Histopathological Spectrum of Ovarian Tumors: A Prospective Study at College of Medical Sciences and Teaching Hospital, Bharatpur, Chitwan, Nepal

Background: Ovary is the third most common site of neoplastic lesions in female genital tract. Ovarian tumors occur right from childhood to postmenopausal age group. Ovarian neoplasms have become increasingly important not only because of their large variety, but more because they have gradually increased the mortality rate due to female genital cancers.

Objectives: To find out the histopathological pattern of ovarian tumors in College of Medical sciences and Teaching Hospital (CMS-TH), Bharatpur and to evaluate correlation between clinical and histopathological diagnosis.

Methods: This descriptive study was carried out on 75 cases of surgically resected ovarian tumor specimens fulfilling the inclusion criteria at Department of Pathology in CMS-TH, Bharatpur from January 2016 to June 2017. Clinical data was recorded  in a predesigned proforma. The specimens were grossed, processed and embedded using standard procedures, were stained with Haematoxylin and Eosin stain and were analyzed using light microscopy. Statistical analysis was done using SPSS (Statistical Pacakage for Social Sciences) 20.0 and a correlation was done between clinical and histopathological diagnosis using Chi-square test (liklihood ratio) and Spearman correlation, and p value was calculated.

Results: Age range of the patients was from 10 to 70 years with maximum cases (32.0%) in the age group of 21-30 years. The most common presenting complaint was pain abdomen (57.4%). Clinical diagnosis was mature cystic teratoma in 29 (38.7%) cases, serous cystadenoma in 24 (32.0%) cases, mucinous cystadenoma in 11 (14.7%) cases, dysgerminoma 7 (9.3%) in cases, serous cystadenocarcinoma in 3 (4.0%) cases and mucinous cystadenocarcinoma in 1 (1.3%) case. Histopathological diagnosis was mature cystic teratoma in 29 (38.8%) cases, serous cystadenoma in 22 (29.4%) cases, mucinous  cystadenoma  in  6 (8.0%) cases,  borderline mucinous  tumor in  4  (5.3%) cases, serous cystadenocarcinoma in 3 (4.0%) cases, dysgerminoma in 3 (4.0%) cases, steroid cell tumor in 2 (2.7%) cases, and borderline serous tumor, mucinous cystadenocarcinoma, mature cystic teratoma transforming into squamous cell carcinoma (SCC), immature teratoma, Sertoli Leydig cell tumor  and fibroma in each 1 (1.3%) case. There was significant statistical correlation between clinical and histopathological diagnosis (p<0.001).

Conclusion: Benign tumors were more common than malignant tumors for all age group. Most of the tumors were of surface epithelial cell origin. Mature cystic teratoma was the most common ovarian tumor as well as the most common benign tumor. Serous cystadenocarcinoma and dysgerminoma were most common malignant tumors. Malignant surface epithelial tumors usually occurred in older age whereas malignant germ cell tumors occurred in younger age. There was significant statistical Clinico-pathological correlation.


Himanshu Regmi

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