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Harrison's Principles of Internal Medicine, 18e
| Part 7. Oncology and Hematology > Section 1. Neoplastic Disorders > |
Chapter 97. Gynecologic Malignancies
Sections: Ovarian Cancer, Fallopian Tube Cancer, Cervical Cancer, Uterine Cancer, Gestational Trophoblastic Tumors, Further Readings.
Topics Discussed: gynecologic cancer; pathophysiology of disorders of the female reproductive tract; pathophysiology of neoplasia.
Excerpt:"Ovarian cancer is the most lethal malignancy of gynecologic origin in the United States and other countries that have organized and effective cervical cancer screening programs. In 2010, 21,880 cases of ovarian cancer with 13,850 deaths are expected in the United States. The ovary is a complex and dynamic organ and, between the ages of approximately 11 and 50 years, is responsible for follicle maturation associated with egg maturation, ovulation, and cyclical sex steroid hormone production. These complex and linked biologic functions are coordinated through a variety of cells within the ovary, each of which possesses neoplastic potential. By far the most common and most lethal of the ovarian neoplasms arise from the ovarian epithelium found both on the surface of the ovary and in subsurface locations, known as cortical inclusion cysts, believed to be entrapped epithelium from the healing associated with prior follicle rupture during ovulation. The ovarian epithelium in good health appears as a simple epithelium, but with neoplastic transformation, it undergoes metaplastic changes into what is termed müllerian epithelium. The müllerian epithelium has a variety of subtypes each of which provide a specific phenotype of the tumor and in some cases different clinical presentations...."
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