Stage I ovarian carcinoma: different clinical pathologic patterns

Objective: To analyze clinicopathologic patterns of early ovarian carcinoma. Design: Retrospective chart and histopathology review. Setting: Mount Sinai School of Medicine, New York and the Centre Jean Perrin, Clermont Ferrand, France. Patient(s): Seventy-six consecutive cases of Fédération Internationale de Gynécologie et d'Obstétrique stage I ovarian carcinoma. Intervention(s): Surgical staging. Main Outcome Measure(s): Symptomatology, pathology, and histology analysis. Result(s): Twenty-two cases (29%) were serous papillary carcinomas and 54 were nonserous carcinomas (71%) (40 endometrioid, 10 clear cell, and 4 mixed endometrioid and clear cell carcinomas). Ninety-eight percent of ovarian endometriosis, 95% of endometrial carcinomas, and 83% of endometrial polyps and hyperplasias were associated with nonserous carcinomas. Most patients with serous papillary carcinoma presented with asymptomatic pelvic masses; patients with nonserous carcinomas presented with pelvic pain or abnormal vaginal bleeding with or without pelvic mass. Conclusion(s): Over two thirds of stage I ovarian carcinomas were nonserous, and were diagnosed because of associated symptoms: pelvic pain with endometriosis and/or adnexal masses, or vaginal bleeding from endometrial pathology. Serous papillary carcinomas were often asymptomatic and diagnosed during follow-up evaluations in breast cancer patients. Stage I ovarian carcinoma has different clinical and pathologic patterns than advanced ovarian carcinoma. The risk of ovarian and endometrial malignancy should be taken into consideration during evaluation of patients with endometriosis and breast cancer histories.