Ovarian Cancer

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Term Paper Title	Ovarian Cancer
# of Words	4100
# of Pages (250 words per page double spaced)	16.4

Ovarian Cancer

Ovarian Cancer

        Of all gynecologic malignancies, ovarian cancer continues to have the
highest mortality and is the most difficult to diagnose.  In the United States
female population, ovarian cancer ranks fifth in absolute mortality among
cancer related deaths (13,000/yr).  In most reported cases, ovarian cancer,
when first diagnosed is in stages III or IV in about 60 to 70% of patients
which further complicates treatment of the disease (Barber, 3).

        Early detection in ovarian cancer is hampered by the lack of appropriate
tumor markers and clinically, most patients fail to develop significant symptoms
until they reach advanced stage disease.  The characteristics of ovarian cancer
have been studied in primary tumors and in established ovarian tumor cell lines
which provide a reproducible source of tumor material. Among the major
clinical problems of ovarian cancer, malignant progression, rapid emergence of
drug resistance, and associated cross-resistance remain unresolved.  Ovarian
cancer has a high frequency of metastasis yet generally remains localized
within the peritoneal cavity.  Tumor development has been associated with
aberrant, dysfunctional expression and/or mutation of various genes.  This can
include oncogene overexpression, amplification or mutation, aberrant tumor
suppressor expression or mutation.  Also, subversion of host antitumor immune
responses may play a role in the pathogenesis of cancer (Sharp, 77).

        Ovarian clear cell adenocarcinoma was first described by Peham in 1899
as "hypernephroma of the ovary" because of its resemblance to renal cell
carcinoma. By 1939, Schiller noted a histologic similarity to mesonephric
tubules and classified these tumors as "mesonephromas."   In 1944, Saphir and
Lackner described two cases of "hypernephroid carcinoma of the ovary" and
proposed "clear cell" adenocarcinoma as an alternative term.  Clear cell tumors
of the ovary are now generally considered to be of mullerian and in the genital
tract of mullerian origin. A number of examples of clear cell adenocarcinoma
have been reported to arise from the epithelium of an endometriotic cyst
(Yoonessi, 289).  Occasionally, a renal cell carcinoma metastasizes to the
ovary and may be confused with a primary clear cell adenocarcinoma.

        Ovarian clear cell adenocarcinoma (OCCA) has been recognized as a
distinct histologic entity in the World Health Organization (WHO) classification
of ovarian tumors since 1973 and i...

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