Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D. Huda A. Karman, M.D.
On the basis of age of onset, vaginal discharge, and constitutional symptoms, ovarian cancer must be differentiated from tubo-ovarian abscess, ectopic pregnancy, hydrosalpinx, salpingitis, fallopian tube carcinoma, uterine leiomyoma, choriocarcinoma, leiomyosarcoma, pregnancy, appendiceal abscess, appendiceal neoplasm, diverticular abscess, colorectal cancer, pelvic kidney, advanced bladder cancer, and retroperitoneal sarcoma.
On the basis of age of onset, vaginal discharge, and constitutional symptoms, ovarian cancer must be differentiated from tubo-ovarian abscess, ectopic pregnancy, hydrosalpinx, salpingitis, fallopian tube carcinoma, uterine leiomyoma, choriocarcinoma, leiomyosarcoma, pregnancy, appendiceal abscess, appendiceal neoplasm, diverticular abscess, colorectal cancer, pelvic kidney, advanced bladder cancer, and retroperitoneal sarcoma.[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81]
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age of onset | Symptoms | Physical examination | |||||||||||
Lab Findings | Imaging | Immunohistopathology | |||||||||||
Pelvic/abdominal pain or pressure | Vaginal bleeding/discharge | GI dysturbance | Fever | Tenderness | CT scan/US | MRI | |||||||
Gynecologic | |||||||||||||
Ovarian | Follicular cysts [1] |
|
+/– | – | – | – | +/– |
|
|
| |||
Theca lutein cysts [2][3][4] |
|
+/– | – | – | – | +/– |
|
|
|
| |||
Serous cystadenoma/carcinoma [5][6][7][8] |
|
+/– | – | – | – | +/– |
|
|
| ||||
Mucinous cystadenoma/carcinoma [9][10][11] |
|
+/– | – | – | – | +/– |
|
|
|
| |||
Endometrioma [12][13][14] |
|
+ | + | +/– | – | + |
|
|
|
| |||
Teratoma [15][16][17][18] |
|
+/– | – | – | – | +/– |
|
|
| ||||
Dysgerminoma [19][20] |
|
+ | +/– | – | – | +/– |
|
|
|
||||
Yolk sac tumor [21][22][23] |
+ | – | – | – | + |
|
|
|
|
| |||
Fibroma [24][25][26] |
|
|
– | – | – | +/– |
|
|
|
| |||
Thecoma [27][28][29] |
|
+/– | – | – | – |
|
|
|
|
| |||
Granulosa cell tumor [30][31][32][33] |
|
+ | +/– | – | – |
|
| ||||||
Sertoli-leydig cell tumor [34][35] |
|
+/– | – | – | – | – |
|
|
|
| |||
Brenner tumor [36][37] |
|
+/– | – | – | – | – | – |
|
|
|
| ||
Krukenberg tumor [38][39] |
|
+/– | – | +/–
Based on underlying malignancy |
– | – |
|
|
|
| |||
Tubal | tubo-ovarian abscess [40][41][42][43] |
|
+ | + | – | + | + |
|
|
|
| ||
Ectopic pregnancy [44] |
|
+ | + | +/– | – | + |
|
|
|
|
| ||
Hydrosalpinx [45][46][47] |
|
+ | – | – | – | +/– | – |
|
|
| |||
Salpingitis [48] |
|
+ | + | – | + | + |
|
|
| ||||
Fallopian tube carcinoma [49] |
|
+ | + | + | – | +/– |
|
|
|
| |||
Uterine | Leiomyoma [50][51] |
|
+ | + | – | – | +/– |
|
| ||||
Choriocarcinoma [52][53][54][55] |
|
+ | + | +/– | – | + |
|
|
|
| |||
Leiomyosarcoma [56][57][58][59][60] |
|
+ | + | – | – | +/– |
|
|
|
| |||
Pregnancy [61] |
|
+/− | +/− | +/− | – | – |
|
|
|
||||
Non-gynecologic | |||||||||||||
GIT | Appendiceal abscess [62] |
|
+ | – | + | +/– | + |
|
|
|
| ||
Appendiceal neoplasm [63][64][65][66][67] |
|
+ | – | + | – | +/– |
|
|
|
|
| ||
Diverticular abscess [72] |
|
+ | – | + | +/– | + |
|
|
|
| |||
Colorectal cancer [68][69][70][71] |
|
+ | – | + | – | +/– |
|
|
|
|
| ||
Renal | Pelvic kidney [73][74] |
|
−/+
In case of sever hydronephrosis or renal stone we may have pelvic pain |
– | − | − | − | − |
|
|
|
| |
Bladder cancer [75][76][77] |
|
+ | – | – | – | – |
|
|
|
|
| ||
Others | Retroperitoneal sarcoma [78][79][80][81] |
|
+ | – | + | − | − |
|
|
|
|
|
ABBREVIATIONS
BTA=Bladder tumor associated antigen, NMP= Nuclear matrix proteins, CEA= Carcinoembryonic antigen, US= Ultrasound, HCG= Human chorionic gonadotropin, LDH= Lactate dehydrogenase, AFP= Alpha fitoprotein, CA125= Cancer antigen 125, H&E= Hematoxylin and eosin, MRI= Magnetic resonance imaging, GI= Gastrointestinal tract, PID= Pelvic inflammatory disease, CA19-9= Carbohydrate antigen 19-9, 5HIAA= 5-hydroxyindoleacetic acid, MEN syndrome= Multiple endocrine neoplasia syndrome, HNPCC= Hereditary nonpolyposis colorectal cancer, UTI= Urinary tract infection, RCC= Renal cell carcinoma