KANKER OVARIUM

Dr. Dino Rinaldy,

Sp.OG(K)Onk
RSUD Dr. H. Abdul Moeloek
 Ovarian tumor
Sering terjadi
Semua usia
Jenis berbeda sesuai usia
Jenis epiteliel mempunyai prognosis
jelek
 Pendahuluan
Klasifikasi WHO tahun 1973
 Jenis histologi
Ovarain epithelial tumor
Germ cell tumor
Sex-cord stromal cell tumor
Lipid (lipoid) cell tumor
Gonadal blastoma
Non-specific ovarian soft tissue
tumor
Unclassified tumor
Metastatic tumor
Tumor-like lesions
 Gejala dan tanda
Tumor jinak
Jika kecil tak bergejala

Pembesaran perut dan adanya

masa pelvik jika tumor ukuran
menengah
Pemeriksaan ginekologi dijumpai
massa disamping uterus
 Gejala dan tanda
Kanker ovarium
Stadium dini
asimtomatik, ditemukan tidak disengaja
Stadium lanjut
Pembesaran perut, massa abdominal, asites
Pemeriksaan transvagina-rectnum
massa solid or semi-solid, terfiksir
 Complications
Rupture
Frequency about 3%
Traumatic and spontaneous
Symptom
lower abdominal pain
related to the size of rupture
the quality and quantity of cyst fluid
Signs
abdominal tenderness
muscle intensity
ascites
Treatment
emergency surgery
 Diagnosis
Benign tumors
No specific symptoms
A mass found occasionally by physical
examination
Ovarian cancer
No specific symptoms
Gynecological examination
bilateral pelvic mass, solid , poor
movability, with ascites, uterus rectum
nest nodules
 Diagnosis

Pencitraan
Ultrasonografi

diagnosis lesi primer, akurasi >

90%
Radiologi (X-Ray, CT, MRI)
untuk lesi metastasis
Ultrasonografi kanker ovarium
 Diagnosis
Penanda tumor
CA125
meningkat pada 80% kanker epitelial, monitoring
dan prognosis
AFP
meningkat pada endodermal sinus tumor
hCG
choriacarcinoma ovarium
Sex hormone
sex-cord stromal cell tumor
Laparoscopy
Ascitic cytology
 Metastatic pathway
Gambaran
Penyebaran luas pada rongga abdomen
Subclinical metastasis
Cara menyebar
langsung
aliran getah bening
melalui aliran darah
 Clinical surgical-pathology staging (2000
Stage
FIGO)
I Growth limited to ovaries
Growth limited to one side ovaries; no ascites. No
IA
tumor on external surface; capsules intact
Growth limited to both ovaries; no ascites. No
IB
tumor on external surface; capsules intact

Tumor either IA or IB but with tumor on surface

of one or both ovaries;or with capsule ruptured;
IC
or with ascites containing malignant cells, or with
positive peritoneal washings
II Growth involving one or both ovaries with pelvic extension.
Extension and/or metastasis to the uterus and/or
IIA
tubes.
IIB Extension to other pelvic tissues.
Tumor either Stage IIA or IIB, but with tumor on
surface of one or both ovaries; or with capsule
IIC
ruptured; or with ascites containing malignant
cells, or with positive peritoneal washings.
Tumor involving one or both ovaries with peritoneal implants outside pelvis and/or positive
III
retroperitoneal or inguinal nodes. Superficial liver metastasis equals Stage III.
Tumor grossly limited to true pelvis with negative
nodes, but with histologically confirmed
IIIA
microscopic seeding of abdominal peritoneal
surfaces.

Tumor of one or both ovaries with histologically

confirmed implants to abdominal peritoneal
IIIB
surfaces, none exceeding 2 cm in diameter Nodes
are negative.
Abdominal implants >2 cm in diameter and/or
IIIC
positive retroperitoneal or inguinal nodes.
Growth involving one or both ovaries with distant metastasis. If pleural effusion present, must be
IV
positive cytology to assign a case to Stage IV. Parenchymal live metastasis equals Stage IV.
 Terapi
Pembedahan
Tujuan
Konfirmasi diagnosis
Reseksi tumor
Penentuan stadium
Kemotherapi
follow-up
Mudah berulang
 Thank you
!