High-grade serous carcinoma

High-grade serous carcinoma (HGSC) is a type of ovarian cancer that is considered the most aggressive and common subtype of ovarian carcinoma. It is characterized by its high-grade histology and serous differentiation. HGSC accounts for approximately 70% of all ovarian cancer cases and is associated with a poor prognosis due to its advanced stage at diagnosis and its resistance to chemotherapy.

Epidemiology

High-grade serous carcinoma is the most common type of ovarian cancer, accounting for approximately 70% of all cases. It is most commonly diagnosed in postmenopausal women, with the average age at diagnosis being around 63 years. However, it can occur in women of all ages.

Pathogenesis

The exact cause of HGSC is not known, but it is thought to originate from the fallopian tubes rather than the ovaries. It is believed that the cancer cells spread from the fallopian tubes to the ovaries and then to other parts of the body. Several risk factors have been identified for HGSC, including a family history of ovarian or breast cancer, mutations in the BRCA1 and BRCA2 genes, and certain genetic syndromes such as Lynch syndrome and Li-Fraumeni syndrome.

Clinical Features

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High-grade serous carcinoma under the microscope

Patients with HGSC often present with non-specific symptoms such as abdominal bloating, pelvic pain, and changes in bowel habits. Due to the non-specific nature of these symptoms, the disease is often diagnosed at an advanced stage. Other symptoms may include fatigue, weight loss, and urinary symptoms.

Diagnosis

The diagnosis of HGSC is usually made based on the results of a biopsy of the ovarian mass. The biopsy is examined under a microscope to look for the characteristic features of HGSC, such as high-grade histology and serous differentiation. Other tests that may be used to aid in the diagnosis include CT scans, MRI, and blood tests to measure levels of a protein called CA-125, which is often elevated in women with HGSC.

Treatment

The treatment of HGSC typically involves a combination of surgery and chemotherapy. The goal of surgery is to remove as much of the cancer as possible, a process known as debulking. This is often followed by chemotherapy to kill any remaining cancer cells. Despite aggressive treatment, the prognosis for HGSC is generally poor, with a 5-year survival rate of less than 30%.

Research

Research into HGSC is ongoing, with a focus on understanding the genetic changes that lead to the development of the disease and identifying new treatment strategies. Clinical trials are also being conducted to test new drugs and treatment approaches.