Ovarian cancer surgery technique of omentectomy
|
|
|
- Suzan Patterson
- 7 years ago
- Views:
Transcription
1 Ovarian cancer surgery technique of omentectomy intraperitoneal omentum omentum adherent to anterior abdominal wall dissect off anterior abdominal wall
2 Ovarian cancer surgery technique of omentectomy liver mobilize hepatic flexure and carve omentum off liver
3 Ovarian cancer surgery technique of omentectomy gastrohepatic ligament hepatic flexure cut line of toldt and gastrohepatic ligament
4 Ovarian cancer surgery technique of omentectomy gastrocolic ligament posterior surface transverse mesocolon transverse colon incise gastrocolic ligament to open lesser sac
5 Ovarian cancer surgery technique of omentectomy omentum lesser sac transverse mesocolon the proper plane is avascular
6 Ovarian cancer surgery technique of omentectomy lesser sac transverse colon omentum attached to stomach only
7 Ovarian cancer surgery technique of omentectomy stomach resect gastroepiploic arch with omentum
8 Risk of Developing Ovarian Cancer 30 yo G2P2, nurse on the oncology unit. I want to be tested for ovarian cancer. 42 yo G1P1 My mother has been diagnosed with ovarian cancer. What is my risk?
9 OVARIAN CANCER LIFETIME RISK # of First-degree Relatives Lifetime Risk (%) with Ovarian Cancer Definite Hereditary Syndrome 40.0
10 Screening for Non-hereditary Ovarian Cancer Transvaginal sonography CA-125 level Pelvic Exam Insufficient evidence to support routine use. Clinical Investigation Growth Factors (LPA, EGF, MMP) Proteomics spectroscopy patterns
11 OVARIAN CANCER ULTRASOUND SCREENING AUTHORS NUMBER WOMEN SURG. # CANCERS # STAGE I OVARIAN Campbell ,479 (18-78) DePriest 3, (33-90) Bourne 1, (17-79) Karlan (35-80) Muto, (20-60) TOTAL 11, (5 Invasive) SENS. % OV CA (5 Ov Ca) 5 (3 LMP) (1 granulosa) (6 Ov Ca) (3 LMP) (LMP) PPV % OV CA
12 NIH CONSENSUS CONFERENCE OVARIAN CANCER: SCREENING, TREATMENT, AND FOLLOW-UP THERE IS NO EVIDENCE AVAILABLE YET THAT THE CURRENT SCREENING MODALITIES OF CA-125, AND TRANSVAGINAL ULTRASONOGRAPHY CAN BE EFFECTIVELY USED FOR WIDESPREAD SCREENING TO REDUCE MORTALITY FROM OVARIAN CANCER NOR THAT THEIR USE WILL RESULT IN DECREASED RATHER THAN INCREASED MORBIDITY AND MORTALITY. JAMA, 1995, 273:
13 Risk of Developing Ovarian Cancer 30 yo G2P2, nurse on the oncology unit. I want to be tested for ovarian cancer. 42 yo G1P1 My mother has been diagnosed with ovarian cancer. What is my risk?
14 Non-surgical Risk Reduction
15 RISK OF OVARIAN CANCER ORAL CONTRACEPTIVE EFFECT REVIEW OF CANCER AND STEROID HORMONE STUDY (CASH) SURVEILLANCE, EDIPEMIOLOGY & END RESULTS STUDY (SEER) META ANALYSIS ESTIMATES PER 100,000 OC USERS COMPARED TO NEVER USERS COMPARED USERS VS NONUSERS STRATIFIED FOR AGE, PARITY, DURATION OF USE 5 YEARS OF USE BY NULLIP = PAROUS NONUSER 10 YEARS OF USE WITH POS. FAMILY HX = or < RISK OF NEG. FAMILY HX NONUSER GROSS & SCHLESSELMAN, Obstet Gynecol, 1994
16 RISK OF OVARIAN CANCER EFFECT OF ORAL CONTRACEPTIVES YEARS OF OC 0 YEARS OF OC 1 YEARS OF OC 5 YEARS OF OC 10 POS. FAMILY HX AGE AGE AGE NEG. FAMILY HX AGE AGE AGE GROSS AND SCHLESSELMAN, Obstet Gynecol, 1994
17 Pelvic Mass Likelihood of Ovarian Cancer? 74 yo, G6P6 with hip fracture. Ovarian mass found during MRI of left hip. 40 yo, G2P1Ab1 with complaints of pelvic pain. Sono shows 7 cm solid and cystic mass. CA-125 = 96 units. 54 yo Go with early satiety and bloating. CT scan shows a 12 cm complex mass and probable ascites.
18 Pelvic Mass Evaluation and Therapy Symptomatic Yes / No? Sonographic Characteristics CA-125 level Optimal Surgical Candidate Yes / No?
