Clear Cell Ovarian Carcinoma and Its Distinct Coagulopathy Profile: Molecular Drivers and Clinical Implications

Clear cell ovarian carcinoma is a rare but clinically aggressive subtype of epithelial ovarian cancer characterized by a striking tendency toward hypercoagulability. This narrative review highlights the molecular and clinical underpinnings of CCOC-associated coagulopathy, emphasizing its distinction from other ovarian cancer subtypes. Key drivers include tissue factor overexpression, pro-inflammatory cytokines such as interleukin-6, endothelial dysfunction, and tumor-derived microparticles, all of which converge to activate the coagulation cascade and increase the risk of venous thromboembolism. Comparative data reveal a higher incidence of VTE in CCOC than in serous carcinoma, underscoring the need for histology-specific risk assessment. Current prophylactic strategies rely on standard anticoagulation, but emerging trials targeting coagulation pathways and cytokine signaling show promise for more tailored approaches. Understanding this unique tumor-coagulation interplay is critical for improving early detection, guiding thromboprophylaxis, and informing future therapeutic strategies.