Introduction/Background*Ovarian cancer (OC) is the most lethal gynaecological malignancy worldwide, specially because it´s diagnosed as advanced-stage disease. Clinical aspects are inespecific and appear in advanced stages. Ultrasound study (US) remains the primary modality for assessment of ovarian tumors. Computed tomography (CT) imaging is the standard of care for pre-operative evaluation of ovarian cancer patients. Serum CA125 assay has low sensitivity in early stages.
Methodology Retrospective analysis of women under 45 years old diagnosed of epithelial and non-epithelial ovarian cancer during the last 10 years.
Result(s)*25 women under 45 years with OC were reviewed. Mean age at diagnosis was 36.27 years (SD 5.77; min:21, max: 43). Most of the tumors (52% N:13) were epithelial serous OC (Clear cells: 20.0% N:5; Endometrioid: 12.0 N:3; Mucinous: 8.0% N:2; Endodermal sinus: 4.0% N:1; Granulosa cell: 4.0% N: 1). Most of the patients were diagnosed in advanced tumoral stages (III-IV: 68.0%, N:17). Only 24.0% of patients were asymtomatic (N:6) at the time of diagnosis. Abdominal pain (44.0% N:11) or abdominal distension (40.0% N:10) were the most frequent complain. Other clinical aspects included: intestinal obstruction (N:4), dyspnoea (N:4), deep venous thrombosis (N:2), fever (N:1) or cerebellar degeneration (N:1). US study revealed an extended abdominal mass in most cases with a mean diameter of 10.09 cm (5.72 SD, max: 20 cm; min:4 cm). US suspicion of malignancy was high or intermediate in 77.27% (N:17%). Ascites was found in 26.09% (N:6). CT imaging completed the preoperative study detecting extrapelvic affectation in 50.0% of cases (N: 12) with liver extension in 29.17% (N:7), retroperitoneal dissemination in 45.83% (N:11) and supradiafragmatic disease in 6 patients (25.0%). Serum Ca125 was normal in 5 patients (22.72%): 1 high grade epithelial serous OC, 2 clear cell OC, 1 endometrioid carcinoma, 1 granulosa cell OC.
Conclusion*Early diagnosis of OC in premenopausal women is difficult. Clinical aspects were inespecific. Ultrasound features showed a big pelvic mass in most cases with high grade of suspicion of malignancy. CT imaging completed the preoperative study. Ca 125 is not always a good marker for the diagnosis in this group of patients.
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