scholarly journals Clinico pathological study of ovarian neoplasms

Author(s):  
Lina Baru ◽  
Ranjita Patnaik ◽  
Kunja Bihari Singh

Background: Ovarian tumors are common form of neoplasm in women and account for 30% of female genital tract cancers. Ovarian cancer is the sixth most common cancer in women and the leading cause of death in women with gynaecological malignancy. Due to inefficient diagnosis/prognosis strategies mainly due to the lack of specific symptoms at the initial stage of the disease about 70% cases diagnose at advanced stage when the metastatic tumor has acquired drug resistant phenotype.Methods: Prospective study of two years duration with sample of 108 cases of simple oophorectomy and hysterectomy with unilateral or bilateral salpingo oophorectomy specimens are included in this study.Results: Maximum cases were in the age group of 21 to 45 years. Mean age of presentation was 42.84 years (benign tumors), 46.66years (Borderline tumors) and 32.6 years (malignant tumors). Epithelial ovarian tumors are the commonest and constituted 78.7% of all ovarian tumors. In present study 40.74% were benign, 2.78% were borderline and 56.48% were malignant ovarian tumors.Conclusions: Most of the ovarian neoplasms presented in the reproductive age group but ovarian malignancy can occur at all age group and abdominal symptoms are the only clue for the diagnosis of the disease. There is no definite universal screening protocol yet, for malignant ovarian tumors however abdominal symptoms supported by tumor markers like serum CA-125 and ultrasound of abdomen and pelvis with Doppler may be yardstick for early diagnosis of malignant ovarian tumor.

Author(s):  
Sahana N. Naik ◽  
Sunil Kumar K. S. ◽  
Girija B.

Background: Ovarian tumors account for 30% of all cancers of female genital tract which represents the sixth most common cancer and fourth leading cause of death in women. The present study was done with an objective to determine the frequency and distribution of various ovarian tumors and to study their clinical and histopathological presentations.Methods: It is a retrospective observational study of patients with ovarian tumors subjected to surgery in the department of obstetrics and gynecology, SDM College of Medical Sciences and Hospital from January 2005 to December 2015.Results: There were 642 cases comprising of 77.7% of neoplastic lesions and 22.3% of non-neoplastic lesions. Majority of the ovarian tumors (83%) were seen in the age group of 20 to 50 years. Mean age for ovarian tumors was 38 years.  Among the neoplastic lesions 84% were benign, 14.2% were malignant and 1.8% were borderline tumors. Surface epithelial tumors were the commonest tumors (60.9%) followed by germ cell tumors (12.8%).  Serous cystadenoma was the most common benign tumors (47.1%) followed by mucinous cystadenoma (18.4%). Among the ovarian malignant tumors; serous cystadenocarcinoma was the most common (4.5%) followed by mucinous cystadenocarcinoma (2.6%). Chocolate cysts were the most common among the non-neoplastic lesions (36.4%).Conclusions: Ovarian neoplastic lesions were more common than non-neoplastic lesions. Benign ovarian tumors were common in reproductive age group.  The mean age of occurrence for ovarian tumor was 38 years. The most common neoplasm was surface epithelial tumors, of which serous tumors was the commonest. Chocolate cysts were the most frequently encountered histopathological finding among the non-neoplastic lesions.