19 Pelvic Mass Diagnostic Factors Mass Size Diagnostic Tests Symptoms Pt. Age Exam History
20 OVARIAN MASS EVALUATION TVS SCORING SYSTEM WALL SMOOTH OR - SOLID OR PAPILLARITIES STRUCTURE IRREG < 3mm NONAPPLICABLE >or= 3mm SHADOWING YES NO - - SEPTA NONE OR THIN THICK <3mm >or= 3mm - - ECHOGENICITY SONOLUCENT OR - - MIXED OR HIGH LOW ECHO LERNER et al, AM J OBSTET GYN, 1994
21 OVARIAN CARCINOMA SCREENING SONOGRAPHY PROLATE ELLIPSOID FORMULA W x H x L x.523 NORMAL VOLUME = 8 CUBIC CM. OR < MORPHOLOGY CONSIDERED ALSO UNIFORMITY COMPLEXITY CYSTIC NATURE SEPTAE VAN NAGELL, CANCER, 1991
22 OVARIAN CARCINOMA SONOGRAPHIC SCREENING 1,300 ASYMPTOMATIC, POST- MENOPAUSAL WOMEN 33/1300 (2.5%) OVARIAN MASSES 27/33 EXPLORATORY LAPAROTOMY 3/27 CARCINOMA 1 METASTATIC COLON CA. 2 STAGE I OVARIAN CA. VAN NAGELL, CANCER, 1991
23 Simple cyst
24 Multiseptated ovary
25 Complex mass
26 PELVIC MASS SONO ACCURACY 312 PATIENTS SURGERY FOR PELVIC MASS PREOPERATIVE SONOGRAPHY HERRMAN, OBSTET GYNEC, 1987
27 SONO CRITERIA BENIGN vs MALIGNANT SIZE UNI vs MULTILOCULAR THIN OR THICK SEPTAE COMPLEX (SOLID & CYSTIC) HERRMAN, 1987
28 PELVIC MASS SONO ACCURACY HISTOLOGY BENIGN MALIGNANT NORMAL PELVIS 7 0 BENIGN BORDERLINE 1 3 CANCER 6 38 HERRMAN, 1987
29 PELVIC MASS SONO ACCURACY SENSITIVITY 83% SPECIFICITY 92% PREDICTIVE POWER POSITIVE 73% NEGATIVE 96% HERRMAN, OBSTET GYNEC, 1987
30 CA-125 EXPRESSED BY DERIVATIVE OF COELOMIC EPITHELIUM GLYCOPROTEIN > 200 KD SHED INTO SERUM IDENTIFIED BY RIA USING OC-125
31 CANCER CA-125 LEVELS % > 35 U/ML OVARIAN 83 PANCREATIC 59 LUNG 32 BREAST 12 COLORECTAL 23 MISC GI 27 MISC NON-GI 25
32 CA-125 LEVELS POPULATION STUDIED % > 35 U/ML NORMAL, HEALTHY 1 BENIGN COND. 6 PREGNANCY, EARLY 16 PID 10 LEIOMYOMAS 4 CIRRHOSIS 70 PERICARDITIS 70 ENDOMETRIOSIS 54
33 PELVIC MASS LOW RISK PREMENOPAUSAL MASS <8 CM IN DIAMETER NORMAL CA-125 UNILATERAL LESION REASSURING SONOGRAPHY UNILOCULAR NON-COMPLEX (CYSTIC ONLY) NO ASCITES
34 PELVIC MASS HIGH RISK POSTMENOPAUSAL PATIENT MASS > 8 CM. IN DIAMETER ELEVATED CA-125 BILATERAL MASSES SYMPTOMATIC NONREASSURING SONOGRAPHY MULTILOCULATED COMPLEX (SOLID & CYSTIC) ASCITES
35 Ovarian Carcinoma Postmenopausal Pelvic mass CA-125 >95 U/ML High Risk 85-96% Positive Predictive Value for carcinoma. Einhorn et al, Obstet Gynecol,1992;80:14-18 Zurawski et al.int J Cancer, 1988;42: Malkasian et al,
