Histopathological Spectrum of Ovarian Tumors – A Descriptive Study.

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