Histological Types Of Ovarian Tumors Research Articles

Relationship of Age and Different Histological Types of Ovarian Tumors

Background: Ovarian tumours are common problem in gynaecology and have varied age of appearance of different histopathological types.
 Objective: This study was undertaken to find out the relationship of age and different histological types of ovarian tumors Methods: A retrospective study was carried out in the Department of Obstetrics and Gynaecology and Department of Pathology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, during May 2010 and December 2014. Five hundred forty seven (547) cases of ovarian tumours were studied in respect to their age and histopathological appearance.
 Results: The range of age of patients with ovarian tumour was 11 – 82 years. About 63% malignant and 73% benign ovarian tumours were found in the age group of 20 – 49 yrs. About 31% malignant ovarian tumours and 15% Benign tumours occurred in menopausal woman (≤50 yrs.). Overall, mean age of presentation of ovarian tumours was 34.29± 12.84 yrs. Mean age of patients with malignant ovarian tumour was 40.29± 14.28 (median 40 yrs; mode 45 yrs.). Mean age of benign ovarian tumour was 34.69 ± 13.08 (median 34 yrs; mode 40yrs) and mean age for borderline tumours 32.75 ± 11.70 mm (median 33 yrs., mode 20 yrs.). Mean age of non tumour ovarian masses / cysts was 31.14± 10.76 yrs (median 29.5; mode 25.4). The difference of mean age of occurance of malignant and benign ovarian tumours were statistically significant P<0.00>. Dysgerminoma (mean age 23.5± 4.43) and yolk sac tumour (mean age 18 .00 ± 5.00 yrs) occurred in younger patients. Serous cyst adenocarcinoma, endometriod carcinoma and poorly differentiated carcinoma occurred around 45 years of age. Mean age of presentation of most of the benign ovarian tumours was between 30 – 37 yrs.; except thecoma which occurred in extremes of age.
 Conclusion: Most of the patients with malignant and benign ovarian tumours have presented in reproductive age adult women (20 – 49 yrs.); and some specific varieties of tumour (e.g. thecoma) presented in the extremes of age.
 Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 99-105

Histopathological study of ovarian tumors in a tertiary care center

Introduction: Ovary is a complex structure and its neoplasms show a wide spectrum of histological types and clinical behavior. The present study was done with the aim of studying the histopathological pattern of ovarian tumors in women of various age groups. Ovarian tumors represent about 30% of all cancers of the female genital system. Ovarian tumor is the seventh leading cause of cancer death. Ovarian tumors are often difficult to detect until they are advanced in stage or size, as symptoms are vague and insidious. An accurate and early diagnosis of malignant lesions will go a long way in the optimal management of these cases. Aims and Objectives: To determine the frequency of different histological types of ovarian tumors in a tertiary care center. Materials and Methods: This was a retrospective study included 150 cases of histopathologically proven ovarian tumors, reported in the Sree Mookambika Institute of medical sciences, over a one and half year period (January 2018 to June 2019). These were classified according to the WHO classification of ovarian tumors. Clinical presentation of the patients was analyzed from archived case records. Results: Of 150 cases of ovarian tumors, 138 masses were unilateral (92%) and 12 were bilateral (8%). Benign neoplastic lesions were 58.7%, and malignant was 2%.In benign neoplastic, the most common neoplasm was serous cystadenoma followed by mucinous cystadenoma In malignant, the current study had 2 cases of mucinous cystadenoma with borderline malignancy and 1 case was serous papillary cystadenocarcinoma Conclusion: A more detailed prospective study include genetic profiling, to establish the reason for this low incidence of malignant lesions

Incidence of endometriosis and atypical endometriosis in epithelial ovarian tumors