36 Ovarian Cancer UKSM,W IV 9% Not Spec 13% I 21% III 48% II 9% 2005, 772 Pt.
37 Ovarian Cancer % Alive, NED Stage I Stage II Stage III Stage IV Not Spec. 6 UKSM,W, 2005, 772 Pt.
38 OVARIAN STROMAL TUMORS PATHOLOGY GRANULOSA-STROMAL TUMORS GRANULOSA CELL TUMORS ADULT TYPE JUVENILE TYPE THECOMA-FIBROMA GROUP THECOMA FIBROMA FIBROSARCOMA SCLEROSING STROMAL TUMOR
39 OVARIAN STROMAL TUMORS PATHOLOGY SERTOLI-LEYDIG CELL TUMORS (ANDROBLASTOMA) SERTOLI CELL TUMORS LEYDIG CELL TUMOR (HILUS CELL TUMOR) SERTOLI-LEYDIG TUMOR (WELL, MODERATE, POORLY DIFFERENTIATED)
40 OVARIAN STROMAL TUMORS PATHOLOGY GRANULOSA-STROMAL TUMORS GRANULOSA CELL TUMORS ADULT TYPE JUVENILE TYPE THECOMA-FIBROMA GROUP THECOMA FIBROMA FIBROSARCOMA SCLEROSING STROMAL TUMOR SERTOLI-LEYDIG CELL TUMORS (ANDROBLASTOMA) SERTOLI CELL TUMORS
41 STROMAL TUMORS CHARACTERISTICS THECOMA-FIBROMA TUMORS PERI AND POSTMENOPAUSAL WOMEN MENSTRUAL IRREGULARITY OR POSTMENOPAUSAL BLEEDING MAY PRODUCE ESTROGEN UNILATERAL, SOLID ASYMPTOMATIC MASS
42 STROMAL TUMORS CHARACTERISTICS SERTOLI-LEYDIG CELL TUMORS THIRD AND FOURTH DECADE OF LIFE MAY BE SOLID OR CYSTIC VIRILIZATION IS COMMON OLIGOMENORRHEA/AMENORRHEA BREAST ATROPHY HIRSUTISM CLITOROMEGALY RARELY BILATERAL (<1%)
43 Ovarian Cancer UKSM,W # of Pt. 0 Stage I Stage II Stage III Stage IV Not Spec. 2005, 698 Pt.
44 OVARIAN CARCINOMA POPULATION RISK LIFE TIME RISK WITH NO AFFECTED RELATIVES: 1/70 LIFE TIME RISK WITH 1 FIRST-DEGREE RELATIVE: 5% LIFE TIME RISK WITH 2 FIRST-DEGREE RELATIVES: 7% HEREDITARY OVARIAN CANCER SYNDROME: 40-50%
45 OVARIAN CARCINOMA GENETIC RISK LYNCH SYNDROME II OVARIAN CARCINOMA IN HEREDITARY NONPOLYPOSIS COLORECTAL CANCER HEREDITARY BREAST-OVARIAN CANCER SITE SPECIFIC OVARIAN CANCER FAMILIES
46 PELVIC MASS PRE-OP REQUIREMENTS PRE-OP BOWEL PREP MIDLINE INCISION AVAILABILITY OF ACCURATE FROZEN SECTION EVAL. CAPABILITY TO PERFORM FULL STAGING ABILITY TO PERFORM APPROPRIATE AND AGGRESSIVE CYTOREDUCTIVE SURGERY ABILITY TO PRESERVE FERTILITY IN APPROPRIATE PATIENTS
47 OVARIAN CANCER STAGING (FIGO-SURGICAL) STAGE I GROWTH LIMITED TO OVARIES Ia LIMITED TO ONE OVARY, NO TUMOR ON EXTERNAL SURFACE, CAPSULE INTACT. Ib LIMITE D TO BOTH OVARIES, NO TUMOR ON EXTERNAL SURFACE, CAPSULE INTACT. Ic TUMOR ON SURFACE OF OVARY(IES), OR CAPSULE RUPTURED, OR WITH ASCITES/PERITONEAL WASHINGS WITH (+) CYTOLOGY.
48 OVARIAN CANCER STAGING (FIGO-SURGICAL) STAGE II PELVIC EXTENSION IIa TO UTERUS AND/OR TUBES IIb EXTENSION TO OTHER PELVIC ORGANS IIc EITHER IIa OR IIb WITH TUMOR ON SURFACE OR RUPTURED CAPSULE, OR (+) CYTOLOGY
49 STAGE III IIIa IIIb IIIc OVARIAN CANCER STAGING (FIGO-SURGICAL) GROSSLY LIMITED TO PELVIS, WITH NEG. NODES BUT MICROSCOPIC DISEASE IN UPPER ABDOMEN ABDOMINAL IMPLANTS <2 CM. NODES NEG IMPLANTS > 2 CM., +/OR POS. RETROPERITONEAL OR INGUINAL NODES
50 OVARIAN CANCER STAGING (FIGO-SURGICAL) STAGE IV DISTANT METASTASES +/OR PLEURAL EFFUSIONS (+) +/OR PARENCHYMAL LIVER METS.