Author(s):  
Manupriya Sharma ◽  
Anjali Soni ◽  
Rashmi Kaul

Background: Ovarian tumors are one of the ubiquitous and common forms of neoplasms in women. The aim of the study was to understand the pattern of benign and malignant ovarian neoplasms and their distribution in different age groups in rural population of India.Methods: A retrospective study conducted in the Department of Pathology in close collaboration with Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda (HP), India. All the patients irrespective of age group who were operated for ovarian neoplasms (benign or malignant) were included in this retrospective analysis over duration of four years (2013 to 2016). “WHO classification system” was used, for classification of all these ovarian tumors. The incidence of these tumors with respect to age group was also studied.Results: During the study period (2013-2016), there were a total of 242 surgeries for ovarian neoplasms. Of these, majority of the tumours were benign 184 (76%), but an alarming number of women had malignant ovarian tumours 51 (21%), remaining 7 (3%) cases were borderline. Age wise distribution was 7% (16/242) in less than 20 years age, 19% (46/242) in 20-30 years age, 29% (69/242) in 30-40 years age group, 24% (59/242) in 40-50 years and remaining 21% (52/242) in more than 50 years age group. Pre-dominantly benign tumors were surface epithelial tumors (serous/ mucinous cystadenoma), germ cell tumors (mature cystic teratoma) and endometrioma. Major malignant tumors were surface epithelial tumors (serous/mucinous cystadeno-carcinoma), and germ cell tumors (dysgerminoma, immature teratoma).Conclusions: In this sub-Himalayan belt of rural India, the incidence of benign ovarian tumors was 76%. Borderline ovarian tumors were seen in 3% cases and the remaining 21% cases were malignant ones. Even though benign tumors were the commonest for each age group, however as the age of women increased the proportion of malignant tumors in them increased. Surface epithelial tumors are the most common class of tumors in both benign and malignant tumors. Serous cystadenoma is the most common ovarian tumor overall as well as most common benign tumor whereas serous cystadeno-carcinoma is most common malignancy. Stromal ovarian tumor (one case) is a rarity. Only one woman had bilateral ovarian tumor.  


Author(s):  
Sachin G. Vedpathak ◽  
Vaishali R. Korde Nayak

Background: Ovarian masses are a frequent clinical diagnosis in general Gynecology. The aim of the present study was to assess risk factors, clinical features, CA 125 levels, histopathological diagnosis of the patients of all ovarian tumors that underwent surgical management between August 2013 to August 2017.Methods: This was the retrospective study conducted in the department of Obstetrics and Gynecology in MIMER Medical College. We studied 50 patients those who underwent surgical management. Most of the patients 56% were in the reproductive age group, 28% patients were in the perimenopausal age group, 14% were in the postmenopausal age group. 82% patients were parous.Results: Pain abdomen was most common symptom in 50% patients. Bilaterality of the tumor was common in malignant tumors. CA 125 was found to be increased more in malignant tumors. Most common co morbid condition was hypertension found in 12% patients. Most common ovarian tumor found was serous cystadenoma 34% and most common malignant tumors were serous cystadenoma carcinoma 16%.Conclusions: Out of all operated patients 11 (22%) were malignant, 37 (74%) were benign and 2 (%) were borderline tumors. Out of all malignant tumors 8 (72%) were serous cysadenocarcinoma. It is difficult to always differentiate between malignant and benign tumors clinically. Analysis of risk factors and protective factors, thorough abdomino-pelvicbimanual examination, certain features on radiological imaging, presence of ascites and bilaterality, CA125 levels, helps increasing the accuracy of the diagnosis.


2021 ◽  
pp. 43-44
Author(s):  
Momota Naiding ◽  
Nitu Mani Khakhlari ◽  
Nandakanta Mahanta ◽  
Shah Alam Sheikh

Introduction : Ovarian tumor accounts for 30% of female genital tract cancers and comprises of large variety of neoplastic entities. Mortality rate has due to ovarian tumor has gradually increased. The present study was undertaken to study the frequency of various histomorphological spectrum, histological subtypes and age distribution pattern of ovarian tumors. Methods: Retrospective study was carried during period of 1st January 2015 to 31st st December 2019, 455 cases of ovarian neoplastic lesions were taken from the records of the department. Classication was done according to WHO classication. Results: Of the 455 cases, 332 cases (73%) were benign, 16 cases (3.5%) cases were borderline and 107 cases (23.5%) cases were malignant. Among the histological subtypes surface epithelial tumors are common comprised of 76.9% followed by germ cell tumors (19.6%). Serous cystadenoma (42.8%) was the most common benign tumor followed by mature cystic teratoma (16.5%). Among the malignant tumors, the most common was Serous cyst adenocarcinoma (11.9%) Tumors were seen over age range of 11-81 years. Maximum number of cases were in the 4th to 6th decade. Benign tumors were primarily seen in Younger age group , whereas malignant tumors were common in elderly age group. Conclusions: In our study we analysed all the spectrum of ovarian tumors diagnosed on the basis of histomorphology. Surface epithelial tumors were the commonest ovarian tumor. Maximum numbers of ovarian tumors were in the age range 40-59years and malignant tumors were common in age >40 years


Author(s):  
Priya V.