Introduction. Several previous studies have identified an association between endometriosis and the development of ovarian carcinomas. This study aims to follow-up the prevalence of endometriosis and the histological features in ovarian tumors. Materials and method. The study group included 50 patients from the County Emergency Hospital of Galaţi diagnosed with different histological types of ovarian tumors of the surface epithelium during the period 2015-2018. The cases were reviewed in order to highlight the presence of endometriosis and the different histopathological changes. Results. In this study, the incidence of endometriosis was 14% (7/50). The average age of patients in the group with endometriosis associated with ovarian tumors was 59.4±11.35, respectively 59.5±13.4 in the group presenting only ovarian tumors. From the group of 50 patients, 29 (58%) were diagnosed with serous carcinoma, 8 (16%) with endometrioid carcinoma, 5 (10%) with mucinous carcinoma, 4 (8%) with serous borderline tumors, one (2%) with mucinous borderline tumor, one (2%) with clear cell carcinoma, one (2%) with undifferentiated carcinoma, and one (2%) with malignant Brenner tumor. From the seven cases of tumors associated with endometriosis, two presented areas with atypia, considered premalignant lesions. Conclusions. Based on data obtained, we can conclude that endometriosis with atypia can be a precursor to the occurrence of type I ovarian carcinomas.

Histopathological pattern of ovarian lesions: a Hospital based study in Batticaloa, Sri Lanka

Ovarian tumors are one of the most common neoplasms encountered in females. Material and methods; A five and half year of retrospective study of ovarian tumors was carried out in a tertiary care hospital-Teaching Hospital, Batticaloa, Sri Lanka, to find out the different histological types of ovarian tumors. Results; 537 ovarian mass specimens were sent for histopathological evaluation from January 2012 to June 2017, either as solitary specimens or as part of total abdominal hysterectomy (TAH) specimens. 20-39 years constituted the majority. Benign neoplastic lesions constituted the majority of lesions diagnosed (49%).Among neoplastic ovarian lesions 80.1% cases were benign, 3.7% case was at borderline and 16.2% cases were malignant. Among benign ovarian neoplasms, 43.3% were serous cystadenoma; 30.0% benign cystic teratoma ; 22.4% mucinous cystadenoma. Majority of malignant (58.5%) were serous cystadenocarcinoma followed by mucinous cystadenocarcinoma, clear cell carcinoma, dysgerminoma and germ cell tumour shares 5 cases per each

Pathomorphological characteristics of of ovarian tumors in domestic animals

Pathomorphological and clinical studies of 23 cases of ovarian tumors of dogs and cats have been carried out, which allowed to determine the morphological, clinical and anamnestic features of different histological types of ovarian tumors. Both types of animals dominated benign tumors. Malignant neoplasms were registered only in dogs, and only dogs observed proliferative tumors. 2 cases were verified as tumor-like lesions, one for each animal species. The group of epithelial tumors was the most widely reported in dogs and cats, namely different histological variants of cystadenoma. The variety of variants of cystadenoma in the dog prevailed – serous, serous proliferative, mucinous and malignant variants (cystadenocarcinoma) were observed, whereas only serous cystadenoma was diagnosed in cats. In addition to cystadenoma, adenofibroma in cats and light-cell carcinoma and Brenner`s tumors in dogs have been described. In the second place in the prevalence are the Sex Cord–Stromal Tumors. Our studies only registered granulosa-stromal cell tumors, which were represented by granulosa cell tumors of the ovary in dogs, and fibroma of the ovary in cats. Germ Cell Tumors were recorded as dysgerminoma. In both species of animals, there is a clear dependence of the appearance of neoplasm on its histological type. All neoplasms with one or more cavities referred to different variants of cystadenoma. Other histological types of ovarian tumors looked like a single, limited knot of soft or dense consistency of different sizes. At the time of detection of ovarian tumors, the age of dogs varied about 9 years, cats – about 12 years. Among the dogs of the general group, a large proportion was made by breeding animals. In the study group, dogs of the following breeds were registered: Labrador, German Shepherd Dog, Staffordshire Terrier, Caucasian Shepherd Dog and Doberman. Among the 6 cats, only one was pedigree. Tumors of ovaries in dogs and cats were almost not accompanied by clinical symptoms. In most cases, ovarian tumors were found accidentally during routine sterilization.