51 OVARIAN CARCINOMA CURRENT INVESTIGATION Doublet/Triplet Therapy Taxol/Carboplatin (+) Doxil or Topotecan or Gemzar Intraperitoneal Therapy?? Consolidation Therapy Gene Therapy Immune Therapy Targeted Therapy
Frequently Asked Questions About Ovarian Cancer
Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues
Ovarian Cysts Made Simple Michael East. Oxford Clinic
Ovarian Cysts Made Simple Michael East Oxford Clinic Objectives of this talk To understand risk of malignancy and thus not fear it Practical advice for follow up of asymptomatic cysts Practical advice
Ovarian cysts Diagnosis and Management
Ovarian cysts Diagnosis and Management Mr P K Athanasias MRCOG Consultant Gynaecologist St Anthony s Hospital pathanasias@gmail.com Introduction ovary is an ovum-producing reproductive organ located in
The Adnexal Mass and Early Ovarian Cancer
The Adnexal Mass and Early Ovarian Cancer Fred Ueland, MD University of Kentucky Gynecologic Oncology Never give in. Never give in. Never, never, never, never- in nothing great or small, large or petty-
ProSono Copyright 2006. Ovarian Pathology
Ovarian Pathology Physiologic cysts: Functional cysts Pathology: A simple cyst is a sac containing fluid or semi-solid material. Physiologic cysts are generic types of hormonally active cysts that result
Benign Ovarian Masses
Benign Ovarian Masses Anthony Hanbidge Learning Objectives Describe technique for assessment of ovarian masses Explain importance of transvaginal scan List the common benign masses Specify distinguishing
POSTMENOPAUSAL ASSESS AND WHAT TO DO
POSTMENOPAUSAL OVARIAN CYSTS:HOW TO ASSESS AND WHAT TO DO Steven R. Goldstein, MD Professor of Obstetrics and Gynecology Director of Gynecologic Ultrasound Co-Director, Bone Densitometry New York University
OVARIAN CYSTS. Types of Ovarian Cysts There are many types of ovarian cysts and these can be categorized into functional and nonfunctional
OVARIAN CYSTS Follicular Cyst Ovarian cysts are fluid-filled sacs that form within or on the ovary. The majority of these cysts are functional meaning they usually form during a normal menstrual cycle.
Gynecology Abnormal Physiology of the ovaries. Simple Cystic Masses
Gynecology Abnormal Physiology of the ovaries (Effective February 2007) pediatric, reproductive, and perimenopausal/postmenopausal (24-28 %) Simple Cystic Masses ovary s function is to mature oocytes until
3 Summary of clinical applications and limitations of measurements
CA125 (serum) 1 Name and description of analyte 1.1 Name of analyte Cancer Antigen 125 (CA125) 1.2 Alternative names Mucin 16 1.3 NLMC code To follow 1.4 Description of analyte CA125 is an antigenic determinant
Gynecologic Cancer in Women with Lynch Syndrome
Gynecologic Cancer in Women with Lynch Syndrome Sarah E. Ferguson, MD FRCSC Division of Gynecologic Oncology, Princess Margaret Hospital, University of Toronto June 11, 2013 Objective 1. To review the
Progress and Prospects in Ovarian Cancer Screening and Prevention
Progress and Prospects in Ovarian Cancer Screening and Prevention Rebecca Stone, MD MS Assistant Professor Kelly Gynecologic Oncology Service The Johns Hopkins Hospital 1 No Disclosures 4/12/2016 2 Ovarian
Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S.
Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S. Gynecologic Oncology, Surgery and Endoscopy 4370 Alpine Road Portola Valley, CA 94028-7523 Phone: (650)-851-6669 FAX: (650) 851-9747 Regarding Ovarian Cancer,
Ovarian Cancer: A Case Report
Ovarian Cancer: A Case Report Abstract Ovarian cancer is a very common cancer among women. It is an extremely diverse disease requiring several treatment options. Occasionally ovarian cancer is diagnosed
DISCLOSURE OBJECTIVES IN THE INEREST OF TIME LAPAROSCOPY AND AN APPROACH TO THE ADNEXAL MASS
LAPAROSCOPY AND AN APPROACH TO THE ADNEXAL MASS DISCLOSURE I do not have any financial relationship with commercial interests. Michael Traynor Michael Traynor MD MPH Northwest Permanente, PC KAISER PERMANENTE
How To Treat A Uterine Sarcoma
EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition 2001 Uterus: Uterine Sarcomas Jeffrey L. Stern, MD Uterine sarcomas
Guideline on the management of ovarian masses. Gynaecologists, radiologists, sonographers, nurses. Ovarian masses, ovarian cysts, management
Guideline on the management of ovarian masses. A clinical guideline recommended for use In: By: For: Key words: Written by: Gynaecology Services Gynaecologists, radiologists, sonographers, nurses Management
Understanding Your Risk of Ovarian Cancer
Understanding Your Risk of Ovarian Cancer A WOMAN S GUIDE This brochure is made possible through partnership support from Project Hope for Ovarian Cancer Research and Education. Project HOPE FOR OVARIAN
Screening Asymptomatic Women for Ovarian Cancer: American College of Preventive Medicine Practice Policy Statement
ATTENTION This Policy was reaffirmed by the ACPM Board of Regents on 1/31/2005 and is effective through 1/31/2010. Screening Asymptomatic Women for Ovarian Cancer: American College of Preventive Medicine
Breast Cancer Follow-Up
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Breast Cancer Follow-Up Breast Cancer Follow-Up Version 2002: Thomssen / Scharl Version 2003 2009: Bauerfeind / Bischoff /
Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system.
