Ovarian neoplasm is the commonest condition observed in gynecology practice. Both non-neoplastic as well neoplastic ovarian tumors are common. In the present study neoplastic ovarian tumors were analyzed for their age of occurrence, site of ovary involved and histological typing. Oophrectomy/Hysterectomy and Oophrectomy was performed on patient suffering from ovarian tumors and the specimens were sent to Pathology department LMC &amp; Teaching Hospital for their histological study. The present study of 40 cases of ovarian neoplasm is from 2068/05/05 B.S. to 2070/05/30 B.S. The mean age of patient was 39 years with S.D of 1.25 years. The size of the tumor varies from 5 cm to 32.9 cm and weight varies from 41 gms to 350 gms. Commonest tumor was mature cystic teratoma (52.5 %) followed by serous cyst adenoma (30%). Not much difference was found for ovarian tumor regarding its site right and left ovary. Only two cases of malignant ovarian neoplasm were found in this study, one case (2.5 %) was of immature cystic teratoma and another (2.5 %) was of serous cyst adenocarcinoma

Jain, S K

Jain, Sushila

Paudel, Anuj

Journal of Lumbini Medical College

English

Ovarian neoplasm is the commonest condition observed in gynecology practice. Both non-neoplastic as well neoplastic ovarian tumors are common. In the present study neoplastic ovarian tumors were analyzed for their age of occurrence, site of ovary involved and histological typing. Oophrectomy/Hysterectomy and Oophrectomy was performed on patient suffering from ovarian tumors and the specimens were sent to Pathology department LMC & Teaching Hospital for their histological study. The present study of 40 cases of ovarian neoplasm is from 2068/05/05 B.S. to 2070/05/30 B.S. The mean age of patient was 39 years with S.D of 1.25 years. The size of the tumor varies from 5 cm to 32.9 cm and weight varies from 41 gms to 350 gms. Commonest tumor was mature cystic teratoma (52.5 %) followed by serous cyst adenoma (30%). Not much difference was found for ovarian tumor regarding its site right and left ovary. Only two cases of malignant ovarian neoplasm were found in this study, one case (2.5 %) was of immature cystic teratoma and another (2.5 %) was of serous cyst adenocarcinoma

Sushila Jain

S K Jain

Anuj Paudel

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Clinico-Pathological Study of ovarian tumors:  A two years study at LMC & Teaching Hospital, Tansen – 11, Parvas, Palpa.

Journal of Lumbini Medical College (JLMC)

