Intraoperative Consultation (Frozen Section) in the Diagnosis of Ovarian Tumour

Ovarian cancer is a devastating disease preoperative evaluation of the patients with an ovarian tumour is difficult. So frozen section biopsy of ovarian tumour is important to determine the extent of surgery. This retrospective cross-sectional study was carried out in the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University from August 2016 to July 2017 to determine the validity of frozen section biopsy in the diagnosis of ovarian tumour. Fifty cases of ovarian tumour underwent frozen section biopsy were included by purposive sampling. Histopathological finding was taken as the gold standard. Data was analyzed by SPSS version 16. The sensitivity of frozen section in the diagnosis of benign, borderline and malignant were 100%, 100% and 97.67% respectively as well as the specificities were 100%, 97.96% and 100% respectively. Similarly the accuracy, PPV, NPV for the benign, borderline and malignant ovarian tumour were also high except the borderline tumour which had low PPV. Bangladesh Med J. 2019 Sep; 48 (3): 34-38

D-DIMER AND FIBRINOGEN IN PATIENTS UNDERWENT SURGERY IN MALIGNANT AND BENIGN OVARIAN TUMOR (D-Dimer Dan Fibrinogen Pada Pasien-Pasien Yang Menjalani Tindakan Pembedahan Pada Tumor Ovarium Ganas Dan Jinak)

Ovarian tumour ranks second in gynecology tumour cases and ranks second in gynecology tumour death in Indonesia. Tumour cause hypercoagulable that increase risk of thrombosis by procoagulant mechanism. Tumout cells also can cause hyperfibrinogenemmia that can cause bleeding. The aim of study was to know D-dimer and fibrinogen value to investigate primary hyperfibrinolysis on malignant and benign ovarian tumour; and to know whether operation procedure on malignant and benign tumour change D-dimer and fibrinogen value. Prospective analysis study, subject were malignant and benign ovarian tumour patients undergoing surgery in Haji Adam Malik Hospital, Medan. One way Annova test dan Wilcoxon Sum-Rank test were performed. Stastical differentiation is indicate with p<0,05. Study subject was 16 patient where 8 malignant and benign ovarian tumour patient respectively. Malignant ovarian tumour D-dimer values was higher than benign ovarian tumour (p<0,01) that indicate fibrinolysis increase in malignant ovarian tumour. Malignant ovarian tumour fibrinogen values as same as benign ovarian tumour (p>0,05) that indicate the fibrinolysis in ovarian tumour wasn’t primary hyperfibrinolysis. Surgery procedure didn’t influence D-dimer and fibrinogen values. Primary hyperfibrinolysis wasn’t occur in ovarian tumour.Keywords : Ovarian tumour, malignant, benign, D-dimer, fibrinogen.

Clinical correlation of ovarian mass with ultrasound findings and histopathology report

Background: As the ovarian malignancy is most common among genital malignancy, the diagnosis of malignant ovarian tumour helps us to plan the treatment modality like neoadjuvant chemotherapy, chemoradiation, radiotherapy, surgery and fertility sparing surgery depending upon stage of the disease and age of the patient. This study correlates between the clinical and ultrasound findings of ovarian tumours to diagnose the nature of the tumour whether benign or malignant and offer appropriate treatment and finally correlated with histopathology report. The aim of this study was to correlate clinical, USG morphology, colour doppler indices in ovarian mass with histopathology report.Methods: This is a prospective observational study conducted at Saveetha Medical college and hospital between June 2016 to May 2017 for women who were clinically diagnosed to have ovarian mass and operated for it. These patients underwent trans vaginal (if married) or trans abdominal ultrasound and Doppler using GE S7 expert or Sonoline Acuson x300 (siemens) or Philips HD 11xE. Based on clinical findings and on the characterization of the image in USG and colour doppler findings it will be concluded whether the mass is benign or malignant. This is correlated with HPE report.Results: Out of 113 women studied ovarian mass diagnosed clinically as benign in 78%and malignant in 21%. USG prediction of ovarian cancer was 88.00% sensitivity, 80.68% specificity. When Doppler findings were included sensitivity was 91.43% and specificity was 91.03%. The combined use of clinical and USG with Doppler for diagnosis of ovarian malignancy was 92.31% sensitive and 95.95% specific. The positive predictive value of combined use of clinical and USG with Doppler for diagnosis of ovarian malignancy was 92.31%.Conclusions: From this study clinical, USG and Doppler are important modalities in diagnosing benign or malignant ovarian tumour. When both are combined the diagnostic value is extremely high. This aids in planning the management.

Frequency and Socio-demographic Characteristics of Patients presented with Ovarian Tumour at a tertiary care hospital

Background: Ovarian tumour causes great morbidity and mortality.Objective: The purpose of the present study was to analyze the different presentation of ovarian tumours to see the frequency and clinic-demographic characteristics of ovarian tumour.Methodology: This cross sectional study was conducted in the Department of Gynaecology & Obstetrics, Shaheed Suhrawardy Medical College, Dhaka during the period from January to June 2013 for a period of six months. Patient admitted in Department of Obstetrics Gynaecology ward in Shaheed Suhrawardy Medical College Hospital with provisional diagnosis of ovarian tumour were selected as study population. Proper permission was taken from the ethical committee of Shaheed Suhrawardy Medical College Hospital for this study. All the patients were informed about the various aspects of the study. Their verbal consents were taken. Women of all ages with ovarian tumour were included in this study. Women with all other tumour except ovarian tumour were excluded from this study. A thorough history variably collected, clinical examination and investigations was carried out. The result of benign and malignant ovarian neoplasms in regard to age parity, physical sign, vaginal examination, laparotomy findings, together with their macroscopic findings are tabulated separately. Histopathological examination was done by senior pathologists of ShSMCH.Result: A total 50 cases of ovarian tumour had been studied of which 26 (52%) were benign and 24(49%) were malignant ovarian tumours which were confirmed by histopathological examination (P>0.05). 28% and 12% patient with benign ovarian tumour were in age group of 18-34 years and 35-45 years and 14% patient with malignant ovarian tumour in age group >45 years (p>0.05). 32% patient with benign ovarian tumours came from poor socio economics condition and 20% from middle class, 28% patient with malignant ovarian tumour came from poor and 16% from middle class family. Out of 50 cases of ovarian tumour , 39 were married and 11 were unmarried. 51% patients did not use any contraceptives and 31% oral contraceptives (P<0.05). No family history was found in 92% patients. 16% patients with benign tumours were unmarried.Conclusion: In conclusion ovarian tumour are mostly benign of which middle age group are most commonly reported.J Shaheed Suhrawardy Med Coll, 2014; 6(2):76-78

Meigs’ Syndrome Associated With Elevated Ca 125 Level – A Rare Case

Meigs’ syndrome is a rare but well known syndrome. It is a triad of ovarian fibroma with ascites and pleural effusion that resolves after resection of the tumour. Postmenopausal women with solid adnexal masses, ascites and pleural effusion with elevated CA125 level are highly suggestive for malignant ovarian tumour. Only few cases of Meigs, syndrome with elevated CA 125 have been reported in different literatures. Here we report a case of Meigs syndrome due to right sided ovarian fibroma with elevated CA 125 level in postmenopausal woman.J Dhaka Medical College, Vol. 24, No.1, April, 2015, Page 76-78