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

Emmanuel Ifeanyi Obeagu1,2 1Department of Biomedical and Laboratory Science, Africa University, Mutare, Zimbabwe; 2Department of Medical Laboratory Science, Kampala International University, Ishaka, UgandaCorrespondence: Emmanuel Ifeanyi Obeagu, Department of Biomedical and Laboratory Science, Africa University, Mutare, Zimbabwe, Email [email protected]: 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.Keywords: clear cell ovarian carcinoma, hypercoagulability, thrombosis, tissue factor, coagulopathy