Patient: [Patient Name]
MRN: [Medical Record Number]
Date: [Date of Encounter]
Chief Complaint:
(Can vary depending on the specific type of non-epithelial ovarian cancer)
Pelvic pain or pressure
Abdominal bloating or distention
Abnormal vaginal bleeding or discharge
Urinary urgency or frequency
Back pain
Weight loss or gain (unintentional)
Fatigue
History of Present Illness:
Onset, duration, and severity of any symptoms.
Specific details of any pelvic pain (location, character, radiation).
Character and amount of any vaginal bleeding or discharge.
Urinary symptoms (frequency, urgency, incontinence).
Gastrointestinal symptoms (bloating, constipation, diarrhea).
Constitutional symptoms (fatigue, weight changes).
Prior surgeries or pelvic procedures (may increase risk of certain
non-epithelial ovarian cancers).
Past Medical History:
Underlying medical conditions (e.g., diabetes, hypertension).
Prior diagnoses of any gynecological malignancies.
Family history of cancer (particularly ovarian or other genitourinary cancers).
Social History:
Smoking history (smoking may increase risk of certain types of
non-epithelial ovarian cancer).
History of pelvic inflammatory disease (PID) (may increase risk of
certain types of non-epithelial ovarian cancer).
Family History:
First-degree relative with ovarian cancer, breast cancer, or other
genitourinary cancers.
Consider genetic testing for conditions like Cowden syndrome or Li-Fraumeni syndrome (which can increase risk of certain cancers, including non-epithelial ovarian cancers).
Physical Exam:
General examination: Assess for signs of weight loss or cachexia
(wasting syndrome).
Pelvic examination: Evaluate for pelvic masses, tenderness, or ascites (fluid accumulation in the abdomen).
Laboratory Tests:
Complete blood count (CBC): May show anemia if there is significant bleeding.
Serum electrolytes and liver function tests: To assess overall health and potential for treatment complications.
Tumor markers (CA-125): May be elevated in some non-epithelial
ovarian cancers, but not specific for this type of cancer. Other tumor markers
may be used depending on the suspected type of non-epithelial ovarian cancer.
Pregnancy test: To rule out pregnancy as a cause of symptoms.
Imaging Studies:
Pelvic ultrasound: Initial imaging study to visualize the ovaries and
pelvic organs for masses or abnormalities.
(Additional imaging based on ultrasound findings and suspected cancer type):
CT scan of the abdomen and pelvis: Provides detailed anatomical
information and helps assess for spread of cancer.
MRI scan of the abdomen and pelvis: Can be helpful for further
characterizing tumors and assessing spread.
PET scan: May be used to assess for distant metastases (cancer
spread beyond the ovaries).
Biopsy:
Tissue biopsy is essential for definitive diagnosis. Biopsy can be
obtained during surgery, laparoscopy, or guided by ultrasound.
Assessment:
Non-epithelial ovarian cancer: Suspected based on clinical presentation, imaging studies, and confirmed by tissue biopsy.
Specific type of non-epithelial ovarian cancer: There are several
different types of non-epithelial ovarian cancers, each with different
treatment approaches and prognoses. The specific type will be determined
based on the biopsy results.
Stage of cancer: Cancer staging determines the extent of cancer spread
and guides treatment decisions. Staging may involve laparotomy (surgical
exploration of the abdomen).
Performance status: Assesses a patient’s overall health and ability
to tolerate treatment.
Differential Diagnoses:
Consider other causes of pelvic pain, masses, or symptoms:
Epithelial ovarian cancer (more common)
Benign ovarian cysts or tumors
Pelvic inflammatory disease (PID)
Uterine fibroids
Endometriosis