Ovarian tumors are tumors that occur on the ovaries. It is one of the common tumors of the female genitalia. Ovarian malignancies also have the highest mortality rate among gynecologic malignancies. Although great progress has been made in recent years in both basic research and clinical management of ovarian malignancies, unfortunately, the 5-year survival rate is still not significantly improved, hovering at 30%. Pathogenetic factors: The etiology of ovarian malignancies is still unclear. The classification of ovarian tumors is as follows: 1. Germ cell tumors. Asexual cell tumors, endodermal sinus tumors, teratomas (mature – substantial, cystic; immature, unilamellar epithelial – ovarian mesenchymal, carcinoid, neuroectodermal, mixed), embryonal carcinomas, malignant mixed germ cell tumors, polyembryonal tumors ( polyembryoma), choriocarcinoma, gonadoblastoma. 2. Non-germ cell tumors. Epithelial (plasmacytotic, mucinous), gonadal-stromal (granular, supportive-mesenchymal, mixed). Pathogenesis 1. The “constant ovulation” theory of carcinogenesis: Ovarian tumors have a high incidence in women who have early menarche, late menopause, and have not given birth, while women who have given birth more often and who are breastfeeding and taking oral contraceptives have a reduced risk of developing them. This “constant ovulation” theory of carcinogenesis suggests that ovulation causes damage to ovarian epithelial cells, and that repeated damage and repair processes promote carcinogenesis. Genetic factors: It is one of the more researched causes in recent years, and most cases are inherited by autosomal dominant. In the last decade, molecular genetic studies have made great progress. Narod et al. have identified a specific gene for carcinoma susceptibility in patients with hereditary breast-ovarian malignancy (HBOC) syndrome on chromosome 17, now called BRCA1, and recently another susceptibility gene, BRCA1, has been identified on chromosome 13. Mutations in these two genes allow most epithelial ovarian malignancies to develop genetically. There are three main types of hereditary ovarian malignancies: (1), high-risk patients: one is familial ovarian malignancy syndrome, such as a mother or sister with ovarian malignancy, who is a high-risk patient. (2) 50% risk: It is breast-ovarian malignant tumor syndrome, if mother or sister has one or two types of cancer, the risk of ovarian malignant tumor is 50%. (3), is a family history of cancer: the risk of developing ovarian malignancy, endometrial cancer, breast cancer and colorectal cancer may be increased. 2. Pathology (1), histological classification (Table 1): (2), histological grading: histologically undifferentiated cells accounting for 0% to 25% as G1; undifferentiated cells accounting for 25% to 50% as G2; undifferentiated cells >50% as G3, as determined by Broder. The pathogenesis of ovarian tumors is unclear, but environmental and endocrine influences are most valued among the pathogenic factors of ovarian tumors. According to its epidemiological and etiological investigations, the factors and high-risk groups for its development are: (1) Environmental factors: The high incidence of ovarian cancer in women from industrially developed countries and upper classes may be related to high cholesterol in the diet. In addition, ionizing radiation and asbestos and talcum powder can affect oocytes and increase the chance of ovarian tumors. Smoking and vitamin A, C and E deficiency may also be related to the incidence. (2) Endocrine factors: Ovarian tumors mostly occur in women who have not given birth or have not had children. Pregnancy seems to have an antagonistic effect on ovarian tumors, and it is believed that repeated breakage of ovarian epithelial cells due to daily ovulation is related to the occurrence of ovarian tumors. In addition, breast cancer and endometrial cancer are often complicated by ovarian tumors, and all three diseases are estrogen-dependent. (3) Genetic and familial factors: about 30%-50% of ovarian tumor patients have tumor patients in their immediate family.