Background: Adolescence is the period of transition from childhood to adulthood. 1% neoplasm occurs in this age group below 17 years, of this, 3% are ovarian neoplasms. Aim was to study retrospectively the clinicopathological profile and outcome of ovarian tumors in the age group 10-20 years in Government Medical College, Kottayam, Kerala, India from January 2008 for six years.Methods: Fifty Patients who have undergone laparotomy in this institution during the period were taken for study. Data regarding age, mode of presentation, diagnostic methods, treatment and histopathology were recorded. Follow-up was also taken into consideration. Patients with polycystic ovary, corpus luteal cyst, follicular cyst and endometriotic cyst are excluded.Results: Majority of the patients fall between the age group 15-20 years. Major clinical presentation was pain (40%), followed by abdominal mass. Laparotomy was done for all cases except three where laparoscopy was done. Imprint cytology taken for 3 cases. Histopathology showed malignant tumors in 6 cases and benign tumors in 44 cases. Epithelial tumors outnumbered germ cell tumors.Conclusions: This study shows the predominance of epithelial neoplasms in the age group 10-20 years. Proportion of malignancy is 12%.


Author(s):  
О. М. Sukhina ◽  
K. V. Nemaltsova ◽  
V. S. Sukhin

Background. Timely diagnosis of recurrence of malignant tumors of the ovaries can improve treatment outcomes. Purpose – determine the feasibility of using the tumor marker HE-4 in case of recurrence of malignant ovarian tumors. Materials and methods. To analyze the levels of HE-4 and CA-125 in patients with recurrence of malignant ovarian tumors and determine the feasibility of using HE-4 at this stage of monitoring, 29 patients with known indicators of HE-4 and CA-125 at the time of recurrence and their baseline data were selected. Results and discussion. The paper presents the results of the study of the HE-4 and CA-125 tumor markers levels in 29 patients with a proven recurrence of malignant ovarian neoplasms depending on the timing of its appearance – up to 12 months (n = 9), 13–24 months (n = 11) and after 24 months (n = 9). The values of the tumor-associated HE-4 marker were decreased during the relapse compared to baseline expression levels. When analyzing of the HE-4 serum, their significant difference was revealed only in the event of relapse in the period of up to one year (1207.00 pmol/l) from recurrence rates in the periods of 13–24 and of over 24 months (567.00 and 655.50 pmol/l, respectively). Conclusions. Only the baseline expression of HE-4 is prognostically significant for determining the timing of recurrence of ovarian malignancies.


2012 ◽  
Vol 01 (02) ◽  
pp. 59-62 ◽  
Author(s):  
Monisha Choudhury ◽  
Seema Goyal ◽  
Mukta Pujani ◽  
Meenu Pujani

Abstract Background: The present study was undertaken to evaluate the diagnostic accuracy of imprint cytology in ovarian neoplasms, investigate the biological significance of p53 expression in malignant ovarian tumors and correlate it with histological type, grade and stage of tumor. Material and Methods: A total of 50 cases including 25 prospective and 25 retrospective cases were studied. Imprint cytology was performed on 25 ovarian tumors and compared with histopathological diagnosis. p53 immunohistochemistry was performed on all 50 cases. Results: On immunohistochemistry, all the benign tumors were negative for p53 while 42% of primary ovarian malignant tumors were positive. p53 expression was found to have a diagnostic value in differentiating benign from malignant tumors. p53 overexpression did not show any significant correlation with prognostic factors as stage of disease, grade of differentiation and type of tumor. Conclusion: The present study confirms the importance of p53 tumor suppressor gene expression as documented by immunohistochemistry in the differentiation of malignant and benign ovarian tumors.


