Ovarian cancers are diagnosed based on imaging (ultrasound, CT or MRI scans) findings as complex ovarian cysts. Histological proof is not seeked for as needle biopsy (FNAC) can rupture the cyst & spread the disease. Ovarian cancers may arise from the surface epithelium (more common) or from the deeper substance (germ cell tumors or sex cord-stromal cell origin).
Standard treatment of suspected epithelial ovarian and fallopian tube cancers includes a comprehensive surgical staging. This procedure includes a total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal cytologic washings, biopsies of adhesions and peritoneal surfaces, omentectomy, and retroperitoneal lymph node sampling from the pelvic and para-aortic regions through a generous vertical midline laparotomy incision. As there is no preoperative histological proof, a frozen section or imprint cytology is performed on the oophorectomy or on-table biopsy specimen.
Non-epithelial tumors are also treated similarly. However, usually these are detected earlier than epithelial cancers due to pain & they occur at younger age when fertility preservation is important. In most of the cases fertility preserving surgery is possible.