A 55-year-old postmenopausal woman presents with abdominal distension and weight loss for 3 months. Examination reveals a hard, fixed pelvic mass with ascites. CT scan confirms bilateral adnexal masses with omental caking and peritoneal deposits. Serum CA-125 is 1200 U/mL. What is the MOST common histological type of ovarian malignancy in this age group?
- A Mucinous adenocarcinoma
- B Endometrioid carcinoma
- C Serous adenocarcinoma ✓
- D Clear cell carcinoma
Correct answer: C. Serous adenocarcinoma
Explanation
High-grade serous adenocarcinoma is the most common histological type of epithelial ovarian cancer, accounting for approximately 70% of cases, and is the predominant type in postmenopausal women. It is associated with BRCA1/2 mutations and presents at an advanced stage (FIGO III-IV) in the majority of cases due to lack of early symptoms. CA-125 is elevated in >90% of advanced serous ovarian cancers and is the primary tumor marker used for monitoring.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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