseases. Especially when it comes to the development of cancer in the early stages.

Serous adenocarcinoma of the ovaries

Serous ovarian adenocarcinoma is the most aggressive variant of this type of cancer. It differs in that it most often affects both ovaries. Tumor cells produce serous fluid. This liquid in composition is similar to that which is excreted by the epithelium of the fallopian tubes. The tumor itself has a multi-chambered cystic structure.

With serous adenocarcinoma of the ovaries, the size of the tumor is large, even sometimes giant.

The tumor itself is actively growing, rather quickly sprouting the capsule itself. Metastases develop actively, penetrating into other organs. Strongly amazed by the large omentum. Omentum performs an important cushioning and protective function, is associated with the circulatory and digestive system. Thus, the development of serous adenocarcinoma inevitably leads to disturbances in the work of these organ systems, complicating the general condition of the patient.

Metastases penetrate various layers of the peritoneum. In most cases, patients suffering from this type of ovarian cancer develop ascites - a large amount of water in the abdominal cavity. In people, ascites is called dropsy.

In 75% of cases of development of epithelial ovarian cancer, it is serous cancer. Speaking about the age of patients, it can be noted that most often it occurs in middle age.

Low-grade adenocarcinoma of the ovaries

Low-grade adenocarcinoma of the ovary is a case of the development of a tumor of the glandular tissue of the ovary, in which the cells of tumor formation have a low level of differentiation. In this case it does not mean that the type of cancer is not defined or it is difficult to establish its nature. Low differentiation is expressed in the fact that the tumor cells themselves do not have pronounced characteristics, which are often encountered in such cases.

Low-grade adenocarcinoma of the ovary is often considered the next stage in the development of serous adenocarcinoma. But on this score today there is no consensus. An important role in the study of this problem today is played by the latest research of geneticists in the field of various mutations of specific oncogenes.

Low-grade adenocarcinoma of the ovary is characterized not only by the low typicality of tumor cells, but also by their relatively slow growth. These properties are characteristic of borderline tumors. Borderline refers to such tumors that have a low degree of malignancy and do not germinate into neighboring tissues. This is a fairly common form of epithelial tumor, which nevertheless is less dangerous in comparison with the rest.

Papillary adenocarcinoma of the ovary

Papillary adenoccinoma of the ovaries is the most common type of ovarian adenocarcinoma. On it comes about 80%. It should be noted that the death rate from him is relatively high.

Papillary adenocarcinoma of the ovary is distinguished by a special structure of the tumor itself. In this case, it is considered as a kind of serous tumor, which has a pronounced capsule. The capsule inside is lined with epithelium that has expanded in the form of papillae and liquid contents. The outgrowths themselves have a connective tissue base, are permeated with blood vessels, although sometimes there are outgrowths without them, and are covered with cubic and cylindrical epithelium. On the outgrowths sometimes there are calcined masses.

Because of its structure, papillary adenocarcinoma is often confused with other types of neoplasms. In this case, one should pay attention to whether one or both ovaries are affected, what is the structure and condition of the epithelium, which covers the outgrowths, what deposits there are, and what degree of differentiation. This will distinguish adenocarcinoma of the ovary from other non-malignant formations. So often doctors, discovering papillary cysts mistakenly begin to immediately attribute them to malignant.

Mucinous adenocarcinoma of the ovary

Mucinous adenocarcinoma of the ovary is characterized by the formation of cysts. These cysts are filled with a mucus-like fluid, from which the name of this variety of adenocarcinoma occurs. In addition, the cells of the malignant tumor can germinate the stroma of the cyst and, as a consequence, settle in the peritoneum. The cells themselves are different in form and structure, the architectonics of the gland itself is also disturbed. Those tumor metastases that germinate into the peritoneum secrete a large amount of mucus into it.

The mucus itself forms inside the cyst due to the fact that its inner surface is lined with epithelium, which is similar to what is in the cervix and produces mucus.

Also, the distinctive feature of mucinous adenocarcinoma of the ovary is that in the formed cysts a large number of partitions forming distinctive chambers. It is this feature that plays a crucial role in the diagnosis of this type of cancer.

Most often this type of cancer occurs after 30 years. While the tumor is small, the disease runs almost imperceptibly for the patient. The tumor itself can reach huge dimensions with further development. Quite often mucinous adenocarcinoma affects both ovaries.

Clear cell adenocarcinoma of the ovary

Light-cell adenocarcinoma of the ovary is one of the most rare cases of adenocarcinoma. It occurs in about 3% of all cases of neoplasm in the ovaries that arise from epithelial tissue. This cancer differs in that the tumor consists of several types of cells, most often there are transparent cells with glycogen content, and "clove" cells.

Due to the fact that this type of cancer is extremely rare, then its knowledge is to date the smallest.

Most often, this disease occurs in patients who are older than 50 years.

The light-celled adenocarcinoma of the ovary has a high capacity for metastasis. Moreover, the very fact of the occurrence of a clear-cell adenocarcinoma in the ovary can often be the result of metastasis of the clear-celled cancer of other organs (for example, the kidneys).

It is known that light-celled cancer has a very high degree of malignancy.

