Histopathological Spectrum of Ovarian Tumors – A Descriptive Study.

Field: Medicine (Health Sciences)

Ovarian Cancer Is The Fifth Most Common Malignancy Among
Women And Second Most Common Gynecologic Malignancy. It Is The Most
Common Cause Of Death Due To Malignancy Of Female Genital Tract.1
Ovarian Malignancies Constitute About 4% Of The Total Cancers In Females
And 25% Of Malignant Tumors Of The Female Genital Tract.2 In India, The
Ovary Is Next In Importance To Cervix As The Seat Of Cancer Of Female
Genital Tract. Surface Epithelial Ovarian Tumors Constitute Two Thirds Of All
Ovarian Tumors And Malignant Forms Account For 90% Of Ovarian Cancers.3
They Exist In Different Histological Patterns And Exhibit Varying Degree Of
Aggressiveness.4
Ovary Is Subjected To Monthly Endocrine And Traumatic Insults
During Normal Ovulatory Cycles And Becomes Susceptible To
Tumorogenesis. Repeated Ovulatory Rupture And Repair Theoretically
Creates Opportunities For Malignant Gene Mutations. This May Explain The
Apparent Protective Effects Of Oral Contraceptives, Late Menarche, Early
Menopause, Multiparity, And Breast Feeding. Each Of These Factors
Decrease The Occurrence Of Ovulation.5 Although No Age Group Is Free
From The Tumors, Different Tumors Tend To Involve Different Age Groups
Preferentially. The Complex Anatomy Of The Ovary And Its Peculiar
Physiology With The Constant Cyclical Changes From Puberty To
Menopause Give Rise To Number Of Cell Types, Each Of Which Is Capable Of
Giving Rise To Tumors. Both Primary And Secondary Tumors Of The Ovaries
Are Relatively Frequent Showing A Variety Of Histopathological Patterns.6
Since Germ Cells Are Totipotential, It Is Not Surprising That A Very Wide
Variety Of Neoplasms May Develop From Them. Germ Cell Tumors Are The
Commonest Ovarian Neoplasms In Young Age Group And Constitute Two
Thirds Of Ovarian Tumors In This Age Group, Out Of Which One Third Are
Malignant. These Tumors Account For 25-30% Of All Ovarian Tumors, With
Great Majority Of Them In The Category Of Mature Cystic Teratoma, The Most
Common Variety Of Ovarian Neoplasm In Humans.3 Ovarian Tumors In
Children And Adolescent Girls Constitute An Important Part Of
Gynecological Oncology. Detection Of These Tumors At Such A Young Age
Creates Much Anxiety To Parents And Throws Up A Great Challenge To
Doctors In Charge As The Question Of Operative Safety, Chance Of
Malignancy And Prospects Of Future Child Bearing Associated With
Treatment. Practice Of Fertility Sparing Surgery, Replacement Of
Radiotherapy By Chemotherapy And Arrival Of Newer Chemotherapeutic
Drugs Has Made The Prognosis Much Better Today. The Main Aim Lies In
Distinguishing Ovarian Neoplasms From The Wide Spectrum Of Nonneoplastic
Lesions. Despite The New Techniques In Imaging And Clinical
Diagnosis, The Diagnosis Of Ovarian Tumors Is Primarily Dependent Upon
Histopathological Examination.
Determination Of Various Histologic Patterns Of Ovarian Tumors Is
Very Important In Diagnosis As Well As Prognosis Of Ovarian Tumors.
Prognosis Of The Tumors Can Also Be Predicted From The Degree Of
Differentiation Of The Tumors. The Stage And Laterality Of The Tumors Also
Indicates Their Nature For Example, Tumors In The Sex Cord Stromal
Category Are Almost Always Confined To A Single Ovary. On The Other Hand,
Approximately 65% Of The Metastatic Tumors Are Bilateral. In This Study, It
Was Aimed To Find Out The Histopathological Patterns Which Are More
Prevalent In Our Population And Whether They Are Significantly Different
From Other Populations.7 Their Characteristics With Regard To Age, Size,
Laterality, Gross Features Were Evaluated. Incidence Of Benign Versus
Malignant Tumors Was Also Studied.