Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2020
The most significant risk factors for ovarian cancer are age and a family history of the disease. Epithelial ovarian carcinomas are classified into four main histological subtypes: serous, endometrioid, clear cell, and mucinous. Ninety-five percent of women with ovarian cancer experience symptoms before diagnosis. Ovarian cancer spreads via local shedding into the peritoneal cavity and local invasion of bowel and bladder. Epithelial malignancies arising from the fallopian tube, and the peritoneum in females, occur through similar etiological pathways and demonstrate similar clinical behavior; therefore, they are managed using the same treatment algorithm(s) as epithelial ovarian cancer. Factors precluding successful primary surgery include extensive upper abdominal disease, in particular that involving the porta hepatis or mesentery, and poor performance status secondary to symptoms associated with ovarian cancer and/or comorbidities. Poly(ADP-ribose) polymerase inhibitors are a standard of care maintenance treatment in relapsed, platinum-sensitive high-grade serous or endometrioid ovarian cancer.
Damage to the uterus, the fallopian tubes and the ovaries
David J Cahill in Practical Patient Management in Reproductive Medicine, 2019
This chapter discusses those conditions which cause distortion and damage to the uterus, the fallopian tubes and the ovaries, and includes options for management. The pathological conditions affecting the uterus can be divided into: congenital structural abnormalities and acquired conditions, the latter divided into myometrial pathology and endometrial pathology. The layer of endometrium on the septum or the distal end of the bicornuate uterus has very little stromal tissue underneath it. The conditions predisposing to the development of intrauterine adhesions postsurgery are when the uterus is soft and when the uterine lining is less firmly attached to the stroma. The evidence for surgical management of congenital uterine anomalies is limited and not supportive of intervention. Uterine fibroid surgery can cause significant blood loss and adhesion formation, but careful attention to haemostasis intraoperatively and use of Ringer's lactate can address the satisfactorily. Peritubal adhesions and blockage are usually caused by Chlamydia.
The normal endometrium
T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng in Diagnostic Endometrial Pathology, 2019
The endometrium forms the mucosal lining of the myometrium between the interstitial segments of the fallopian tubes in the uterine cornua on either side of the fundus and the isthmical portion above the cervix. It is a complex tissue composed of surface epithelium, glands, stromal and inflammatory cells and blood vessels. The morphology of the endometrium is dependent on its anatomical location within the uterus. The endometrium is generally fairly uniform in appearance in the fundus and body and is conventionally divided into two components: the basal layer, adjacent to the myometrium, and the functional layer, superficial to the basal layer. Stromal edema becomes prominent and delineates the middle of the endometrium into the spongy layer. The spiral arteries give off anastomosing branches to the glands and stroma of the functional layer, and they terminate in a complex anastomotic network in the superficial layer of the endometrium.
Acute abdominal pain due to internal herniation of the sigmoid colon, fallopian tube and left ovary, a rare presentation of Allen Masters syndrome
Published in Acta Chirurgica Belgica, 2019
C. H. Mazzetti, N. Hock, S. Taylor, J. Lemaitre, K. Crener, E. Lebrun
In 1955, Allen and Masters describe a painful syndrome which associates traumatic delivery to laceration found on the posterior leaf of the broad ligament. Herniation through this defect is a rare entity, accounted for about 4–7% of all internal hernias. Normally, it involves the small bowel. The authors present the case of a multiparous woman admitted at emergency for constipation and abdominal pain. The CT scan showed an extremely rare case of internal hernia of the sigmoid colon, fallopian tube and left ovary through a large defect of the broad ligament. The patient underwent a full laparoscopic surgery that allowed the reduction of the hernia and the suture of the defect with very good outcome.
Altered innervation of the fallopian tube in ectopic pregnancy
Published in Journal of Obstetrics and Gynaecology, 2014
X. M. Zhang, X. Huang, H. Xu, M. J. Quinn
Three cases of ectopic pregnancy demonstrate different patterns of abnormal innervation in the fallopian tube. In the isthmus of the fallopian tube, we observed either (1) loss of nerves in one or more muscle layers of the fallopian tube or (2) large numbers of abnormal nerve profiles in one or more layers of muscle of the fallopian tube. Each woman had a prior history of one or more surgical terminations of pregnancy at indeterminate gestational ages. A proportion of uterine and tubal nerves pass through the uterosacral ligaments to reach the endometrial–myometrial nerve plexus and terminate as the innervation to the ipsilateral fallopian tube. We propose that injuries to the uterosacral ligaments by excessive traction to the cervix, or over-vigorous curettage to the endometrial–myometrial nerve plexus may account for these neuro-immunohistochemical findings. There were no signs of chronic infection or inflammation in the fallopian tube in any of these cases.
The polycystic ovary syndrome and gynecological cancer risk
Published in Gynecological Endocrinology, 2020
Blazej Meczekalski, Gonzalo R. Pérez-Roncero, María T. López-Baena, Peter Chedraui, Faustino R. Pérez-López
This review updates the knowledge regarding the association between the polycystic ovary syndrome (PCOS) and the risk of gynecological cancer. We performed a literature review of clinical and epidemiological studies concerning PCOS and the risk of breast, endometrial and ovarian cancer after selecting information by quality of scientific methodology. It was found that evidence does not support a link between PCOS and breast cancer risk. There is an increased risk of endometrial cancer, while data concerning ovarian cancer are contradictory. Regarding PCOS and its association to cervical, fallopian tube, and vulvar cancer, the quality of evidence is heterogeneous. In conclusion, women with PCOS should be screened for endometrial cancer and more research is warranted to determine in this population the true risk of developing other gynecological cancers such as breast and ovarian.
Related Knowledge Centers
- Broad Ligament
- Epithelium
- Ovary
- Ovum
- Round Ligament
- Oviducts
- Adnexa Uteri