Ovary is home place or favorite place for tumors and cysts to grow and develop. Many different types of tumors grow and develop in ovaries. Ovary may rightly be called woman body’s center for cancers. Both benign and malignant tumors grow and develop in ovaries. Ovary cancer is so common in women that it is counted among five life risking malignancies of women. The mortality rate of ovarian cancers is very high..Malignancies of genital tract account for one fifth of all cancers in women. In metropolitan cities of India the mortality from ovarian carcinoma exceeds the combined mortality from cervicaland endometrial carcinomas. Latest researches in gynecological field are very disappointing and discouraging. Even there has risen questioning and debates about the validity and authenticity of screening techniques employed for the early detecting of ovarian cancer. Now the uselessness of CA-125, the tumor marker of ovarian cancer is world wide acknowledged. The utility of CA-125 is widely questioned. An 18-year study from the National Cancer Institute of America has found that widespread screening and other diagnostic techniques for ovarian cancer do not save lives of victims but rather leave many a woman in dilemma for needless surgery and avoidable complications.
. Dysgerminoma make up two thirds of all malignant ovarian neoplasm in women younger than 20 years. It is the fourth most frequent cause of death in women in the United States.20% of ovarian tumors are germ cell tumors. In virgin girls under the age of ten years almost 85% of all ovarian tumors are of germ cell origin.
Dysgerminoma is absolutely a germ cell tumor of the ovary that is mostly or usually malignant in nature, from the very beginning. It is the most common malignant germ cell ovarian cancer. Carcinoma tumors of ovaries are epithelial in nature and it is their inherent nature that they most metastasize to different parts of body like lungs and liver etc. The most common way of metastasis in carcinomas is be way of lymph nodes. When a piece of original tumor is detached it swims to lymph node, by producing secondary cancer..lymphadonopathy is commonly seen in all carcinomas.
What fascinates this carcinoma is its characteristic nature that it is adolescent carcinoma. It mostly occurs in virgin girls and their early adult life. In pre pubertal girls its occurrence is around 5%. It also occurs in married women in the age group of 20-30 years. After menopausal periods its occurrence is almost rare. Its male or testicular counterpart is seminoma. Dysgerminoma exactly corresponds to its male counterpart seminoma, histologically and pathologically. Of all the gem cell tumors of ovaries, dysgerminoma is the most common malignant ovarian germ cell tumor Chromosome 12p abnormalities are genetic hallmarks of testicular seminoma. The genetic changes or mutations in dysgerminoma.are yet to be discovered. All dysgerminoma are considered malignant, but only one third of dysgerminoma behave aggressively. Besides dysgerminoma the other germ cell tumors found in ovaries are
• Endodermis sinus tumor
• Embronal carcinoma
• Poly embroyoma
• Chorico –carcinoma
Unfortunately the women with ovarian tumors are often symptom free for a very long time this is very tragic view of all ovarian cancers. .Many women with early stages of ovarian carcinoma have no symptoms.at all. Or these are non specific. Early symptom free nature of ovarian cancers makes it more difficult for their detection and diagnosis. Unfortunately by the time the ovarian malignancy is diagnosed two thirds of women have advanced carcinoma. The prognosis in such cases remains utterly unfavorable. Abdominal symptoms including pressure, pain, pelvic pressure, low back discomfort, mild nausea, feeling full early when eating, constipation and gas are all non specific in nature. . In their early manifestation Dysgerminoma are almost totally symptoms free or asymptomatic in the early stages…Abnormal bleeding during menstruation should raise alarm and suspicion but again non specific. The symptoms can be summarized as:
• Asymptomatic in early stages of growth and development
• Pelvic pain
• Excessive and abnormal bleeding during menstruation
• Increased frequency of urination
• Mild abdominal symptoms
• Pelvic mass or Pelvic fullness
In early stage cancer both ovaries are operated upon or removed. If the malignancy is far advanced than uterus has to be removed Surgical, radiotherapy and chemotherapy measures are employed. And these techniques have their own complications. Truly speaking the prognosis of ovarian cancer is not promising rather it is shocking and tormenting.
For risk factors see my recently published factoids named “Risk & protective factors in ovarian cancer”.