Histopathological diagnosis of ovarian mass

Materials and Methods: This is the retrospective study of patients with the ovarian masses at Ahvaz Imam Khomeini Hospital from 2010 2015. The relevant clinical details about the patient were retrieved from hospital data. Clinical characteristics of patients such as patient's age, presenting signs and symptoms, histopathological diagnosis, mass type, mass subtype, size of cysts and ovary which is involved were noted.


INTRODUCTION
Ovarian cysts are extremely common forms of gynecological problems in females of all age groups, 1  that can be range from physiological cysts to highly aggressive neoplastic lesions. 2  A woman's chance of getting ovarian cancer during her lifetime is about 6.0-7.0%3 and the lifetime risk of ovarian cancer in women with no family history is 1.6%.4  Ovarian cancer is the sixth most common female cancer 2 and the fifth most common leading cause of cancer death in women worldwide ranked after lung and bronchus, breast, colorectal, and pancreatic cancers in United States and causes half of the deaths from female reproductive system.8][9] Ovarian tumors are divided into three major categories: epithelial, germ cell, and sex cord-stromal tumors.10 and mostly, physiological cysts are follicular and luteal cysts. 116][7][8][9][10][11][12] Kayastha et al demonstrated the incidence of benign tumor as 90.5% in Nepal. 13Pradhan SB et al showed the incidence of benign ovarian tumors as 86.8 percent. 14In Iranian studies the incidence of benign ovarian tumors lies between 67-69.77 In this study, we aimed to find prevalence and frequency of different histopathological patterns of ovarian lesions and their correlation with various parameters in Ahvaz Imam Khomeini Hospital.In our study the age of the patients ranged from 2-78 years.

This
The age range varied in different studies.In Chanu et al, the age range was 18-83 years 19 and in the Danish et al, study it was 5-72 years. 18The age range in other study done in Iran was 11-85 years. 20 the present study, the incidence of tumor like conditions was 61.0%, and from all 39% of ovarian tumor obtained from histopatological examination, of which, benign tumors were 92.3% and malignant tumors were 7.7%.Similar to our finding Hassani et al reported 91.4% benign tumors and 8.6% malignant tumours. 20In a study done by Khatri et al, 68.0% of ovarian tumors were benign and 32.0% were malignant. 21The difference is probably because our study was undertaken in a referral hospital and malignant tumors diagnosed before surgery were referred to this center.
Most common benign tumor was mature cystic teratoma followed by serous cyst adenoma.Yogambal et al, 22 Yasmin et al, 23 and Hassani et al 20 found that the most common benign tumor was serous cyst adenoma which followed by mature cyst teratoma.Ahmed et al 24 and Pradhan et al 14 studies showed benign cystic teratoma was the commonest benign tumor.
In our study the most common presenting symptom was abdominal pain followed by abdominal mass and abnormal uterine bleeding.Similarly, Yogambal et al, 22 Yasmin et al, 23 and Rashid et al 25 observed abdominal pain followed by abdominal mass was the commonest presenting symptom.In contrast to our findings, S.N et al mentioned that menstrual irregularities/ abnormal vaginal bleeding followed by pain in abdomen was the most common clinical symptoms in women with ovarian tumors. 12 our study, 89.5% tumors were unilateral and 10.5% were bilateral.The incidence of unilaterality in S.N et al study (78.18%) was little less than our study. 12In a study done by Garg et al majority of the tumors were unilateral (95.3%). 9 In our study maximum number of ovarian tumors was noted in 21-30 years age group which concord with the study done by Pradhan et al. 14 However, Garg et al, 9 and Jindal et al. 26 observed that most common ovarian tumors were in 30-50 years age group.

CONCLUSION
In our study, benign tumors are more common than malignant tumors in all age groups.Germ cell tumors followed by surface epithelial cell tumors are the commonest class of tumors.Mature cystic teratoma was the most common tumor in our study followed by serous cystadenoma.Unilaterality is more frequently seen in ovarian tumors and various tumors are seen in various age groups.

Table 1 : Nutritional status of anemic children according to IAP classification
17gns and symptoms, histopathological diagnosis, mass type, mass subtype, size of cysts and ovary which is involved (unilateral or bilateral)were noted.All cases without complete records were excluded from the study.A total of 643 cases fulfilled the inclusion criteria.We reviewed all the present histopathology reports of the cases in the study (267 cases).The Ovarian cysts were classified according to World Health Organization (WHO) system for ovarian neoplasms.17Dataanalysiswasperformedbydescriptivestatistics (standard deviation, mean, percent, and frequency), chi-square (analysis of qualitative variables), Pearson's correlation and t test (quantitative variables analysis).RESULTSFrom the total 643 patients who enrolled in the study, only 267 specimens of ovarian tumor obtained for histopathological examination during period of January 2010 to March 2015.The average age of the patients was 32.41± 12.19(min: 2, max: 78).The mean age of patients with tumor like conditions was 30.48±10.66, with benign tumors was 35.46±13.79 and for women with malignant tumors, it was 35.12±14.7 years.The commonest presenting symptom in patients was abdominal pain (247 cases, 92.5%) followed by abdominal mass (7 patients, 2.6%), abnormal uterine bleeding (7 patients, 2.6%) and abdominal distention (6 cases, 2.2%).DOI :10.3126/jpn.v8i1.19448