Nonepithelial ovarian cancers
JournalThe Obstetrician & Gynaecologist
RightsCopyright © 2021 Elsevier B.V. All rights reserved.
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Key content Nonepithelial ovarian cancers (NEOCs) are rare forms of ovarian cancer, including malignant ovarian germ cell tumours (MOGCTs), sex cord-stromal tumours (SCSTs) and ovarian sarcoma. Tumour markers including alpha-fetoprotein, human chorionic gonadotrophin, lactate dehydrogenase and inhibin can be useful in aiding preoperative diagnosis of malignant ovarian masses. NEOCs are staged using a similar classification to epithelial ovarian tumours; however, the staging system for male germ cell tumours is considered a more useful prognostic tool. These tumours can occur at any age; however, many present in the reproductive years, and fertility-sparing treatments are often required. Advanced-stage MOGCTs and SCSTs are managed with debulking surgery and platinum-based adjuvant chemotherapy, with the regimen of bleomycin, etoposide and cisplatin being most widely used. Learning objectives To understand the classification and pathology of NEOCs. To describe the role of tumour markers in diagnostic criteria and to be aware of the FIGO staging classifications and their prognostic use. To understand management protocols and follow-up regimens. Ethical issues Patients of reproductive age risk infertility if preoperative diagnosis is incorrect and more extensive surgery involving bilateral salpingo-oophorectomy is performed.