Histological Patterns of Ovarian Neoplasms – A Five Year Experience in North-East India

<p><strong>Background:</strong> Ovary is one of the common sites of neoplasm in females. They manifest in wide spectrum of clinical, morphological and histological features. Ovary is the second most common site of primary malignancy in female genital tract.</p><p><strong>Objectives:</strong> To study the frequency of different histological types of ovarian tumors and to analyze age distribution of these tumors.</p><p><strong>Materials and Methods:</strong> This was a retrospective study of all cases of ovarian tumors received at Pathology Department of Agartala Government Medical College during the period of 5 years from January 2012 to December 2016.</p><p><strong>Results:</strong> A total number of 242 cases were studied. Among these 189 cases (78.1%) were benign, 12 cases (4.96%) were borderline and 41 cases (16.94%) were malignant. Benign neoplasms were most commonly seen between 3<sup>rd</sup> and 5<sup>th</sup> decade of age whereas malignant neoplasms after 4<sup>th</sup> decade. Serous cystadenoma was the commonest benign tumor followed by mucinous cystadenoma and mature cystic teratoma. Among the malignant surface epithelial tumors, mucinous cystadenocarcinoma was most common, followed by serous cystadenocarcinoma.</p><p><strong>Conclusion:</strong> Benign ovarian neoplasms outnumber the malignant ones in all age groups. Surface epithelial tumors are the most common class of tumors and mucinous cystadenocarcinoma is the commonest malignant neoplasm.</p>

Histomorphological Study Of Ovarian Tumors: At A Tertiary Care Centre

Background: Ovarian tumors account for about 30% of female genital tract tumors and is fourth leading cause of cancer deaths in females. This study was conducted to evaluate the frequency and distribution of histological types of ovarian tumors. Methods: This was a retrospective seven years observational study based on histomorphological evaluation of 151 ovarian tumours received in department of pathology. Statistical analysis was done and chi-square test was used to see the association. Results: Out of 151 cases, 149 were primary ovarian tumors and two were metastatic tumors to ovary. There were 124 benign tumors, one was borderline and 26 were malignant. Most common age group affected was 31 to 45 years. Benign tumors were common in 16 to 30 years age group, whereas malignant tumors in 46-60 years. For all age group, benign tumors were more common than malignant tumors. Surface epithelial tumors (72.2%) were the most common followed by germ cell tumors (19.9%) and then sex cord stromal tumors (6.6%). Serous cystadenoma (41.93%) was the most common benign tumor followed by mucinous cystadenoma (32.25%). Serous cystadenocarcinoma (38.46%) was the most common malignant tumor. Most common germ cell tumor was mature cystic teratoma (73.3%) and granulosa cell tumor (50%) was the most common sex cord stromal tumor. Conclusion: Diagnosis of neoplastic ovarian lesions requires correlation between clinical, gross and microscopy features as the morphologic diversity of ovarian tumors poses many challenges. In difficult cases, immunohistochemistry and molecular diagnosis may be often required.

Transmembrane protein 88 (TMEM88) promoter hypomethylation is associated with platinum resistance in ovarian cancer

ObjectivesEpigenetic alterations have been implicated in the development of platinum resistance in ovarian cancer (OC). In this study, we aimed to identify DNA methylation changes in platinum resistant tumors and their functional implications. MethodsTo identify DNA methylation alterations we used the Illumina 450k DNA methylation array and profiled platinum sensitive and resistant OC xenografts. Validation analyses employed RT-PCR and immunohistochemistry (IHC). ResultsGenome-wide DNA methylation analysis of OC xenografts identified 6 genes (SSH3, SLC12A4, TMEM88, PCDHGC3, DAXX, MEST) whose promoters were significantly hypomethylated in resistant compared to sensitive (control) xenografts (p<0.001). We confirmed that TMEM88 and DAXX mRNA expression levels were increased in platinum resistant compared to control xenografts, inversely correlated with promoter methylation levels. Furthermore treatment of OC cells with SGI-110 (guadecitabine), a DNA methyl transferase (DNMT) inhibitor, increased TMEM88 mRNA expression levels, supporting that TMEM88 is transcriptionally regulated by promoter methylation. TMEM88 was detectable by IHC in all histological types of ovarian tumors and its knock-down by using siRNA promoted OC cell proliferation and colony formation and re-sensitized cells to platinum. Furthermore, TMEM88 knock down induced upregulation of cyclin D1 and c-Myc, known Wnt target genes, supporting that TMEM88 inhibits Wnt signaling. ConclusionsOverall, our results support that OC platinum resistance was correlated with TMEM88 overexpression regulated through decreased promoter methylation. Our data suggest that TMEM88 functions as an inhibitor of Wnt signaling, contributing to the development of platinum resistance.

