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gynecolegy and health 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 13000yr 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 andor mutation of various genes This can include oncogene overexpression amplification ormutation 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 andclassified 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 nowgenerally considered to be of mullerian and in the genital tract of mullerian origin A number of examples of clear cell adenocarcinoma have been reported to arise from the epithelium of an endometriotic cyst Yoonessi 289 Occasionally a
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