卵巢肿瘤Ovarian neoplasms八年制课件.ppt

要求 It’s our task and our goal to find a way to detect the patients qith ovarian cancer at her early stage: Early diagnosis Ancillary test- Tumor markers Tumor Marker Epithelial ovarian cancer CA125 Primary mucinous ovarian cancer or gastric cancers CEA Endodermal sinus tumor AFP Primary choriocarcinoma HCG Granulosa theca cell tumor Estrogen Differential diagnosis- in benign and malignant ovarian tumors Benign Malignant History Age 20- 50 20, 50 Term Long, Grow slowly Short, Grow quickly Signs Pelvic mass Unilateral, cystic, smooth, mobile Bilateral, solid, irregular, fixed, cul-de-sac nodules Ascites No Bloody, positive cytologic test General condition Good Thinness，cachexia Ultrasound Cystic, septum Solid, Irregular, mass or intracystic pappila Tumor markers Normal Elevated Diffrential diagnosis- in benign ovarian tumor Ovarian tumor like conditions Salpingo-ovarian cyst Uterine myoma: subserous, or cystic degeneration Pregnant uterus: early stage Ascites: huge ovarian cyst Differential diagnosis-in malignant ovarian tumor Endometriosis: Inflammation of pelvic connective tissue: Tuberculous peritonitis: Cancers outside the genital tracts: retroperitoneal neoplasm; colon cancer …… Ovarian metastatic tumors: Complications of ovarian tumor Pediculo-torsion: Acute abdominal pain, 10%. Rupture: 3%. if Spontaneous → suspicion of malignancy Infection: Canceration: Treatment of ovarian tumor Individually Considerations: Age Desiring for child General condition Classification Biological behavior Stage Grade Treatment of ovarian tumor Benign Borderline Malignant Biological behavior Benign Surgery: cystectomy; oophorectomy; salpingo- oophorectomy; total hysterectomy + salpingo- oophorectomy Short term observation Borderline (epithelial): IA; without child Unilateral salpingo-oophorectomy, Pelvic washing, Multiple biopsies if necessary IA with child or old woman, IB, IC Total hysterectomy + bilat