Histomorphological Spectrum of Ovarian Lesions at a Rural Care Hospital in Gurugram

Background: The ovaries are paired intrapelvic organs of female reproductive system. It is unique in the variety of lesions that can arise from ovary as it is complex in its embryology, histology and steroidogenesis. The ovary consists of totipotent sex cord cells and multipotent mesenchymal cells. They are common site of non-neoplastic and neoplastic lesions. Some non-neoplastic lesions of the ovary usually present as a pelvic mass and mimic an ovarian neoplasm and thus posses a great challenge to gynecological oncologist and pathologist. Therefore their proper recognition and classification is important for appropriate therapy. Material and Methods: A prospective clinicopathological study of 58 cases of non-neoplastic and neoplastic lesions of ovary was conducted in Department of Pathology, FMHS, SGT University, Gurugram over the period of one years from June 2018 to June 2019. The materials for this study were oopherectomy specimen, ovarian cystectomies as well as hysterectomy with unilateral/bilateral salphingoopherectomy received from department of Obstetrics and Gynecology. The non-neoplastic and neoplastic lesions from representative sections were studied and classified according to World Health Organisation (WHO) and correlation of histopathological patterns with age, bilaterality, morphology and grading of the tumour was done. Results: A total of 58 cases were studied out of which 31 (53.45%) cases were non-neoplastic and 27 (46.55%) cases were neoplastic. Among the 31 nonneoplastic cases, the most common lesion found was simple cyst with 13 (41.94%) cases followed by corpus luteal cyst with 6 (19.35%) cases. Among the 27 neoplastic ovarian lesions, 17 (62.96%) cases were benign tumour, 2 (7.4%) cases were borderline tumour and 8 (29.64%) cases were malignant tumour. These tumours were classified according to WHO classification and categorised in three main groups. Surface epithelial tumours constituted the majority with 17 (62.98%) cases, followed by germ cell tumours which constituted 8 (29.62%) cases and sex cord stromal tumours constituted 2 (7.4%) cases. Conclusion: Ovarian cancers are called as “silent killer” as in most of the primary ovarian tumour they remain asymptomatic until the advanced stage. However, histomorphological study of tumour is still the gold standard method, these observations and results proved to be valuable base line information regarding frequency and pattern of ovarian tumours.