Ovarian Low Malignant Potential Tumors
General Information(Symptoms and Diagnosis)
Stages
Treatment
General Information About Ovarian Low Malignant Potential
Tumors
Key Points
- Ovarian low malignant potential tumor is a disease in which
abnormal cells form in the tissue covering the ovary.
- Signs and symptoms of ovarian low malignant potential tumor
include pain or swelling in the abdomen.
- Tests that examine the ovaries are used to detect (find),
diagnose, and stage ovarian low malignant potential tumor.
- Certain factors affect prognosis (chance of recovery) and
treatment options.
Ovarian
low malignant potential tumor is a disease in which abnormal cells form
in the tissue covering the ovary.
Ovarian low malignant potential tumors
have abnormal cells that may become cancer, but usually do not.
This disease usually remains in the ovary.
When disease is found in one ovary, the other ovary should also be
checked carefully for signs
of disease.
The ovaries are a pair
of organs in the
female reproductive system.
They are in the pelvis,
one on each side of the uterus
(the hollow, pear-shaped organ where a fetus
grows). Each ovary is about the size and shape of an almond. The
ovaries make eggs and female hormones.
Anatomy of the female
reproductive system. The organs in the female reproductive system
include the uterus, ovaries, fallopian tubes, cervix, and vagina. The
uterus has a muscular outer layer called the myometrium and an inner
lining called the endometrium.
Signs
and symptoms of ovarian low malignant potential tumor include pain or
swelling in the abdomen.
Ovarian low malignant
potential tumor may not cause early signs or symptoms. If you do have
signs or symptoms, they may include the following:
- Pain or swelling in the abdomen.
- Pain in the pelvis.
- Gastrointestinal
problems, such as gas, bloating,
or constipation.
These signs and symptoms
may be caused by other conditions.
If they get worse or do not go away on their own, check with your
doctor.
Tests
that examine the ovaries are used to detect (find), diagnose, and stage
ovarian low malignant potential tumor.
The following tests and
procedures may be used:
- Physical
exam and history
: An exam of the body to check general signs of
health, including checking for signs of disease, such as lumps or
anything else that seems unusual. A history of the patient's health
habits and past illnesses and treatments will also be taken.
- Pelvic
exam : An exam of the vagina, cervix, uterus, fallopian tubes, ovaries,
and rectum. A speculum is inserted into
the vagina and the doctor or nurse
looks at the vagina and cervix for signs of disease. A Pap test of the cervix is
usually done. The doctor or nurse also inserts one or two lubricated, gloved fingers
of one hand into the vagina and places the other hand over the lower
abdomen to feel the size, shape, and position of the uterus and
ovaries. The doctor or nurse also inserts a lubricated, gloved finger
into the rectum to feel for lumps or abnormal areas.
Pelvic exam. A doctor
or nurse inserts one or two lubricated, gloved fingers of one hand into
the vagina and presses on the lower abdomen with the other hand. This
is done to feel the size, shape, and position of the uterus and
ovaries. The vagina, cervix, fallopian tubes, and rectum are also
checked.
- Ultrasound
exam: A procedure in which high-energy sound waves
(ultrasound) are bounced off internal tissues
or organs and make echoes. The echoes form a picture of body tissues
called a sonogram.
The picture can be printed to be looked at later.
Abdominal ultrasound.
An ultrasound transducer connected to a computer is passed over the
surface of the abdomen. The ultrasound transducer bounces sound waves
off internal organs and tissues to make echoes that form a sonogram
(computer picture).
Other patients may have a transvaginal
ultrasound.
Transvaginal
ultrasound. An ultrasound probe connected to a computer is inserted
into the vagina and is gently moved to show different organs. The probe
bounces sound waves off internal organs and tissues to make echoes that
form a sonogram (computer picture).
- CT
scan (CAT scan): A procedure that makes a
series of detailed pictures of areas inside the body, taken from
different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help
the organs or tissues show up more clearly. This procedure is also
called computed tomography, computerized tomography, or computerized
axial tomography.
- CA
125 assay
: A test that measures the level of CA 125 in the blood. CA 125 is a substance
released by cells into the bloodstream. An increased CA 125 level is
sometimes a sign of cancer or other condition.
- Chest
x-ray : An x-ray of the organs and bones
inside the chest. An x-ray is a type of energy beam that can go through
the body and onto film, making a picture of areas inside the body.
- Biopsy
: The removal of cells or tissues so they can be
viewed under a microscope
by a pathologist to
check for signs of cancer. The tissue is usually removed during surgery to remove the tumor.
Certain
factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment
options depend on the following:
- The stage
of the disease (whether it affects part of the ovary, involves the
whole ovary, or has spread to other places in the body).
- What type of cells make up the tumor.
- The size of the tumor.
- The patient's general health.
Patients with ovarian
low malignant potential tumors have a good prognosis, especially when
the tumor is found early.
Stages of Ovarian Low Malignant Potential Tumors
Key Points
- After ovarian low malignant potential tumor has been
diagnosed, tests are done to find out if abnormal cells have spread
within the ovary or to other parts of the body.
