Adenocarcinoma of the ovary

Ovarian adenocarcinoma is a cancerous tumor of the glandular tissue of the ovary. This disease is also called glandular cancer.

Ovarian adenocarcinoma is one of the varieties of epithelial ovarian cancer, that is, cancer in which tumor development occurs with the proliferation of cells of various types of epithelium.

The degree of malignancy depends on the level of cell differentiation. That is, the degree to which these cells differ in their structure, shape, composition from healthy cells of a given area of the body, tissue, organ.

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Causes of ovarian adenocarcinoma

To date, there is no single and unambiguous opinion about the causes of ovarian adenocarcinoma. However, some risk factors are important in this prognosis.

Such factors include obesity, the use of certain drugs for the treatment of infertility. Indirect risk factors may also include the use of loose powder cosmetics, such as talc or certain types of powder.

In addition, there is an opinion that there is a connection between the length of the reproductive period and ovarian cancer. Thus, it is believed that the longer the reproductive period (the beginning of the menstrual cycle is early, and menopause occurs late), the higher the probability of developing various types of ovarian cancer, including adenocarcinoma. Although there is no scientifically confirmed connection between these processes.

One cannot rule out such a common risk factor as genetic predisposition. In particular, women who have mutations in genes such as BRCA1 or BRCA2 are more prone to ovarian adenocarcinoma.

There are a number of other suspected risk factors, but they have a very small effect on the possibility of developing ovarian adenocarcinoma. These include ovarian removal surgery, bilateral tubal ligation, and the use of oral contraceptives.

There are also general risk factors that actively influence the possibility of developing any type of cancer, namely radiation, carcinogenic food, environmental conditions, air and water quality.

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Symptoms of ovarian adenocarcinoma

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

In particular, at first glandular cancer makes itself known by an irregular monthly cycle. But this disease is more common in women of pre-menopausal age, so doctors, and patients themselves, often attribute this symptom to the approaching menopause.

Also, integral symptoms in the development of ovarian adenocarcinoma are discomfort and mild pain in the lower abdomen, changes in bowel function, such as a feeling of early satiety when eating, bloating, functional digestive disorders. At later stages, a change in the size and shape of the ovary can already be detected by palpation. Intestinal obstruction or difficulty breathing may also occur. This occurs due to the pressure of the tumor on the internal organs. In rare cases, pain may occur during sexual intercourse.

In the later stages of the disease, changes in the size of the abdomen, severe shortness of breath, and enlargement of the inguinal lymph nodes with possible metastases may already be observed.

In diagnostics of ovarian adenocarcinoma, the definition of tumor markers is of great importance. But their specificity is quite low. Therefore, the so-called false-positive results may occur. Most often, this occurs with such concomitant diseases as endometriosis, adenomyosis, uterine fibroids, benign cysts, menstruation, inflammatory processes of the pelvic organs.

The most important symptom is the appearance of specific data in hardware diagnostic methods, such as ultrasound examinations, multimodal screening.

When assessing symptoms for suspected ovarian cancer, it is important to take a holistic approach, as most symptoms are not ones that directly indicate a problem.

But ovarian cancer is often discovered by chance, during some abdominal surgical interventions, as part of research on other diseases. Especially if we are talking about the development of cancer in the early stages.

Serous adenocarcinoma of the ovary

Serous adenocarcinoma of the ovaries is the most aggressive variant of this type of cancer. It is distinguished by the fact that it most often affects both ovaries. The tumor cells produce serous fluid. This fluid is similar in composition to that secreted by the epithelium of the fallopian tubes. The tumor itself has a multi-chamber cystic structure.

In serous ovarian adenocarcinoma, the tumor size is large, sometimes even gigantic.

The tumor itself is actively growing, rather quickly growing into the capsule itself. Metastases are actively developing, penetrating into other organs. The greater omentum is severely affected. The omentum performs an important cushioning and protective function, is connected with the circulatory and digestive systems. Thus, the development of serous adenocarcinoma inevitably leads to disruptions in the functioning of these organ systems, complicating the general condition of the patient.

Metastases penetrate into various layers of the peritoneum. In most cases, patients affected by this type of ovarian cancer develop ascites - accumulation of a large amount of water in the abdominal cavity. Ascites is commonly called dropsy.

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

Poorly differentiated ovarian adenocarcinoma

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

Low-differentiated ovarian adenocarcinoma is often considered a subsequent stage of serous adenocarcinoma development. However, there is no consensus on this issue today. The latest genetic research in the field of various mutations of specific oncogenes plays an important role in studying this problem today.

Low-differentiated ovarian adenocarcinoma is characterized not only by low typicality of tumor cells, but also by their relatively slow growth. These properties are typical of borderline tumors. Borderline tumors are those that have a low degree of malignancy and do not grow into neighboring tissues. This is a fairly common type of epithelial tumor, which is nevertheless less dangerous than the others.

Papillary adenocarcinoma of the ovary

Papillary adenocarcinoma of the ovary is the most common type of ovarian adenocarcinoma. It accounts for about 80%. It should be noted that the mortality rate from it is also relatively high.

Papillary adenocarcinoma of the ovary is distinguished by the special structure of the tumor itself. In this case, it is considered as a type of serous tumor, which has a pronounced capsule. The capsule is lined inside with papillary epithelium and liquid content. The growths themselves have a connective tissue base, are penetrated by blood vessels, although sometimes there are growths without them, and are covered with cubic and cylindrical epithelium. Calcified masses are sometimes found on the growths.