Ovarian Cysts Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system. Most women have ovarian cysts sometime
WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis
Endometriosis WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The lining of the uterus is called the endometrium. Sometimes, endometrial tissue grows elsewhere in the body. When this happens
The attached guidance is for women of average risk. A summary of this information follows. 1.
Know Your Body. Know The Symptoms. Help Spread The Word. Help Spread The Word. Introduction to Guidance Annually, more than 15,000 women die from ovarian cancer. Survival rates have remained steady near
Nicole Kounalakis, MD
Breast Disease: Diagnosis and Management Nicole Kounalakis, MD Assistant Professor of Surgery Goal of Breast Evaluation The goal of breast evaluation is to classify findings as: normal physiologic variations
Ovarian Cancer. in Georgia, 1999-2003. Georgia Department of Human Resources Division of Public Health
Ovarian Cancer in Georgia, 1999-23 Georgia Department of Human Resources Division of Public Health Acknowledgments Georgia Department of Human Resources......B. J. Walker, Commissioner Division of Public
Overview of Gynaecologic Cancer
Overview of Gynaecologic Cancer Stuart Salfinger Gynaecologic Oncologist St John of God Hospital King Edward Memorial Hospital Cervical Cancer Cervical Cancer Risk HPV Smoking?OCP Cervical Cancer Symptoms
Are You at Risk for Ovarian Cancer?
Are You at Risk for Ovarian Cancer? A Woman s Guide Read this brochure to learn more about ovarian cancer symptoms, risk factors and what you can do to reduce your risk. ALL WOMEN HAVE SOME RISK OF OVARIAN
Try out the online ROMA calculator available on the Elecsys HE4 page at cobas.com
Try out the online calculator available on the Elecsys HE4 page at cobas.com Download the Roche application for the iphone and the ipad from the App Store. Roche References 1 Huhtinen, K. et al. (29).
If you are still in your fertility years If you are past your fertility years and need surgery for a mass or for pain and have normal ovaries
If you are still in your fertility years, an ovary should be removed only if there is a large, complex or persistent mass on it or if you have intolerable pain from endometriosis. There should be an attempt
Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women
Uterus myomatosus A.J. Henriquez March 14, 2015 Uterus myomatosus Definition, incidence, clinical presentation and diagnosis. New FIGO classification for uterine leiomyomas Brief description on treatment
Ovarian Cyst. Homoeopathy Clinic. Introduction. Types of Ovarian Cysts. Contents. Case Reports. 21 August 2002
Case Reports 21 August 2002 Ovarian Cyst Homoeopathy Clinic Check Yourself If you have any of the following symptoms call your doctor. Sense of fullness or pressure or a dull ache in the abdomen Pain during
Luis D. Carcorze Soto, MD PGY-3
Luis D. Carcorze Soto, MD PGY-3 Peritoneal Surface Malignancies Peritoneum Patient Selection Operative Technique HIPEC EPIC Primary: Primary Peritoneal Carcinoma Malignant Peritoneal Mesothelioma Metastatic:
Saint Mary s Hospital. Ovarian Cysts. Information For Patients
Saint Mary s Hospital Ovarian Cysts Information For Patients 2 Contents Welcome 4 What are ovarian cysts? 4 How common are ovarian cysts? 6 Ovarian cysts and fertility 6 What are the symptoms of ovarian
WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Ovarian Cysts
Ovarian Cysts WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The ovaries are two small organs located on either side of a woman s uterus. An ovarian cyst is a sac or pouch filled with fluid
Ovarian cancer. A guide for journalists on ovarian cancer and its treatment
Ovarian cancer A guide for journalists on ovarian cancer and its treatment Contents Contents 2 3 Section 1: Ovarian Cancer 4 i. Types of ovarian cancer 4 ii. Causes and risk factors 5 iii. Symptoms and
EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD. 4 th Edition, 2001
EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition, 2001 OVARY Jeffrey L. Stern, M.D. Carcinoma of the ovary is
Surgical Staging of Endometrial Cancer
Surgical Staging of Endometrial Cancer I. Endometrial Cancer Surgical Staging Overview Uterine cancer types: carcinomas type I and type II, sarcomas, carcinosarcomas Hysterectomy with BSO Surgical Staging
Fallopian Tube Cancer
Fallopian Tube Cancer Fred Ueland, MD University of Kentucky Gynecologic Oncology Anatomy Three layers of the fallopian tube: Internal mucosa (endosalpinx) Intermediate muscular layer (myosalpinx( myosalpinx)
