Ovarian Cancer

Of all gynecologic malignancies, ovarian cancer continues to have the

highest mortality and is the most difficult to diagnose. In the United States

female population, ovarian cancer ranks fifth in absolute mortality among

cancer related deaths (13,000/yr). In most reported cases, ovarian cancer,

when first diagnosed is in stages III or IV in about 60 to 70% of patients

which further complicates treatment of the disease (Barber, 3).

Early detection in ovarian cancer is hampered by the lack of appropriate

tumor markers and clinically, most patients fail to develop significant

symptoms until they reach advanced stage disease. The characteristics

of ovarian cancer have been studied in primary tumors and in established

ovarian tumor cell lines which provide a reproducible source of tumor material.

Among the major clinical problems of ovarian cancer, malignant progression,

rapid emergence of drug resistance, and associated cross-resistance remain

unresolved. Ovarian cancer has a high frequency of metastasis yet generally

remains localized within the peritoneal cavity. Tumor development has been

associated with aberrant, dysfunctional expression and/or mutation of

various genes. This can include oncogene overexpression, amplification or

mutation, aberrant tumor suppressor expression or mutation. Also, subversion

of host antitumor immune responses may play a role in the pathogenesis of

cancer (Sharp, 77).

Ovarian clear cell adenocarcinoma was first described by Peham in 1899 as

"hypernephroma of the ovary" because of its resemblance to renal cell carcinoma.

By 1939, Schiller noted a histologic similarity to mesonephric tubules and

classified these tumors as "mesonephromas." In 1944, Saphir and Lackner described

two cases of "hypernephroid carcinoma of the ovary" and proposed "clear cell"

adenocarcinoma as an alternative term. Clear cell tumors of the ovary are now

generally