Due to its structure, papillary adenocarcinoma is often confused with other types of neoplasms. In this case, it is necessary to pay attention to whether one or both ovaries are affected, what is the structure and condition of the epithelium that covers the growths, what deposits are there, what is the degree of differentiation. This will allow you to distinguish ovarian adenocarcinoma from other non-malignant tumors. So often, doctors, when detecting papillary cysts, mistakenly begin to immediately classify them as 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, which is where the name of this type of adenocarcinoma comes from. In addition, malignant tumor cells can grow into the cyst stroma and, as a result, be located in the peritoneum. The cells themselves are different in their shape and structure, and the architecture of the gland itself is also disrupted. Those tumor metastases that grow into the peritoneum secrete a large amount of mucus into it.

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

Also, a distinctive feature of mucinous adenocarcinoma of the ovary is that the formed cysts have a large number of partitions that form peculiar chambers. It is this feature that plays a decisive 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 proceeds almost unnoticed by the patient. The tumor itself can, with further development, reach enormous sizes. Quite often, mucinous adenocarcinoma affects both ovaries.

Clear cell adenocarcinoma of the ovary

Clear cell adenocarcinoma of the ovary is one of the rarest cases of adenocarcinoma. It occurs in approximately 3% of all ovarian neoplasms that arise from epithelial tissue. This cancer is distinguished by the fact that the tumor consists of several types of cells, the most common being transparent cells containing glycogen and "nail" cells.

Due to the fact that this type of cancer occurs extremely rarely, it has been studied the least to date.

Most often, this disease occurs in patients who are over 50 years old.

Clear cell adenocarcinoma of the ovary has a high metastatic potential. Moreover, the very fact of the occurrence of clear cell adenocarcinoma in the ovary can often be the result of metastasis of clear cell cancer of other organs (for example, kidneys).

Clear cell carcinoma is known to have a very high degree of malignancy.

Most often it affects only one ovary. It is presented as a pelvic tumor of fairly large size.

The difficulty in diagnosis mainly lies in the fact that clear cell adenocarcinoma of the ovary is often confused with dysgerminoma and yolk sac tumor.

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Diagnosis of ovarian adenocarcinoma

In such a serious and dangerous disease as ovarian adenocarcinoma, diagnostics is of great importance. Both the general diagnosis, which indicates that the patient has a malignant ovarian tumor, and differential diagnostics, which allows for a more detailed assessment of the characteristics of a given case of ovarian adenocarcinoma and a precise determination of its type, allow for the most accurate selection of treatment tactics. 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, diagnostics begins with questioning and examining the patient. There are fairly generalized symptoms, but nonetheless, they require attention. These include a general deterioration in condition, pain in the lower abdomen, and menstrual irregularities.

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

Also important in making a correct diagnosis are blood tests of the patient for the presence of a number of tumor markers, which in themselves cannot guarantee the presence of a malignant tumor, but significantly help to make a more accurate diagnosis.

But the most informative analysis to date is the analysis of material collected using a biopsy of ovarian tissue.

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Treatment of ovarian adenocarcinoma

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

However, today the main methods of treating ovarian adenocarcinoma, 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 are no metastases, then the treatment may be limited to surgical intervention only. In this case, the tumor tissue will be removed. In the mildest cases, the tumor is removed, more often the entire ovary is removed. Much also depends on whether one or both ovaries are affected, the age of the patient, the state of her reproductive function. If the case is complicated, the disease is detected at a late stage, then not only the ovary, but also the uterus, and even the omentum in some cases, may be removed.

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

There are also a number of alternative methods of treating oncology in general and ovarian adenocarcinoma in particular. However, their effectiveness has not been reliably confirmed to date. Moreover, such methods of treatment are considered not only ineffective, but also risky, as they take up time that could be spent on better, more accurate treatment and timely diagnostics.

Prevention of ovarian adenocarcinoma

Measures for the prevention of ovarian adenocarcinoma are similar to those for the prevention of any cancer. These include giving up bad habits such as smoking and alcohol abuse, maintaining a healthy lifestyle, and minimizing the consumption of carcinogens from food and household chemicals.

Polluted environment can also contribute to the development of oncology. Therefore, it is worth protecting yourself from polluted areas as much as possible. In a metropolis, this is simply impossible. Therefore, you should be in nature more often, visit ecologically clean places, and maintain the hygiene of your home.

Infectious processes are also important factors in the development of cancer. In this case, complex 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 going to the doctor, treat themselves, often curing, but not completely getting rid of the infection. And long-term sluggish inflammatory processes are more dangerous in terms of oncogenicity.

One of the factors that can provoke ovarian cancer is obesity or simply excess weight. Therefore, people with this problem should be more attentive to their health, undergo preventive examinations more often, and minimize other risk factors.

Certain types of radiation, such as ultraviolet and ionizing radiation, are certainly oncogenic. Such exposures should be avoided. But if for a number of reasons this is impossible, then it is worth undergoing preventive examinations much more often in order to detect the problem at the earliest stages.

Prognosis of ovarian adenocarcinoma

Prognosis for ovarian adenocarcinoma directly depends on the type of tumor and the time of its detection. As well as on the quality and professionalism of the doctor who makes the diagnosis.

The best prognosis is made for those cases of the disease in which the situation is detected at fairly early stages, the tumor cells are well differentiated, and the patient has no 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 such a situation is still time. The later the patient seeks medical help, the worse the prognosis for a full or partial recovery.

Also, the prognosis worsens significantly if there are a number of diseases other than ovarian adenocarcinoma that do not allow the recommended treatment methods to be fully effective.

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

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