- The following stages are used for ovarian low malignant
potential tumor:
- Stage I
- Stage II
- Stage III
- Stage IV
After
ovarian low malignant potential tumor has been diagnosed, tests are
done to find out if abnormal cells have spread within the ovary or to
other parts of the body.
The process used to find
out whether abnormal
cells have spread
within the ovary or
to other parts of the body is called staging.
The information gathered from the staging process determines the stage of the disease. It is
important to know the stage in order to plan treatment. Certain tests
or procedures are used for staging. Staging laparotomy
(a surgical incision made in the wall of
the abdomen to
remove ovarian tissue) may be used. Most
patients are diagnosed
with stage I disease.
The
following stages are used for ovarian low malignant potential tumor:
Stage
I
In stage I, the tumor is found in one or
both ovaries. Stage
I is divided into stage IA, stage IB, and stage IC.
- Stage IA:
The tumor is found
inside a single ovary.
- Stage IB:
The tumor is found
inside both ovaries.
- Stage IC:
The tumor is found
inside one or both ovaries
and one of the following is true:
- tumor cells
are found on the outside surface of one or both ovaries; or
- the capsule
(outer covering) of the ovary has ruptured (broken open); or
- tumor cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of
the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal
cavity).
Stage
II
In stage II, the tumor is found in one or
both ovaries and
has spread into other areas of the pelvis.
Stage II is divided into stage IIA, stage IIB, and stage IIC.
- Stage IIA:
The tumor has
spread to the uterus
and/or fallopian tubes
(the long slender tubes through which eggs pass from the ovaries to the uterus).
- Stage IIB:
The tumor has
spread to other tissue
within the pelvis.
- Stage IIC:
The tumor is found
inside one or both ovaries
and has spread to the uterus
and/or fallopian tubes,
or to other tissue
within the pelvis.
Also, one of the following is true:
- tumor cells
are found on the outside surface of one or both ovaries; or
- the capsule
(outer covering) of the ovary has ruptured (broken open); or
- tumor cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of
the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal
cavity).
Stage
III
Pea, peanut, walnut, and
lime show tumor sizes.
In stage III, the tumor is found in one or
both ovaries and
has spread outside the pelvis
to other parts of the abdomen
and/or nearby lymph nodes.
Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.
- Stage IIIA:
The tumor is found
in the pelvis only,
but tumor cells
that can be seen only with a microscope
have spread to the surface of the peritoneum
(tissue that lines
the abdominal wall
and covers most of the organs
in the abdomen),
the small intestines,
or the tissue that connects the small intestines to the wall of the
abdomen.
- Stage IIIB:
The tumor has
spread to the peritoneum
and the tumor in the peritoneum is 2 centimeters
or smaller.
- Stage IIIC:
The tumor has
spread to the peritoneum
and the tumor in the peritoneum is larger than 2 centimeters and/or has
spread to lymph nodes
in the abdomen.
The spread of tumor cells to the surface of the liver is also considered
stage III disease.
Stage
IV
In stage IV, tumor cells have spread beyond the
abdomen to other
parts of the body, such as the lungs
or tissue inside
the liver.
Tumor cells in the fluid around the lungs is
also considered stage IV disease.
Ovarian low malignant potential tumors
almost never reach stage IV.
Recurrent Ovarian Low Malignant Potential Tumors
Ovarian low malignant potential tumors
may recur (come
back) after they have been treated. The tumors
may come back in the other ovary
or in other parts of the body.
Treatment Option Overview
Key Points
- There are different types of treatment for patients with
ovarian low malignant potential tumor.
- Two types of standard treatment are used:
- New types of treatment are being tested in clinical trials.
- Patients may want to think about taking part in a clinical
trial.
- Patients can enter clinical trials before, during, or after
starting their treatment.
- Follow-up tests may be needed.
There
are different types of treatment for patients with ovarian low
malignant potential tumor.
Different types of
treatment are available for patients with ovarian
low malignant potential tumor. Some treatments are standard (the currently used
treatment), and some are being tested in clinical
trials. A treatment clinical trial is a research study meant to help
improve current treatments or obtain information on new treatments for
patients with cancer,
tumors, and related conditions. When clinical
trials show that a new treatment is better than the standard treatment,
the new treatment may become the standard treatment. Patients may want
to think about taking part in a clinical trial. Some clinical trials
are open only to patients who have not started treatment.
Two
types of standard treatment are used:
Surgery
The type of surgery (removing the tumor in an operation)
depends on the size and spread of the tumor and the woman's plans for
having children. Surgery may include the following:
- Unilateral
salpingo-oophorectomy: Surgery to remove one ovary and one fallopian tube.
- Bilateral
salpingo-oophorectomy: Surgery to remove both ovaries and
both fallopian tubes.
- Total hysterectomy
and bilateral salpingo-oophorectomy: Surgery to remove the uterus, cervix, and both ovaries and
fallopian tubes. If the uterus and cervix are taken out through the vagina, the operation is
called a vaginal hysterectomy. If the uterus
and cervix are taken out through a large incision
(cut) in the abdomen,
the operation is called a total abdominal
hysterectomy. If the uterus and cervix are taken out through a small
incision (cut) in the abdomen using a laparoscope,
the operation is called a total laparoscopic hysterectomy.
