Book Review

Diagnosis and Management of Ovarian Disorders

N Engl J Med 1996; 335:1929-1930December 19, 1996

Article

Diagnosis and Management of Ovarian Disorders
Edited by Albert Altchek and Liane Deligdisch. 492 pp., illustrated. New York, Igaku-Shoin, 1996. $119.95. ISBN: 0-89640-263-0

The ovary is one of the most interesting organs in women. Besides its physiologic role — to produce steroid hormones and eggs — it gives rise to a wide array of neoplasms, benign and malignant. The editors of this book attempt to discuss in a single volume the normal and pathologic embryology, anatomy, and reproductive physiology of the ovary, with substantial emphasis on neoplasia. This juxtaposition of reproductive endocrinology and gynecologic oncology does not follow the traditional lines of clinical subspecialization, but it does allow a comprehensive overview of the biology of the ovary that cannot be found elsewhere.

The editors have assembled a distinguished panel of authors from many fields, including pathology, reproductive endocrinology, and gynecologic oncology, and have organized their contributions in four sections. The section on pathology and basic science includes chapters on the embryology, anatomy, and histology of the normal ovary and on ovarian endocrine function. There is a chapter on the molecular biology of ovarian cancer, and multiple chapters cover the histopathology of the major types of ovarian neoplasms, including epithelial, germ-cell, and stromal tumors. Another section takes up diagnostic techniques for the evaluation of ovarian disorders, including hormone testing and imaging studies. A chapter on the early diagnosis of ovarian cancer highlights the difficulty of such diagnosis. The well-illustrated chapter on ultrasonography of the ovary emphasizes the value of this technique in evaluating pelvic masses, and its accuracy in distinguishing benign from malignant ovarian masses preoperatively.

The final and largest section contains 13 chapters on the management of ovarian disorders. These chapters discuss the use of gonadotropin-releasing–hormone agonists to treat uterine leiomyomas, endometriosis, and other conditions; general concepts of endocrine manipulation for assisted reproduction; laparoscopic surgery; the management of ovarian neoplasms in the young patient; and ovarian tumors in pregnancy. The surgical management of ovarian cancer is considered in some detail, although the chemotherapy of the disease is covered only briefly. A separate chapter discusses the increasingly important area of intraperitoneal chemotherapy of ovarian cancer.

This book will interest clinicians in various fields, from general obstetrician–gynecologists to subspecialists in gynecologic oncology and reproductive endocrinology. The cross-specialty coverage will give subspecialists ready access to material related to their practice that is not generally covered in their own highly specialized literature.

Stephen C. Rubin, M.D.
University of Pennsylvania Medical Center, Philadelphia, PA 19104