Ovarian tumors among Nigerian females: A private practice experience in Benin-City, Nigeria

Background:Ovarian tumors ranked high among gynecological tumor globally. Reports have it that ovarian tumors cut across all age groups, but more common in adult females. Currently, ovarian cancer is the 4th most common cancer in terms of incidence and mortality patterns in women globally. To highlight the frequency and histological types of ovarian tumors in a private practice establishment in Benin-City, Southern Nigeria.Materials and Methods:Hematoxylin and eosin stained-slides of ovarian biopsies diagnosed at the Ashamas Foundation Diagnostic Centre, Benin-City for 10 years were archived and studied. Request forms were analyzed for clinical bio-data, diagnosis and nature of biopsies. Ovarian tumors were classified according to the World Health Organization manual series.Results:A total of 236 of all ovarian lesions were encountered in this study. Of these, 200 (84.7%) were benign lesions while malignant lesions accounted for 36 (15.3%). Of this, 200 benign lesions 79 accounting for (39.5%) were a benign neoplastic tumor. The ratio of benign to malignant tumors was 5.6:1.0. The mean age of benign neoplastic tumor was 31.6 years ± 10.4 standard deviation (SD). Out of the 79 benign neoplastic tumors; germ cell tumors was the most common accounting for 49 (62%). The mean age of the 36 malignant ovarian tumors was 40.1 years ± 16.2 SD with the majority as malignant surface epithelial tumors accounting for (n = 16; 44.4%). The malignant germ cell tumor was the most common constituting 10 (27.7%).Conclusion:Germ cell tumor was the most common with the majority occurring in reproductive age. Our finding is a reversal of what obtains in the western countries where surface epithelial tumor was the most common with the majority occurring in elderly females.

DNA Methylation Profiles of Ovarian Epithelial Carcinoma Tumors and Cell Lines

BackgroundEpithelial ovarian carcinoma is a significant cause of cancer mortality in women worldwide and in the United States. Epithelial ovarian cancer comprises several histological subtypes, each with distinct clinical and molecular characteristics. The natural history of this heterogeneous disease, including the cell types of origin, is poorly understood. This study applied recently developed methods for high-throughput DNA methylation profiling to characterize ovarian cancer cell lines and tumors, including representatives of three major histologies.Methodology/Principal FindingsWe obtained DNA methylation profiles of 1,505 CpG sites (808 genes) in 27 primary epithelial ovarian tumors and 15 ovarian cancer cell lines. We found that the DNA methylation profiles of ovarian cancer cell lines were markedly different from those of primary ovarian tumors. Aggregate DNA methylation levels of the assayed CpG sites tended to be higher in ovarian cancer cell lines relative to ovarian tumors. Within the primary tumors, those of the same histological type were more alike in their methylation profiles than those of different subtypes. Supervised analyses identified 90 CpG sites (68 genes) that exhibited ‘subtype-specific’ DNA methylation patterns (FDR<1%) among the tumors. In ovarian cancer cell lines, we estimated that for at least 27% of analyzed autosomal CpG sites, increases in methylation were accompanied by decreases in transcription of the associated gene.SignificanceThe significant difference in DNA methylation profiles between ovarian cancer cell lines and tumors underscores the need to be cautious in using cell lines as tumor models for molecular studies of ovarian cancer and other cancers. Similarly, the distinct methylation profiles of the different histological types of ovarian tumors reinforces the need to treat the different histologies of ovarian cancer as different diseases, both clinically and in biomarker studies. These data provide a useful resource for future studies, including those of potential tumor progenitor cells, which may help illuminate the etiology and natural history of these cancers.