70Original Article L M Coll J 2013; 1(2): 70-73Clinico-Pathological Study of ovarian tumors: A two years study at LMC & Teaching Hospital, Tansen – 11, Parvas, PalpaJain S, Jain SK and Poudel ADepartment of Obstetrics & Gynaecology, LMC Tansen-11, Parvas, PalpaCorresponding author:  Dr. Sushila Jain (MD), Lecturer in Obstetrics and Gynecology, Lumbini Medical College, Tansen-11, Parvas, Palpa, NepalABSTRACTOvarian neoplasm is the commonest condiƟ on observed in gynecology pracƟ ce. Both non-neoplasƟ c as well neoplasƟ c ovarian tumors are common. In the present study neoplasƟ c ovarian tumors were analyzed for their age of occurrence, site of ovary involved and histological typing. Oophrectomy/Hysterectomy and Oophrectomy was performed on paƟ ent suff ering from ovarian tumors and the specimens were sent to Pathology department LMC & Teaching Hospital for their histological study. The present study of 40 cases of ovarian neoplasm is from 2068/05/05 B.S. to 2070/05/30 B.S. The mean age of paƟ ent was 39 years with S.D of 1.25 years. The size of the tumor varies from 5 cm to 32.9 cm and weight varies from 41 gms to 350 gms. Commonest tumor was mature cysƟ c teratoma (52.5 %) followed by serous cyst adenoma (30%). Not much diff erence was found for ovarian tumor regarding its site right and leŌ  ovary. Only two cases of malignant ovarian neoplasm were found in this study, one case (2.5 %) was of immature cysƟ c teratoma and another     (2.5 %) was of serous cyst adenocarcinoma.Keywords: INTRODUCTIONOvarian cysts, both neoplasƟ c and non-neoplasƟ c are quiet common. No age is immune on developing ovarian tumors. Non-neoplastic cysts are mostly related to hormonal imbalance but neoplasƟ c ones are due to some geneƟ c and acquired causes. The tumors may arise from surface epithelium, germinal epithelium and stromal cells of the ovary. They are classifi ed on the basis of their origin. This study was carried out on clinically diagnosed ovarian tumors and its histological typing in Lumbini Medical College & Teaching Hospital.  MATERIALS AND METHODSThe study comprised of 40 numbers of ovarian tumors diagnosed in the Obstetrics & Gynecology department in LMC & Teaching Hospital from 2068/05/05 B.S to 2070/05/30 B.S. AŌ er obtaining clinical details regarding age and symptoms which were lower abdominal discomfort, dysmenorrhoea and irregular menstrual cycle. The operaƟ ve procedure Oophrectomy/Hysterectomy with Oophrectomy was done and specimens were subjected to Department of Pathology for their histological examinaƟ on.RESULTS  In the present study 40 cases of clinically diagnosed ovarian tumors were analyzed for age group, site of the ovary involved and histological typing of neoplasm. From the above table it appears that the maximum number of 12 cases (30 %) was found in age group of 31-40 years followed by 10 cases (25%) in the age group 41-50 years. PracƟ cally same incidences of 7 cases each (17.5%) were found in the age group of 21-30 years and 51-60 years. Mean age group for ovarian tumor was found to be 39 years with S.D of 1.25 years.So far the site of ovarian tumor is concerned the commonest site was right ovary 21 cases (52.5%) and leŌ  ovary 17 cases (42.5%). Bilateral ovarian involvement was found in only 2 cases (5%).Most common ovarian tumor in present study was Mature cystic teratoma 21 cases (52.5 %) followed by Serous Cyst adenoma 12 cases (30 %). Mucinous cyst adenoma was found in 4 cases (10 %). One case (2.5 %) each was of Brenner tumor (Benign type), malignant serous cyst adenoma and immature cystic teratoma. DISCUSSIONThe mean age for ovarian tumor in the present study was 39 years with S.D of 1.25 years.  The mean age for ovarian tumor of 38 years was reported by Pudasaini et al1 and 33 years by Ghimire et al.2 Commonest age for ovarian neoplasm in the present study was 31-40 years and pracƟ cally with the same incidence of 25 % with mean age group of 41-50 years. Youngest age group for ovarian neoplasm in the present study was 10-20 years (5%).71S Jain et alTable 1: Showing age groups of Ovarian TumorsS.N     Age Group (In Years) No. of cases        Percentage1 11-20 2 5%2 21-30 7 17.5%3 31-40 12 30%4 41-50 10 25%5 51-60 7 17.5%6 61- 70 2 5%Total no. of cases 40 100 %               Table 2: Ahowing the site of involvementS.N Site No. of cases Percentage1 Right 