Aisha Akbar, Ahmareen Khalid and Ashok Kumar
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.
Key Words: Ovarian tumors, Ovarian Malignancy, Serous Cysadenocarcinoma, Mucinous Cystadenocarcinoma, Dysgerminoma.