Medicine an Surgery notes

Apr 24th, 2015
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MALIGNANT DISORDERS OF THE OVARIES Ovarian cancer account for 3 - 4 % of cancers in women 1. AETIOLOGY Incessant ovulation thought to play an important role.Repeated disruption and repair of germinal epithelium may provide opportunity for somatic gene deletions and mutations which can contribute to tumour initiation and progression. Found protectiveMultiparity Oral contraceptivesHistory of breastfeeding Increased risk Nulliparity Infertility Diets with high animal fat saturation High body mass index (BMI) especially for the endometroid type Genetic preponderance in 10 - 12 % of epithelial ovarian cancer patientsTurner's syndrome (45 X0 ) for dysgerminoma and gonadoblastoma.Carcinogenic substances in mullerian ductal system (BTL shown to reduce incidence of ovarian cancer). Hereditary ovarian cancer occurs in two forms a) As breast and ovarian cancer (BOC) syndromesMost often associated with germ line mutations in the BRCAI gene located on chromosome 17 Less commonly with BRCA 2 mutations on chromosome 13.Women with BRCA 1 mutations from high risk families have a lifelong risk of 44% of BRCA 2 upto 27%Autosomal dorminant inheritance b) Hereditary nonpolyposis colorectal cancer (HNPCC) syndrome- Lynch 11 syndromeComprises familial colon cancer (lynch 1 syndrome) and high rate of ovarian, endometrial, GIT and genitourinary malignancies.Genes involved include DNA mismatch repair genes like MLH 1, MSH 2, MSH 3, MSH 6, PMS 1 and PMS 2 A female member in

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