Gynecology Abnormal Pelvic Anatomy and Physiology: Cervix. Cervix. Nabothian cysts. cervical polyps. leiomyomas. Cervical stenosis
Gynecology Abnormal Pelvic Anatomy and Physiology: (Effective February 2007) pediatric, reproductive, and perimenopausal/postmenopausal (24-28 %) Cervix Nabothian cysts result from chronic cervicitis most
Risk of Malignancy in Unilocular Ovarian Cystic Tumors Less Than 10 Centimeters in Diameter
Risk of Malignancy in Unilocular Ovarian Cystic Tumors Less Than 10 Centimeters in Diameter Susan C. Modesitt, MD, Edward J. Pavlik, PhD, Frederick R. Ueland, MD, Paul D. DePriest, MD, R. J. Kryscio, PhD,
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): Now and the Future Mazin Al-kasspooles, MD Associate Professor of Surgery Division of Surgical Oncology Director, Regional Therapy
Ovarian Cancer. Understanding your diagnosis
Ovarian Cancer Understanding your diagnosis Ovarian Cancer Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the large amount
Ovarian Torsion: Sonographic Evaluation
J Clin Ultrasound 17:327-332, June 1989 Ovarian Torsion: Sonographic Evaluation Mark A. Helvie, MD,* and Terry M. Silver, MDI Abstract: The sonographic and clinical findings of 13 patients with surgically
Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer
Safe and Effective Surgery for Endometriosis Including Detection and Intervention for Ovarian Cancer Camran Nezhat,, MD, FACOG, FACS Stanford University Medical Center Center for Special Minimally Invasive
Hereditary Breast and Ovarian Cancer (HBOC)
Oxford University Hospitals NHS Trust Oxford Regional Genetic Department Hereditary Breast and Ovarian Cancer (HBOC) Information for women with an increased lifetime risk of breast and ovarian cancer What
Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE
Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Introduction This guide is designed to help you clarify and understand the decisions that need to be made about your care for the
Advice about familial aspects of breast cancer and epithelial ovarian cancer a guide for health professionals DECEMBER 2010
Advice about familial aspects of breast cancer and epithelial ovarian cancer a guide for health professionals DECEMBER 2010 This guide has three parts: 1. Information for health professionals 2. Tables
OVARIAN CANCER IS A MAJOR CAUSE OF MORBIDITY AND MORTALITY IN WOMEN. Name of Student HTHSCI 1110 WEBER STATE UNIVERSITY.
Ovarian Cancer 2 OVARIAN CANCER IS A MAJOR CAUSE OF MORBIDITY AND MORTALITY IN WOMEN by Name of Student HTHSCI 1110 WEBER STATE UNIVERSITY Ogden, Utah Instructor s Name Date Ovarian Cancer 2 Background
Ovarian Cancer Genetic Testing: Why, When, How?
Ovarian Cancer Genetic Testing: Why, When, How? Jeffrey Dungan, MD Associate Professor Division of Clinical Genetics Department of Obstetrics & Gynecology Northwestern University Feinberg School of Medicine
K Raja/N Varol FPA 2013. FPA Sydney August 31 2013
FPA Sydney August 31 2013 Ms wilson 32 year old woman Presents with worsening, heavy menstrual and intermenstrual bleeding and pain for 6 months. Ms Wilson What is the differential diagnosis What are the
GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER
GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT
Uterine fibroids (Leiomyoma)
Uterine fibroids (Leiomyoma) What are uterine fibroids? Uterine fibroids are fairly common benign (not cancer) growths in the uterus. They occur in about 25 50% of all women. Many women who have fibroids
Endometrial cancer-carcinoma of the lining of the uterus-is the most common gynecologic
EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4th Edition 2001 Uterus: Endometrial Carcinoma Jeffrey L. Stern, MD Endometrial
Carcinosarcoma of the Ovary
Carcinosarcoma of the Ovary A Rare Finding Presented By: Kathryn Kiely Anisa I. Kanbour School of Cytotechnology of the University of Pittsburgh Medical Center Pittsburgh, PA Patient History 55 year old
From www.gp update.co.uk one day courses for GPs, by GPs
Ovarian cancer Ovarian cancer is notoriously difficult to diagnose and is frequently diagnosed late. However, it is not a silent killer. How best can we work out when to suspect it and what investigations
Cornual ruptured pregnancy with placenta increta CORNUAL RUPTURED PREGNANCY WITH PLACENTA INCRETA A RARE CASE
142 CORNUAL RUPTURED PREGNANCY WITH PLACENTA INCRETA A RARE CASE Agarwal NR 1, Rani A 1 *, Batra S 1 1. Department of Obststetrics and Gynaecology, Institute of Medical Sciences, Banares Hindu Univarsity.
Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003
Evaluation and Management of the Breast Mass Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Common Presentations of Breast Disease Breast Mass Abnormal
Ovarian Cystectomy / Oophorectomy
Cystectomy and Ovarian Cysts Ovarian cysts are sacs filled with fluids or pockets located on or in an ovary. In some cases, these cysts need to be removed surgically. Types of Cysts Ovarian cysts are quite
Ovarian Cancer. What is cancer?
What is cancer? Ovarian Cancer The body is made up of trillions of living cells. Normal body cells grow, divide to make new cells, and die in an orderly way. During the early years of a person's life,
NIH Consensus Statement
NIH Consensus Statement Volume 12, Number 3 April 5 7, 1994 Ovarian Cancer: Screening, Treatment, and Followup NATIONAL INSTITUTES OF HEALTH Office of the Director About the NIH Consensus Development Program
LAPAROSCOPIC OVARIAN CYSTECTOMY
LAPAROSCOPIC OVARIAN CYSTECTOMY Information Leaflet Your Health. Our Priority. Page 2 of 5 About this information This leaflet is for you if you have a cyst on one or both ovaries and are considering surgery.
Understanding CA 125 Levels A GUIDE FOR OVARIAN CANCER PATIENTS. foundationforwomenscancer.org
Understanding CA 125 Levels A GUIDE FOR OVARIAN CANCER PATIENTS foundationforwomenscancer.org Contents Introduction...1 CA 125................................... 1 The CA 125 Test...2 The Use of the CA
Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background
Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the
Corporate Medical Policy
Corporate Medical Policy Proteomics-based Testing Related to Ovarian Cancer File Name: Origination: Last CAP Review: Next CAP Review: Last Review: proteomics_based_testing_related_to_ovarian_cancer 7/2010
The Radiologic Evaluation of the Ovary
September 2000 The Radiologic Evaluation of the Ovary Aradhana M. Venkatesan,, Harvard Medical School Year- IV MD 1 Menu of Tests Trans-abdominal pelvic ultrasound Trans-vaginal pelvic ultrasound Pelvic
Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy
Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy Sarah Hutto,, MSIV Marc Underhill, M.D. January 27, 2009 Past History 45 yo female
Breast Cancer Treatment Guidelines
Breast Cancer Treatment Guidelines DCIS Stage 0 TisN0M0 Tamoxifen for 5 years for patients with ER positive tumors treated with: -Breast conservative therapy (lumpectomy) and radiation therapy -Excision
Lung Cancer: Diagnosis, Staging and Treatment
PATIENT EDUCATION patienteducation.osumc.edu Lung Cancer: Diagnosis, Staging and Treatment Cancer begins in our cells. Cells are the building blocks of our tissues. Tissues make up the organs of the body.
Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma
Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History
OBJECTIVES By the end of this segment, the community participant will be able to:
Cancer 101: Cancer Diagnosis and Staging Linda U. Krebs, RN, PhD, AOCN, FAAN OCEAN Native Navigators and the Cancer Continuum (NNACC) (NCMHD R24MD002811) Cancer 101: Diagnosis & Staging (Watanabe-Galloway
Tumour Markers. What are Tumour Markers? How Are Tumour Markers Used?
Dr. Anthony C.H. YING What are? Tumour markers are substances that can be found in the body when cancer is present. They are usually found in the blood or urine. They can be products of cancer cells or
Cervical Cancer The Importance of Cervical Screening and Vaccination
Cervical Cancer The Importance of Cervical Screening and Vaccination Cancer Cells Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Sometimes, this
LIVER TUMORS PROFF. S.FLORET
LIVER TUMORS PROFF. S.FLORET NEOPLASM OF LIVER PRIMARY 1)BENIGN 2)MALIGNANT METASTATIC/SECONDARY LIVER Primary Liver Cancer the Second Killer among tumors high morbidity and mortality(20.40/100,000) etiology
A912: Kidney, Renal cell carcinoma
A912: Kidney, Renal cell carcinoma General facts of kidney cancer Renal cell carcinoma, a form of kidney cancer that involves cancerous changes in the cells of the renal tubule, is the most common type
Ovarian cancer: current management and future directions ˇ
Ovarian cancer: current management and future directions ˇ Sian E Taylor John M Kirwan Abstract Ovarian cancer has the highest mortality of all the gynaecological malignancies. Epithelial ovarian cancer
THYROID CANCER. I. Introduction
THYROID CANCER I. Introduction There are over 11,000 new cases of thyroid cancer each year in the US. Females are more likely to have thyroid cancer than men by a ratio of 3:1, and it is more common in
Full version is >>> HERE Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary
Article Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary Juan Luis Alcázar, MD, María José Galán, MD, Carolina Ceamanos, MD, Manuel García-Manero,
Case Number: RT2009-124(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor
Renal Cell Carcinoma of the Left Kidney Post Radical Surgery with pt4 Classification with Multiple Lung and Single Brain Metastases: the Role and Treatment Consideration of Radiotherapy Case Number: RT2009-124(M)
Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening.
