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Of all gynecologic malignancies ovarian cancer continues to have thehighest mortality and is the most difficult to diagnose In the UnitedStatesfemale population ovarian cancer ranks fifth in absolute mortality amongcancer related deaths 13000yr In most reported cases ovarian cancerwhen first diagnosed is in stages III or IV in about 60 to 70 of patientswhich further complicates treatment of the disease Barber 3Early detection in ovarian cancer is hampered by the lack of appropriatetumor markers and clinically most patients fail to develop significantsymptoms until they reach advanced stage disease The characteristics of ovarian cancer have been studied in primary tumors and in establishedovarian tumor cell lines which provide a reproducible source of tumor materialAmong the major clinical problems of ovarian cancer malignant progressionrapid emergence of drug resistance and associated cross-resistance remainunresolved Ovarian cancer has a high frequency of metastasis yet generallyremains localized within the peritoneal cavity Tumor development has beenassociated with aberrant dysfunctional expression andor mutation ofvarious genes This can include oncogene overexpression amplification ormutation aberrant tumor suppressor expression or mutation Also subversionof host antitumor immune responses may play a role in the pathogenesis ofcancer Sharp 77Ovarian clear cell adenocarcinoma was first described by Peham in 1899 ashypernephroma of the ovary because of its resemblance to renal cell carcinomaBy 1939 Schiller noted a histologic similarity to mesonephric tubules andclassified these tumors as mesonephromas In 1944 Saphir and Lackner describedtwo cases of hypernephroid carcinoma of the ovary and proposed clearcelladenocarcinoma as an alternative term Clear cell tumors of the ovary arenow generally considered to be of mullerian and in the genital tract of mullerianorigin A number of examples of clear cell adenocarcinoma have been reported to arisefrom the epithelium of an endometriotic cyst Yoonessi 289 Occasionallya renal cell carcinoma metastasizes to the ovary and may be confused with a primaryclear cell adenocarcinomaOvarian clear cell adenocarcinoma OCCA has been recognized as a distincthistologic entity in the World Health Organization WHO classification ofovariantumors since 1973 and is the most
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