Malignant diseases of the ovary, fallopian tube, and peritoneum

Among solid tumors afflicting women, ovarian cancer is umcommon, but is the second most common malignancy of the lower part of the female genital tract and is, inauspiciously, the most deadly. Reflecting its many epithelial and stromal components, ovarian cancer is a diverse set of histological subtypes and can be further annotated by unique molecular characteristics. The most common subtype is epithelial, which is believed to have a significant component of origin in the fallopian tube. In light of its anatomical location and absence of unique symptoms, ovarian cancer has been difficult to screen and, as such, is frequently diagnosed when the disease has spread via direct extension, peritoneal deposition, or lymphovascularly. Contemporary treatment paradigms utilize surgery, combination chemotherapy, and biological agents. Insight into genomic alterations such as mutations in the BRCA1/2 genes and global deficiency in homologous recombination have ushered in the poly-(ADP) ribose polymerase (PARP) inhibitors, which have demonstrated impressive effects in selected primary and recurrent patients. Rare subtypes, particularly those involving the germinal and stromal cells, can occur in younger patients and in many settings are curable, even with fertility preservation. As with most oncology, rapid discovery of key cancer-driving alterations is providing fertile soil for drug development with the hopes of improving survival and survivorship.