Clinical Presentation and Histological Types of Ovarian Tumor in Patients Admitted in Tertiary Care Center

Abstract

Background: Ovarian cancer is the eighth most frequent cancer among women worldwide, accounting for 4% of all cancers in the female population. When compared to other reproductive system cancers, ovarian cancer has a high death and morbidity rate. Objectives: The aim of the study was to assess the clinical presentation and histological types of ovarian tumor in patients admitted in tertiary care center. Methods: A descriptive cross-sectional study was conducted to determine the clinical presentation and histopathological types of ovarian tumour diagnosed at Medical college for women, Uttara and Nightingale medical college, Ashulia. The study was approved by the Institutional Review Board (IRB) and 600 patients diagnosed with ovarian tumors were consecutively included in the study from July 2009 to August 2016. The cases were diagnosed and subclassified in accordance with the WHO Classification of Female Genital Tumours, Fourth Edition. Statistical Package for Social Sciences (SPSS) application, version 25, was used for data analysis. Results: Out of Total Gynaecological admission of 4800 patients during the study period, 600 patients were admitted with diagnosis of ovarian Tumor, So occurance was 12.5%. the mean age of the patients was 35 ± 2.09. About 8.6% of the patients had less than 20 years old. 56.6% were within the age group of 21-40, 29.8% were within the age group of 41-60 and only 5% had more than 60 years. The mean Menarche in years was 14.6 ± 1.02 and Menopause in years was 48.7 ± 2.46. Regarding clinical presentation 37.40% had abdominal pain, 55.50% had abdominal mass, 3% had abdominal distension,2% had ascites, 0.50% had menstrual irregularities and 2.50% were asymptomatic. Regarding surgical procedure, 35% undergone Total abdominal hysterectomy and bilateral salpingo-oophorectomy, 18.33% Bilateral salpingo-oophorectomy, 15% Right salpingo-oophorectomy and Left salpingo-oophorectomy recommendation, 13.33% Right cystectomy, 3.33% Left cystectomy. Regarding consistency of tumour 57.33% were cystic, 37% were solid, 5.33% were complex and 0.33% were Diffuse pattern (metastatic tumor). Benign tumors were 77%, borderline 16.67% and malignant 6.33% cases. Out of 462 benign tumors, Serous cystadenoma (230/49.78%), Mucinous cystadenoma (60/12.98%), benign Brenner tumor (10/2.16%), Mature cystic teratoma (110/23.80%), stroma ovarii (10/2.16%), Fibroma (10/2.16%), Fibro-thecoma (12/ 2.59%), leiomyoma (20/4.34%). Out of 38 malignant tumour, Serous cystadenocarcinoma (11/28.94%), mucinous cystadenocarcinoma (6/15.78%), clear cell carcinoma (1/2.63%), Malignant Brenner tumor (1/2.63%), endometroid adenocarcinoma (4/10.52%), squamous cell carcinoma arising in mature teratoma (1/2.63%), Dysgerminoma (7/18.4%), Immature teratoma (1/2.63%), malignant mixed germ cell tumor (1/2.63%), Adult granulosa cell tumor (4/10.52%), Krukenburg tumor (1/2.63%). Survival status was satisfactory; 99.67% patients was alive. Conclusion: The study found that ovarian neoplasms had ambiguous signs and symptoms, were mostly seen in reproductive age groups, and were mostly benign. The proportion of malignant ovarian neoplasms was significantly lower than that of benign ovarian neoplasms. Although incidence of malignant tumor is less common but gynocologists should be more careful in diagnosis of malignancy as ovaries are pelvic organs and definite screening methods are not available and malignancy can occur in any age.