Study of histopathological spectrum of ovarian lesions

Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable. In order to have a better understanding of frequency and histomorphological patterns of different ovarian lesions study was encountered in our tertiary care hospital.To study the histopathology of ovarian non-neoplastic and neoplastic lesions and to study the distribution of ovarian lesions with respect to various parameters like age, bilaterality, gross and microscopic features.This is a prospective study of 125 ovarian specimens received in department of pathology, G.K. General Hospital, Bhuj during August 1, 2018 to July 31, 2020. Total 125 cases of ovarian specimens were studied, amongst them 58 were non-neoplastic and remaining 67 were neoplastic. The most common non-neoplastic lesion seen was follicular cysts 12 cases (21%), followed by endometriosis 9 cases (16%). Among 67 neoplastic ovarian lesions 58(87%) cases were benign, 3(4%) cases were borderline and 6 (9%) cases were malignant. In benign ovarian neoplasm, most commonly seen lesions were serous cystadenoma 24 cases (36%) followed by 13 cases (20%) of mature cystic teratoma. In malignant cases, maximum was of high-grade serous cystadenocarcinoma.Ovarian epithelial tumours are the most common type, while serous cystadenocarcinoma was the most common malignancy. Histological examination is gold standard and in certain difficult cases require immunohistochemistry.Ovary is an important reproductive organ with involvement in production of progeny.Ovarian pathology ranges from innocuous non-neoplastic lesions to malignant neoplastic entities. Ovarian neoplasms have become increasingly important not only because of the wide range of neoplasms, but also because they have gradually increased the mortality rate. The incidence, clinical appearance and the behaviour of the different types of ovarian tumour is extremely variable.

Estimating the risk of malignancy of adnexal masses: validation of the ADNEX model in the hands of nonexpert ultrasonographers in a gynaecological oncology centre in China

Background This study aims to validate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) the Assessment of Different NEoplasias in the adneXa (ADNEX) model in the preoperative diagnosis of adnexal masses in the hands of nonexpert ultrasonographers in a gynaecological oncology centre in China. Methods This was a single oncology centre, retrospective diagnostic accuracy study of 620 patients. All patients underwent surgery, and the histopathological diagnosis was used as a reference standard. The masses were divided into five types according to the ADNEX model: benign ovarian tumours, borderline ovarian tumours (BOTs), stage I ovarian cancer (OC), stage II-IV OC and ovarian metastasis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of the ADNEX model to classify tumours into different histological types with and without cancer antigen 125 (CA 125) results. Results Of the 620 women, 402 (64.8%) had a benign ovarian tumour and 218 (35.2%) had a malignant ovarian tumour, including 86 (13.9%) with BOT, 75 (12.1%) with stage I OC, 53 (8.5%) with stage II-IV OC and 4 (0.6%) with ovarian metastasis. The AUC of the model to differentiate benign and malignant adnexal masses was 0.97 (95% CI, 0.96–0.98). Performance was excellent for the discrimination between benign and stage II-IV OC and between benign and ovarian metastasis, with AUCs of 0.99 (95% CI, 0.99–1.00) and 0.99 (95% CI, 0.98–1.00), respectively. The model was less effective at distinguishing between BOT and stage I OC and between BOT and ovarian metastasis, with AUCs of 0.54 (95% CI, 0.45–0.64) and 0.66 (95% CI, 0.56–0.77), respectively. When including CA125 in the model, the performance in discriminating between stage II–IV OC and stage I OC and between stage II–IV OC ovarian metastasis was improved (AUC increased from 0.88 to 0.94, P = 0.01, and from 0.86 to 0.97, p = 0.01). Conclusions The IOTA ADNEX model has excellent performance in differentiating benign and malignant adnexal masses in the hands of nonexpert ultrasonographers with limited experience in China. In classifying different subtypes of ovarian cancers, the model has difficulty differentiating BOTs from stage I OC and BOTs from ovarian metastases.

Undifferentiated Carcinoma After Laparoscopic Surgery for a Cystic Ovarian Tumour: A Case Study

Background: Laparoscopic surgery for malignant tumours occasionally results in recurrence at the trocar insertion site or port-site metastasis (PSM). We report on a patient requiring emergency laparoscopic surgery for an ovarian tumour with a review of the relevant literature. Case Report: A 42-year-old woman developed sudden abdominal pain and underwent laparoscopic right adnexectomy because of a suspected ovarian cystic tumour rupture. The postoperative histological diagnosis was a mucinous borderline ovarian tumour; however, an undifferentiated carcinoma was detected at the port site eight months after the initial surgery. The histopathological diagnosis of the abdominal wall tumour at the port site differed from intraoperative pathological findings, which was contradictory to PSM definition. Postoperatively, she received three systemic chemotherapy courses but died consequent to tumour metastasis. Conclusion: This is an atypical PSM case with histopathological differences from the initial tumour. Careful preoperative diagnosis and intraoperative attention are essential in such cases.

Immature teratoma with a rare finding of choroid plexus

Mature cystic teratoma of the ovary is the most common ovarian tumour in young women. Immature teratoma is a very rare tumour, representing only 1% of all ovarian cancers. Paediatric ovarian tumours are rare, with a reported incidence rate of 2.2/100,000 in girls aged 0 to 15 years. In the case report presented here, was 12-year-old suspected to have serous cystadenoma of ovary based on CT scan, which was ultimately diagnosed with immature teratoma grade 3 after histopathological examination was done.

Huge mucinous cystadenoma of ovary in a reproductive female: an enigma

To report the occurrence of a rare case of a huge benign ovarian tumour (mucinous cystadenoma) in in a tertiary care rural teaching hospital in Konkan, Maharashtra, India. Our reported case was a young woman of reproductive age group which was very rare who presented with marked abdominal distension and discomfort at the obstetrics-gynaecology OPD of BKL Walavalkar rural medical college. The data were collected by history-taking, clinical examination, laboratory investigations, transabdominal ultrasonographic examination and by histopathological study of the excised surgical specimen. The case was reported as a rare massive ovarian mucinous cystadenoma in a woman of reproductive age group. This case report emphasized the significance of thorough evaluation of all women presented with vague abdominal pain and gradual abdominal distension in reproductive age group. Although the condition is extremely rare, women from rural area neglect such conditions and present late which may pose challenges in the management.