2016 ◽  
pp. 86-93
Author(s):  
M.Yu. Yegorov ◽  
◽  
A.A. Sukhanova ◽  

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.


2016 ◽  
Author(s):  
Dhanya S. Thomas ◽  
Ajit Sebastian ◽  
Vinotha Thomas ◽  
Anitha Thomas ◽  
Rachel Chandy ◽  
...  

Background: Cancer antigen 19-9 (CA 19-9) is a tumor-associated mucin glycoprotein antigen that may be elevated in healthy individuals as well as in patients with benign and malignant tumors. It is useful in the management of pancreatic and other gastrointestinal tumors. CA 19-9 is also elevated in benign and malignant ovarian tumors. Aim: To study the pattern of serum CA19-9 in complex ovarian tumors. Methods: The study design was descriptive, based on data collected from medical records. Patients with a complex ovarian mass, who were investigated with CA 19-9 and had undergone surgery, wereincluded in the study. The study duration was 2 years from January 2014 to December 2015. A total of 273 patients (119 - benign and 154 malignant) with complex ovarian mass and elevated CA 19-9 underwent surgery during the study period. Results: CA 19-9 was elevated in 55 patients (20%). Of these, 23 patients had benign tumors while 32 had malignant tumors.Among patients with benign tumors, 21 had dermoid, 23 had mucinous tumors and 75 had other types of tumors. CA 19-9 was elevated in 10 (47.6%) of the dermoids, 7 (30.4%) of the mucinous tumors and 6 (8%) of the other benign tumors. Among patients with malignant tumors, 138 were epithelial and 16 were non epithelial tumors. Of the epithelial tumors, 31 were mucinous and 107 were non mucinous types. Overall, 29 (21%) had elevated CA 19-9. Of the epithelial tumors, 22.6% of the mucinous type and 20.6% of the non mucinous type had elevated CA 19-9. Among the non-epithelial tumors, 3 (18.8%) had elevated CA19-9. Conclusion: CA 19-9 is elevated in several conditions but most likely to be raised in dermoid cysts and mucinous tumours. CA19-9 levels need to be interpreted along with clinical and radiological findings.


2021 ◽  
pp. 172460082199235
Author(s):  
Weina Zhang ◽  
Yu-min Zhang ◽  
Yuan Gao ◽  
Shengmiao Zhang ◽  
Weixin Chu ◽  
...  

Objective: CA-125 is widely used as biomarker of ovarian cancer. However, CA-125 suffers low accuracy. We developed a hybrid analytical model, the Ovarian Cancer Decision Tree (OCDT), employing a two-layer decision tree, which considers genetic alteration information from cell-free DNA along with CA-125 value to distinguish malignant tumors from benign tumors. Methods: We consider major copy number alterations at whole chromosome and chromosome-arm level as the main feature of our detection model. Fifty-eight patients diagnosed with malignant tumors, 66 with borderline tumors, and 10 with benign tumors were enrolled. Results: Genetic analysis revealed significant arm-level imbalances in most malignant tumors, especially in high-grade serous cancers in which 12 chromosome arms with significant aneuploidy ( P<0.01) were identified, including 7 arms with significant gains and 5 with significant losses. The area under receiver operating characteristic curve (AUC) was 0.8985 for copy number variations analysis, compared to 0.8751 of CA125. The OCDT was generated with a cancerous score (CScore) threshold of 5.18 for the first level, and a CA-125 value of 103.1 for the second level. Our most optimized OCDT model achieved an AUC of 0.975. Conclusions: The results suggested that genetic variations extracted from cfDNA can be combined with CA-125, and together improved the differential diagnosis of malignant from benign ovarian tumors. The model would aid in the pre-operative assessment of women with adnexal masses. Future clinical trials need to be conducted to further evaluate the value of CScore in clinical settings and search for the optimal threshold for malignancy detection.


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