Hysterectomy. The
uterus is surgically removed with or without other organs or tissues.
In a total hysterectomy, the uterus and cervix are removed. In a total
hysterectomy with salpingo-oophorectomy, (a) the uterus plus one
(unilateral) ovary and fallopian tube are removed; or (b) the uterus
plus both (bilateral) ovaries and fallopian tubes are removed. In a
radical hysterectomy, the uterus, cervix, both ovaries, both fallopian
tubes, and nearby tissue are removed. These procedures are done using a
low transverse incision or a vertical incision.
- Partial oophorectomy:
Surgery to remove part of one ovary or part of both ovaries.
- Omentectomy:
Surgery to remove the omentum
(a piece of the tissue
lining the abdominal wall).
Even if the doctor
removes all disease that can be seen at the time of the operation, the
patient may be given chemotherapy
after surgery to kill any tumor cells
that are left. Treatment given after the surgery, to lower the risk
that the tumor will come back, is called adjuvant
therapy.
Chemotherapy
Chemotherapy is a cancer
treatment that uses drugs
to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs
enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When
chemotherapy is placed directly into the cerebrospinal
fluid, an organ,
or a body cavity
such as the abdomen, the drugs mainly affect cancer cells in those
areas (regional chemotherapy).
The way the chemotherapy is given depends on the type and stage of the cancer being
treated.
New
types of treatment are being tested in clinical trials.
Information about
clinical trials is available from the NCI Web site.
Patients
may want to think about taking part in a clinical trial.
For some patients,
taking part in a clinical trial
may be the best treatment choice. Clinical trials are part of the
medical research process. Clinical trials are done to find out if new
treatments are safe and effective or better than the standard treatment.
Many of today's standard
treatments for disease are based on earlier clinical trials. Patients
who take part in a clinical trial may receive the standard treatment or
be among the first to receive a new treatment.
Patients who take part
in clinical trials also help improve the way diseases will be treated
in the future. Even when clinical trials do not lead to effective new
treatments, they often answer important questions and help move
research forward.
Patients
can enter clinical trials before, during, or after starting their
treatment.
Some clinical trials
only include patients who have not yet received treatment. Other trials
test treatments for patients whose disease has not gotten better. There
are also clinical trials that test new ways to stop a disease from recurring (coming back) or
reduce the side effects
of treatment.
Clinical trials are
taking place in many parts of the country. See the Treatment Options
section that follows for links to current treatment clinical trials.
These have been retrieved from NCI's
clinical trials database.
Follow-up
tests may be needed.
Some of the tests that
were done to diagnose
the disease may be repeated. Some tests will be repeated in order to
see how well the treatment is working. Decisions about whether to
continue, change, or stop treatment may be based on the results of
these tests. This is sometimes called re-staging.
Some of the tests will
continue to be done from time to time after treatment has ended. The
results of these tests can show if your condition has changed or if the
disease has recurred
(come back). These tests are sometimes called follow-up tests or
check-ups.
Treatment Options for Ovarian Low Malignant Potential Tumors
Early Stage Ovarian Low Malignant
Potential Tumors (Stage I and II)
Surgery is the standard treatment for early
stage ovarian low malignant potential tumor.
The type of surgery usually depends on whether a woman plans to have
children.
For women who plan to
have children, surgery is either:
- unilateral
salpingo-oophorectomy; or
- partial oophorectomy.
To prevent recurrence of disease, most
doctors recommend surgery to remove the remaining ovarian tissue when a woman no
longer plans to have children.
For women who do not plan
to have children, treatment may be hysterectomy
and bilateral
salpingo-oophorectomy.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage I borderline ovarian surface epithelial-stromal
tumor and stage II borderline ovarian surface epithelial-stromal tumor.
For more specific results, refine the search by using other search
features, such as the location of the trial, the type of treatment, or
the name of the drug. Talk with your doctor about clinical trials that
may be right for you. General information about clinical trials is
available from the NCI website.
Late Stage Ovarian Low Malignant
Potential Tumors (Stage III and IV)
Treatment for late stage ovarian low malignant potential tumor
may be hysterectomy,
bilateral salpingo-oophorectomy,
and omentectomy. A lymph node dissection may
also be done.
Check the
list of NCI-supported cancer clinical trials that are now accepting
patients with stage III borderline ovarian surface epithelial-stromal
tumor and stage IV borderline ovarian surface epithelial-stromal tumor.
For more specific results, refine the search by using other search
features, such as the location of the trial, the type of treatment, or
the name of the drug. Talk with your doctor about clinical trials that
may be right for you. General information about clinical trials is
available from the NCI website.
Recurrent Ovarian Low Malignant Potential
Tumors
Treatment for recurrent ovarian low malignant potential tumor
may include the following:
- Surgery.
- Surgery followed by chemotherapy.
-NIH