21 52.5 %2 LeŌ 17 42.5 %3 Bilateral 2 5 %                 Total 40 100 %Table 3: Showing the morphological types of ovarian neoplasmS.N Morphology No. of cases Percentage1 Serous cyst Adenoma 12 30 %2 Serous cyst adenocarcinoma 1 2.5 %3 Mucinous cyst adenoma 4 10 %4 Brenner’s Tumor (Benign) 1 2.5 %5 Mature CysƟ c Teratoma 21 52.5 %6 Immature CysƟ c Teratoma 1 2.5 %Total 40 100 %So far the site of ovary involved in ovarian neoplasm is concerned there was not much diff erence as compared to Right ovary (52.5%) and LeŌ  ovary (42.5%). Bilateral ovarian neoplasms were seen in only 5 % of cases in the present study. Bilateral ovarian tumors involvement was reported in 8.49 % of cases by Ghimire et al but its higher incidence of 18.6 % was observed by Pudasaini et al.1Benign ovarian tumors were common in present study (95 %). A similar incidence of 83.9 % was reported by Jha and Karki,3 87.3 % by Pudasaini et al and 89.42 % by Ghimire et al. Somewhat lower incidence of 72.9 % was reported by Gupta et al.4Germ cell tumor, mature cysƟ c Teratoma was commonest ovarian tumor 21 cases (52.5 %) in the present study. The mature cysƟ c teratoma was also observed to be commonest tumor by Jha et al, Ghimire et al, Thurlbeck WM et al,5 Peterson WF,6 Dhakal et al8 and Sha et al.9Surface epithelial tumors consisting of serous cyst adenoma, mucinous cyst adenoma and benign Brenner tumor were seen in 17 cases (42.5 %) in present study. Similar observaƟ on of 48.8 % has been reported by Gupta et al, 52.5 % by Jha and karki et al and 43.6 % by Ghimire et al. Yasmin et al7 has reported somewhat higher incidence of 76.5 %. Fig. 1: Immature cysƟ c teratoma showing the glial Ɵ ssue and choroid plexus, H&E stain 10XFig. 2: Serous cyst adenocarcinoma showing sheets of epithelial malignant cells with papillary formaƟ on. H&E stain 40X.Fig. 3: Mature cysƟ c teratoma showing epidermis and appendages. H&E stain 10XFig. 4: Benign Brenner tumor showing islands of transiƟ onal epithelium (Walthard nests) H&E stain 10X72Journal of Lumbini Medical CollegeOnly two cases malignant ovarian tumor, one surface epithelial tumor  Mucinous cyst adenocarcinoma (2.5 %) and one case of germ cell tumor  Immature cysƟ c teratoma (2.5 %) were observed in present study. Incidence of malignant immature teratoma of 9.43 % was observed by Ghimire et al.CONCLUSIONOvarian neoplasms were clinically seen from the age group of 15 – 60 years. Majority of the ovarian tumors were unilateral. Maximum numbers of ovarian neoplasm were benign germ cell tumor, mature cysƟ c teratoma followed by benign surface epithelial tumor serous cyst adenocarcinoma. Only two cases of malignant ovarian neoplasm were observed, one case was of immature cysƟ c teratoma and another case was of serous cyst adenocarcinoma.REFERENCES1. Pudasaini S, Lakhey M, Hirachand S, Akhter J, Thapa B. Astudy of ovarian cysts in a terƟ ary hospital of Kathmandu valley. Nepal Med Coll J 2011; 13(1): 39-412. Ghimire R, Ghimre PG, Goel RG. Histopathological spectrum of ovarian mass lesions: A three years study at Nepalgunj Medical College –Teaching Hospital. J Nepalgunj Med Coll 2012; 10(1): 22-5.3. Jha R and Karki S. Histopathological paƩ erns of ovarian tumors and their age distribuƟ on. Nepal Med Coll J 2008; 10(2): 81-5.4. Gupta and Bisht D, Agarwal AK, Sharma VK. RetrospecƟ ve and prospecƟ ve study of ovarian tumors and tumor -like lesions. Ind J Pathol Microbiol 2007; 50(3): 525-7.5. Thurblbeck WM, Scully RE. Solid teratoma of the ovary. A clinico-pathological analysis of 9 cases. Cancer 1960; 13: 804-11. 6. Peterson WF. Solid, histologically benign teratoma of ovary.  A report of four cases and review of literature. Am j Obstet Gynecol 1956; 72: 1094-1102.7. YasminS, Yasmin A, Asif M. Clinicohistological paƩ ern of ovarian tumors in Peshawor region. J Ayub Med Coll AbboƩ abad 2008; 20(4): 11-3.8. Dhakal HP, Pradhan M. Histological paƩ ern of gynecological cancers. J Nepal Med Assoc 2009; 48 (176): 301-5.9. Sah SP, Uprety D, Rani S.  Germ cell tumors of ovary in clincopathological study of 121 cases from Nepal. J Obstet Gynecol Res 2004; 30(4): 303-8.

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Clinico-Pathological Study of ovarian tumors: A two years study at LMC & Teaching Hospital, Tansen – 11, Parvas, Palpa.

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