CANCER SCREENING Dr. Tracy Sexton (updated July 2010) What is screening? Screening is the identification of asymptomatic disease or risk factors by history taking, physical examination, laboratory tests
Diagnosis and Prognosis of Pancreatic Cancer
Main Page Risk Factors Reducing Your Risk Screening Symptoms Diagnosis Treatment Overview Chemotherapy Radiation Therapy Surgical Procedures Lifestyle Changes Managing Side Effects Talking to Your Doctor
Kidney Cancer OVERVIEW
Kidney Cancer OVERVIEW Kidney cancer is the third most common genitourinary cancer in adults. There are approximately 54,000 new cancer cases each year in the United States, and the incidence of kidney
WHAT S WRONG WITH MY GALL BLADDER? GALL BLADDER POLYPS
WHAT S WRONG WITH MY GALL BLADDER? GALL BLADDER POLYPS This is a patient information booklet providing specific practical information about gall bladder polyps in brief. Its aim is to provide the patient
Something Old, Something New.
Something Old, Something New. Michelle A. Fajardo, D.O. Loma Linda University Medical Center Clinical Presentation 6 year old boy, presented with hematuria Renal mass demonstrated by ultrasound & CT scan
HEREDITARY BRCA1. Faulty gene INFORMATION LEAFLET. How Do I Reduce My Risk?
HEREDITARY BREAST CANCER BRCA1 Faulty gene INFORMATION LEAFLET How Do I Reduce My Risk? Page 1 CONTENTS Part A 1 What is BRCA1 2 How does BRCA1 affect a person s risk of cancer? 3Testing for BRCA1 4Benefits
Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group
Screening for Cancer in Light of New Guidelines and Controversies Christopher Celio, MD St. Jude Heritage Medical Group Screening Tests The 2 major objectives of a good screening program are: (1) detection
RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What?
RESEARCH EDUCATE ADVOCATE Just Diagnosed with Melanoma Now What? INTRODUCTION If you are reading this, you have undergone a biopsy (either of a skin lesion or a lymph node) or have had other tests in which
Additional information >>> HERE Recommendations for cross-sectional imaging in cancer management, Second edition
www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who
Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D.
Breast Cancer: from bedside and grossing room to diagnoses and beyond Adriana Corben, M.D. About breast anatomy Breasts are special organs that develop in women during puberty when female hormones are
All you need to know about Endometriosis. Nordica Fertility Centre, Lagos, Asaba, Abuja
All you need to know about Endometriosis October, 2015 About The Author Nordica Lagos Fertility Centre is one of Nigeria's leading centres for world class Assisted Reproductive Services, with comfort centres
General Rules SEER Summary Stage 2000. Objectives. What is Staging? 5/8/2014
General Rules SEER Summary Stage 2000 Linda Mulvihill Public Health Advisor NCRA Annual Meeting May 2014 National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention
Protocol for the Examination of Specimens From Patients With Tumors of the Peritoneum
Protocol for the Examination of Specimens From Patients With Tumors of the Peritoneum Protocol applies to all primary borderline and malignant epithelial tumors and malignant mesothelial neoplasms of the
Ovarian Cancer 101 Jessica McAlpine, MD
Ovarian Cancer 101 Jessica McAlpine, MD Different types of ovarian cancer: Outline: Ovarian Cancer Presentation, behavior, site of origin Primary treatment: surgery, chemo, +/-radiation Role of genetics
Renal Cell Carcinoma The New Frontier (To boldly go... ) Sean A. Pierre, MD, RCPSC (Urology)
The New Frontier (To boldly go... ) Sean A. Pierre, MD, RCPSC (Urology) QUEENSWAY CARLETON HOSPITAL DIVISION OF UROLOGY NEPEAN, ON, CANADA Disclosures None Objectives Advances in the field of Renal Cell
Cancer Facts for Women
2006, American Cancer Society, Inc. No.200700-Rev.03/08 The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem
Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org
Columbia University Mesothelioma Center www.mesocenter.org Multimodal clinical trials, treatment (surgery, radiation, chemotherapy) Peritoneal mesothelioma program Immunotherapy translational, experimental
Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA
Breast Imaging Made Brief and Simple Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA What women are referred for breast imaging? Two groups of women are referred for
Cancer of the Cervix
Cancer of the Cervix WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 A woman's cervix (the opening of the uterus) is lined with cells. Cancer of the cervix occurs when those cells change,