Most often it affects only one ovary. Presented as a pelvic tumor of rather large size.

The difficulty in diagnosing, basically, is that the clear celled adenocarcinoma of the ovary is often confused with the dysherminoma and the yolk sac tumor.

[9], [10], [11], [12]

Diagnosis of ovarian adenocarcinoma

With such a serious and dangerous disease as adenocarcinoma of the ovary, the diagnosis is of great importance. As the statement of the general diagnosis, which says that the patient has a malignant tumor of the ovary, and differential diagnosis, which allows more detailed assessment of the features of this case of adenocarcinoma of the ovary and determine its exact form, it is possible to select the tactic of treatment as precisely as possible. This is of great importance, and often not only significantly alleviates the patient's condition, but also gives him the opportunity to survive.

In any case, the diagnosis begins with a survey and examination of the patient. There are quite generalized, but nevertheless, requiring attention, symptoms. These include general deterioration of the condition, lower abdominal pain, menstrual irregularities.

Changes in the condition of the internal organs can be detected by a gynecologist during examination and palpation. Namely, a change in the architectonics of the ovary, the appearance of a mobile neoplasm, an increase in the size of the ovary. But more accurate and reliable are hardware diagnostic methods, such as ultrasound, computed tomography, MRI.

Also important role in the correct diagnosis is taken by the patient's blood tests for the presence of a number of oncomarkers in her, which alone can not guarantee the presence of a malignant tumor, but help significantly to make a more accurate diagnosis.

But the most informative for today is the analysis of the material selected with the help of ovarian tissue biopsy.

[13], [14], [15], [16]

Treatment of adenocarcinoma of the ovary

Treatment of adenocarcinoma of the ovary will largely depend on the stage at which the disease was detected, which type of tumor develops, what the general condition of the patient is, and whether there are concomitant diseases.

But nevertheless, today the main methods of treatment of adenocarcinoma of the ovary, regardless of the type of tumor, are surgical intervention and the use of chemotherapy.

If the disease was detected at a sufficiently early stage, its cells are well differentiated, there is no metastasis, then the treatment can be limited only by surgical intervention. In this case, the tumor tissue will be removed. In the most light cases, the tumor is removed, more often - the entire ovary is removed. Much depends also on whether one or both ovaries are affected, at what age is the patient, in what state is her reproductive function. If the case is complicated, the disease is found at a late stage, then the removal can be subjected not only to the ovary, but also the uterus, and even in some cases the omentum.

If surgery can not guarantee the removal of all tumor cells, then chemotherapy is used. It can be used as an independent treatment method or in combination with surgical procedures.

There are a number of non-traditional methods of treating oncology in general and ovarian adenocarcinoma in particular. But their effectiveness to date has no reliable evidence. Moreover, such methods of treatment are considered not only ineffective, but also risky, as they take time that could be spent on better accurate treatment and timely diagnosis.

Prophylaxis of ovarian adenocarcinoma

Measures to prevent adenocarcinoma of the ovaries with measures to prevent any cancer. These include the rejection of bad habits, such as smoking and alcohol abuse, the dictates of a healthy lifestyle, minimizing the use of carcinogens from food and household chemicals.

Also, a polluted environment can contribute to the development of oncology. Therefore it is necessary to protect yourself from polluted zones as much as possible. In a megacity, it is simply impossible. Therefore, you should visit nature more often, visit ecologically clean places, and maintain housing hygiene.

Infectious processes are important factors in the development of cancer. In this case, complicated or untreated infectious processes of the pelvic organs can significantly affect the development of ovarian adenocarcinoma. Infections are also dangerous because when they occur, patients often ignore the doctor's appointment, are treated independently, often healing, and not completely getting rid of the infection. And prolonged sluggish inflammatory processes are more dangerous from the point of view of oncogeneity.

One of the factors that can cause cancer with the ovary is obesity or simply excessive weight. Therefore, people with such a problem should be more careful about their health, often undergo preventive examinations, minimize other risk factors.

Unconditional oncogeneity has various kinds of radiation, such as ultraviolet, ionizing. Such effects should be avoided. But if for a number of reasons this can not be done, then it is much more likely to undergo preventive examinations in order to detect the problem at the earliest stages.

Prognosis of ovarian adenocarcinoma

Prognosis of ovarian adenocarcinoma directly depends on the type of tumor and the moment of its detection. And also on the quality and professionalism of the doctor who diagnoses.

The best predictions are made for those cases of the disease in which the situation is detected at rather early stages, the tumor cells are well differentiated, the patient does not have concomitant diseases.

Much depends on the type of tumor. Some of them are more malignant, some are so-called borderline tumors.

But the decisive factor in this situation is still time. The later the patient seeks medical help, the worse the prognosis for complete or partial cure.

Also, the forecasts worsen significantly if there are a number of diseases other than adenocarcinoma of the ovary that do not allow the effective use of the recommended methods of treatment to the full.

The quality of medical care, the psychological condition of the patient, the availability of the necessary information on this issue can also have a strong influence on the development of ovarian adenocarcinoma, both improving it and worsening.

In addition to general data, when predicting the course of the disease, much attention is paid to chemical and genetic analysis.