Etiology and Pathogenesis of Epithelial Ovarian Cancer

Ovarian cancer is complex disease composed of different histological grades and types. However, the underlying molecular mechanisms involved in the development of different phenotypes remain largely unknown. Epidemiological studies identified multiple exogenous and endogenous risk factors for ovarian cancer development. Among them, an inflammatory stromal microenvironment seems to play a critical role in the initiation of the disease. The interaction between such a microenvironment, genetic polymorphisms, and different epithelial components such as endosalpingiosis, endometriosis, and ovarian inclusion cyst in the ovarian cortex may induce different genetic changes identified in the epithelial component of different histological types of ovarian tumors. Genetic studies on different histological grades and types provide insight into the pathogenetic pathways for the development of different disease phenotypes. However, the link between all these genetic changes and the etiological factors remains to be established.

A Pathology Study of Malignant and Benign Ovarian Tumors Among Atomic-Bomb Survivors - Case Series Report -

The present article describes the series of incident primary ovarian tumors in the Life Span Study (LSS) cohort of the Radiation Effects Research Foundation, with particular emphasis on case ascertainment and characterization of histological features of the tumors. We identified 723 ovarian tumors (260 malignant, 463 benign) in 648 individuals of about 70,000 female LSS subjects; 71 cases had more than one ovarian tumor. We histologically confirmed 601 tumors (182 malignant, 419 benign tumors). The most frequent histological type was common epithelial tumor (90.7% for malignant and 59.7% for benign tumors). The distributions of ovarian tumors by histological type were similar to those from other studies. Among malignancies, the frequency of common epithelial types relative to other tumor types increased with radiation dose (p = 0.02). Among benign tumors, the relative frequency of sex-cord stromal tumors increased with radiation dose (p = 0.04). The women with mucinous cancer had better survival than those with serous cancers (p = 0.03). Within tumor types, there was no consistent pattern of survival by radiation dose. Variations in histological types of ovarian tumors in response to radiation dose, suggested by the case series data need to be followed up by population-based incidence analysis.

Allelic imbalance and mutations of thePTEN gene in ovarian cancer

The PTEN/MMAC1/TEP1 tumor-suppressor gene, which maps to chromosome 10q23.3, is mutated and homozygously deleted in a variety of human tumors, including endometrioid-type ovarian tumors. We examined 33 primary ovarian cancers and 3 ovarian borderline tumors for allelic imbalance (AI) of the 10q23.3 region using 5 polymorphic markers, including an insertion/deletion-type polymorphic marker identified in intron 4 of the PTEN gene. AI at one or more loci was detected in 12 of 31 (39%) informative ovarian cancers and none of 3 ovarian borderline tumors. The commonly deleted region was mapped between the D10S215 and D10S541 loci, including the PTEN locus. Moreover, the incidence of AI at the PTEN locus (38%) was the highest among the 5 loci examined. Therefore, we searched for mutations in the entire coding region of the PTEN gene by PCR-SSCP and sequencing analyses in these tumors and 7 ovarian cancer cell lines. Mutations were detected in 3 of the 33 (9%) ovarian cancers: 2 cases with double mutations and 1 case with a mutation on 1 allele accompanied by deletions on both alleles in the poly T tract preceding the splice acceptor site in intron 7. An intragenic deletion was detected in 1 of the 7 (14%) ovarian cancer cell lines. PTEN mutations were detected not only in the endometrioid type but also in the serous and mucinous types of ovarian cancer. However, PTEN was not mutated in the 12 tumors that showed AI of the PTEN locus. Our results suggest that the PTEN gene plays an important role in the development of a subset but diverse histological types of ovarian tumors. However, it is possible that another tumor-suppressor gene in the close vicinity of the PTEN gene is also inactivated by AI of the 10q23.3 region.

