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Table 5 Summary table of local, nodal and haematogenous spread in ovarian carcinoma

From: Common primary tumours of the abdomen and pelvis and their patterns of tumour spread as seen on multi-detector computed tomography

Local spread •Uterus and broad ligament (via the fallopian tube);
•Direct invasion of the rectum, colon, bladder and pelvic side wall
Lymph node spread •Via lymphatics travelling along with the ovarian vessels to terminate in common iliac and para-aortic nodes;
•Via the broad ligament to terminate in the internal iliac and obturator nodes;
•Via the round ligament to terminate in the external iliac and inguinal nodes
Trans-coelomic spread Common sites: undersurface of the diaphragm, liver surface, pouch of Douglas, omentum, serosal bowel surfaces
Haematogenous spread •This occurs late during the disease;
•Liver > lungs, kidney, bone
Note •Ascites arise from increased production from tumour surfaces and/or occlusion of retroperitoneal lymph nodes