Types of Ovarian Cancer

Ovarian cancer doesn’t come with just one type of tumor, one type of cell, or four general stages. There are different types of cells, types of tumors, and stages to keep in mind if your doctor gives you the dreaded news.

There are over 30 types of ovarian cancer because of the type of cell from which they start. Cancerous tumors can start from three common cell types:

• Surface Epithelium - cells covering the lining of the ovaries
• Germ Cells - cells that are destined to form eggs
• Stromal Cells - cells that release hormones and connect the different structures of the ovaries

The most common tumors include:

• Common Epithelial Tumors. They develop from cells that cover the outer surface of the ovary. Most of the tumors like this are benign (noncancerous) and include several types: serous adenomas, mucinous adenomas, and Brenner tumors.
• Cancerous Epithelial Tumors. These are carcinomas, which begin in the tissue that lines the ovaries, and are the most common and most dangerous.
• Borderline tumors or tumors of low malignant potential (LMP tumors). These are tumors that aren’t clearly identified as cancerous under a microscope.
• Germ Cell Tumors. These develop from the cells that produce the ova or eggs. Most are benign, but some are cancerous and may be life threatening. The most common germ cell malignancies are maturing dysgerminomas, teratomas, and endodermal sinus tumors.
• Stromal Tumors. These belong to a rare class of tumors that develop from connective tissue cells that hold the ovary together, in addition to cells that produce the female hormones: estrogen and progesterone. The most common types of stromal tumors are granulosa-theca and Sertoli-Leydig cell tumors and are considered to be low-grade cancers

The stages of ovarian cancer include:

• Stage I – Cancer growth is limited to the ovary or ovaries.
• Stage IA - Growth is limited to one ovary and the tumor is confined to the inside of the ovary. Stage IB - Growth is limited to both ovaries without any tumor on their outer surfaces.
• Stage IC - The tumor is Stage IA or IB and (1) tumor is present on the outer surface of one or both ovaries; (2) the capsule has ruptured; and/or (3) there are ascites containing malignant cells or with positive peritoneal washings.
• Stage II - Growth of the cancer involves one or both ovaries and has extended to the pelvis.
• Stage IIA - The cancer has extended to and/or involves the uterus, fallopian tubes, or both.
• Stage IIB - The cancer has extended to other pelvic organs.
• Stage IIC - The tumor is Stage IIA or IIB and (1) tumor is present on the outer surface of one or both ovaries; (2) the capsule has ruptured; and/or (3) there are ascites containing malignant cells or with positive peritoneal washings.
• Stage III - Growth of the cancer involves one or both ovaries, and (1) the cancer has spread beyond the pelvis to the lining of the abdomen; and/or (2) the cancer has spread to lymph nodes.
• Stage IIIA - During an operation, the surgeon can see cancer on one or both of the ovaries, but not in the abdomen or lymph nodes. However, small deposits of cancer are found in the abdominal peritoneal surfaces when biopsies are checked under a microscope.
• Stage IIIB - The tumor is in one or both ovaries, and deposits of cancer are visibly present in the abdomen during surgery, but not exceeding 2 cm in diameter. The cancer has not spread to the lymph nodes.
• Stage IIIC - The tumor is in one or both ovaries, and (1) the cancer has spread to lymph nodes; and/or (2) the deposits of cancer exceed 2 cm in diameter and are found in the abdomen.
• Stage IV - The most advanced stage. Growth involves one or both ovaries and distant metastases (spread of the cancer to organs located outside of the peritoneal cavity) have occurred. Finding ovarian cancer cells in pleural fluid (from the cavity which surrounds the lungs) is also evidence of stage IV disease.

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