Germ cell tumors of the ovary: a clinicopathologic study of 121 cases from Nepal.

Abstract

Although many reports have been published about germ cell tumors of the ovary in developed countries, there has been no such documentation from Nepal. The retrospective study presented here reports the clinicopathologic profile of germ cell tumors of the ovary studied at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. A retrospective analysis of 121 histopathologically proven cases of germ cell tumor of the ovary operated on at either our institute or somewhere else (but processed in our institute) from November 1995 to April 2001 (5.5 years) was done. Clinical data, histopathologic findings and complications were recorded. The prevalence of germ cell tumors was 43.36% (121/279) of all ovarian neoplasms. Patient age varied from 8 to 65 years (median 31 years). Tumor occurrence was most frequent in patients aged 21-40 years. Only eight of 121 cases (6.61%) were malignant; the rest (93.39%) were mature teratomas. Of great interest was the unexpectedly high number of cases (47.93%) found in patients who were hill natives such as Rai and Gurung. Pain and abdominal fullness were common symptoms noted in 85.95% and 79.31% of patients, respectively. Seventeen (14%) asymptomatic cases were found either on routine physical examination (12 cases) or during pregnancy (five cases). The left ovary was involved in 39.7% cases and the right in 35.5%. Bilateral involvement was seen in 24.8% of cases. Torsion was noted in 20.66% and was the most common complication. Of all the germ cell tumors 93.39% were cystic and only 6.61% were solid on gross appearance. There were three cases of monodermal benign teratoma, four cases of immature teratoma and one case of malignant transformation. Mature teratoma is the most common germ cell tumor and accounts for 40.50% of all ovarian neoplasms. The high prevalence of germ cell tumors of the ovary found among patients who were hill natives needs to be explored further.