Patient's question:
[All symptoms: Onset time and cause: In June 2010, I experienced occasional stomach bloating, and on July 10, I discovered lower abdominal bleeding and went to the hospital for examination. The diagnosis was tumors in both the uterus and ovaries. Treatment history: On July 15, surgery was performed, and the ovary tumor was removed and tested as malignant! Pathological diagnosis: Specimen of total hysterectomy + bilateral adnexa removal, (right adnexa) clear cell adenocarcinoma of the ovary, moderately differentiated, tumor size 1096 cm, no clear intravascular cancer emboli or neural involvement. Fallopian tube tissue. (Total uterus) Endometrium showed atrophic changes, chronic cervicitis with polyp formation. Immunohistochemical staining (10-823): CK7(+), CK20(+), CK(+), HCG(+), AFP(+/-), KI-1.Doctor's answer:
[Knowledge about the treatment of clear cell ovarian cancer: Although ovarian epithelial tumors are the most common type of ovarian tumors, very few tumor cells have endocrine functions. Currently, it is certain that clear cell ovarian cancer is the only type of tumor that causes clinical endocrine symptoms. In patients with ovarian epithelial tumors, irregular vaginal bleeding and menstrual disorders may occasionally occur due to the luteinization of tumor stromal tissue, which produces hormones. Clear cell ovarian cancer accounts for 5-11% of ovarian cancers, with an average onset age of 58 years. The tumor is cystic and solid, with a diameter of more than 15 cm, and is mostly unilateral. Under the microscope, tumor cells are arranged in sheets, nests, or strands, or appear as glandular, papillary structures. The tumor cells have abundant cytoplasm rich in glycogen, appearing transparent or vacuolated; some tumor cells, due to nuclear protrusion, have only a small amount of cytoplasm, referred to as "boots cell"; some tumor cells exhibit significant nuclear atypia. The tumor often contains components such as endometrioid adenocarcinoma and serous cystadenocarcinoma. Clear cell ovarian cancer has a close relationship with endometriosis, with endometriosis present in about 24% of affected ovaries, and pelvic endometriosis lesions present in about 25-50% of cases. This is uncommon in other types of ovarian epithelial cancers. The common clinical symptoms include abdominal masses and bloating, with about half of the patients experiencing menstrual disorders, postmenopausal bleeding, or a history of infertility, while a few may develop ascites. 10% of patients may have hypercalcemia, as the tumor cells can produce a substance similar to