Ovarian Neoplasms among Sudanese Females: A clinicopathological Study

Introduction: Tumours of ovary are common form neoplasms in women. Diverse histopathologies are common in ovarian tumours reflecting the different cells origins of tumours. Determination of various histological patterns of ovarian tumours is very important in diagnosis as well as prognosis of ovarian tumours. Aims: The study is to determine the histopathological patterns of ovarian neoplasms and to show the distribution of age, residency, risk factors and clinical presentation in Sudanese females. Methodology: This is descriptive a retrospective study conducted on Sudanese females in the period from January 2009 to through January 2010 at the National Health Laboratory and Khartoum Teaching Hospital. The slides were done from tissue fixed in 10% formalin for 24 hours or more, handled according to histological protocol, embedded in paraffin wax, sectioned by microtome of 3-5mm thickness of sections, and stained by hematoxylin and eosin stain. Results: One hundred and forty three patients with ovarian neoplasms were included in the study. The commonest age group was 21- 30 years and the age for all patients range between 9-80 years. Ovarian neoplasms showed some geographical variation in Sudan. The majority of these cases were from Western and Northern regions. The most common symptoms were lower abdominal pain and abdominal enlargement. One hundred and eleven of the ovarian tumours (77.6%) are benign, and (22.4%) 32/143 are malignant. Surface epithelial stromal tumours were the most common 75/143 (52.4%), followed by the germ cell tumour 52/143 (36.4%). Mature cystic teratoma was the most benign tumour 46/111(41.4%), followed by serous cyst adenoma 44/111 (39.7%). Serous adenocarcinoma was the commonest malignant tumour 8/32 (25.0%), followed by granulosa cell tumour 7/32 (21.9%). For all age groups the benign tumours were more than malignant ones, the most benign ovarian tumours (38.2%) were seen in the age group 21-30 years but the most malignant tumours occurred above 40 years (51.6%). Conclusion: This study concluded that, the benign tumours were more common than malignant ones for all age groups. The age of most ovarian tumours were between 21 – 30 years old. Surface epithelial tumours were most common class of ovarian tumours, where germ cell tumours were next to it. Benign surface epithelial tumours being most common benign tumours and malignant ones being most malignant tumours. Considering individual tumours, mature cystic teratoma was the most common ovarian tumours overall, as well as most common benign tumour followed by serous cyst adenoma. Serous cyst adenocarcinoma was most common malignancy, followed by granulosa cell tumours. Malignant ovarian tumours were more common above 40 years. The presenting symptoms were lower abdominal pain and abdominal enlargement. Recommendations: Further in depth studies are highly recommended to be carried out for more evaluation of risk factors and find out the cause of high rate of the disease in this country. For unnecessary removal of the ovary, frozen section is recommended. Improvement of the cancer reporting and registration activity. Detailed histopathological diagnosis, grading and staging