Tumours in Iceland. 9. Malignant tumours of the ovary. A histological classification, epidemiological considerations and survival.

In the period 1955-1979, 337 patients with carcinoma of the ovary were reported to the Icelandic Cancer Registry. Sufficient histological material existed for 314 of these to make it possible to classify the tumours according to the Histological Typing of Ovarian Tumours of WHO (11). The tumour was in the right ovary in 85 and the left in another 85 patients. In 137 patients both ovaries were involved at the time of diagnosis and in 30 patients the side was not known. The most frequent tumours were the group of serous adenocarcinomas, papillary adenocarcinomas and papillary cystadenocarcinomas (IA3a), occurring in 113 patients, giving an age-standardized incidence of 4.4 per 100.000. Second in frequency was the endometrioid adenocarcinoma (IC3a1), in 58 patients, and the third the group of mucinous adenocarcinoma and cystadenocarcinomas (IB3a) in 43 patients. The fourth type in frequency was undifferentiated carcinoma (IG) in 18 patients. During the period, the overall incidence of ovarian cancer did not change. However, there was an increase in the frequency of mucinous and endometrioid types of carcinoma and a decrease in serous carcinoma. Granulosa cell carcinoma was found to have been under-reported to the Icelandic Cancer Registry. ABO blood groups for 192 of the patients were available and showed a significant excess of blood group A, with patients of blood group B significantly fewer than expected. This study of malignant tumours of the ovary is the ninth in a series of investigations into the histological classification of tumours occurring in Iceland during the 20-year period between 1955 and 1974. The tumours occurring in the period 1975-1979 were included in this particular study to increase the number available for classification.

Morphometric data to FIGO stage and histological type and grade for prognosis of ovarian tumours.

The prognostic value of using histological typing, grading, and morphology, in addition to clinical staging, was assessed in 98 cases of invasive ovarian cancer of the common epithelial types (serous, mucinous, and endometrial). All of these cases had at least five years of follow up. When regression analysis was used, the International Federation of Gynaecology and Obstetrics' (FIGO) staging system was the best indicator for prognosis. Analysis of a combination of morphometric features was the second best indicator, being especially useful for the those patients with stage I disease. Variables that indicated a relatively poor prognostic outcome were mitotic index above 30; volume percentage epithelium above 65%; shortest nuclear axis above a mean of 1 X 1 micrometers. Histological typing of ovarian tumours was of limited value; mucinous tumours have a somewhat better prognosis than serous tumours, but the prognostic value of typing alone was found to be limited. Qualitative histological grading was useful, but the prognostic value of morphometric grading was better. Measurement of morphological features with an interactive computer program is simple and can be done by a pathologist or a technician: in future it is likely that such automated systems of measurement will improve the objectivity of tissue analysis.

Book Reviews

Book reviewed in this article:Histological Typing of Ovarian Tumours. Edited by S. F. Serov and R. F. Scully.Ovarian Tumours. N. A. Janovski and T. L. Para‐manandhan.Mathematical Models of Conception and Birth. Mendel C. Ships and Jane A. Menken.The Abortion Experience. Edited by H. J. Osofsky and J. D. Osofsky.Eugenic Sterilization. Compiled and edited by Jonas Robitscher. Charles C. ThomasEndocrinology of Woman. Jose Botella‐Llusia. Translated by Edward A. Moscovic. 10th Edn.Experimental Embryology and Teratology 1. Edited by D. H. M. Woollam and G. M. Morriss.

International Histological Classification of Tumours, No. 9. Histological Typing of Ovarian Tumours

International Histological Classification of Tumours, No. 9. Histological Typing of Ovarian Tumours

BOOK REVIEWS

Book reviewed in this article: Histological Typing of Ovarian Tumours. Edited by S. F. Serov and R. E. Scully in collaboration with L. H. Sobin Paediatric Priorities in the Developing World. By David Morley Antenatal Diagnosis of Genetic Disease. Edited by A. E. H. Emery