Clinicopathological and Prognostic Features of Ovarian Tumors – An Institutional Look

Abstract

Ovarian cancer is one of the most common malignancies in Pakistan. Due to high incidence and
mortality rate, it is important to determine changing trends in ovarian tumors in different settings.
Knowing histological subtypes, grading and staging of tumor also has prognostic significance. The present study
was carried out to determine histopathology and clinico-pathologic features of malignant ovarian tumors.
Methods: It is retrospective study of 80 cases of malignant ovarian masses in 3 years, received in Histopathology
Department of Pakistan Institute of Medical Sciences, Islamabad. Histological typing and grading of the tumor
was done according to WHO criteria. Undifferentiated tumors were identified using immunohistochemistry
panel. Different clinico-pathological parameters were assessed including age of the patient, peritoneal fluid
involvement ovarian surface involvement, omental metastasis, nodal involvement, and invasion of other adjacent
organs.
Results: 80 cases of malignant ovarian neoplasms were included. 51(63.7%) patients presented in age group 20-
40 years. Majority of the patients 45 (52%) presented with high tumor grade (poorly differentiated and
undifferentiated tumors). Most frequent tumors were surface epithelial tumors comprising 53 (66.2%) of all cases.
Serous cystadenocarcinoma was most common among epithelial tumors. Dysgerminoma was most common in
germ cell tumors comprising 21(26.2%) cases. Positive peritoneal fluid cytology for malignant cells was seen in
total 37(46.25) cases, most commonly in dysgerminoma. 17 (53.1%) cases of serous adenocarcinoma and 3 (50%)
cases of endometrioid carcinoma showed capsular invasion.
Conclusion: Higher frequency of ovarian tumors was seen in reproductive age group. Epithelial tumors were
most common in our setup, most frequent being serous cystadenocarcinoma. Peritoneal fluid cytology was
positive in majority of the patients being an important independent prognostic marker. Serous and endometrioid
carcinoma showed association with poor prognostic factors like capsular invasion and omental metastasis.