Histopathological insights of ovarian lesions with clinical relevance: Experience from a high volume tertiary care centre

ABSTRACT: Introduction: Ovarian lesions encompass a broad histopathological spectrum, ranging from benign cysts to malignant neoplasms, often presenting with overlapping clinical features that complicate diagnosis. Accurate histological classification is essential for guiding therapeutic decisions and prognostication. This study aims to evaluate the clinical presentation and histopathological patterns of ovarian lesions encountered in a tertiary care center in the Konkan region of India, thereby contributing region-specific insights into their distribution and diagnostic relevance. Materials and Methods: A prospective cross-sectional study was conducted over two years at the Department of Pathology, BKL Walawalkar Rural Medical College, involving 112 cases of ovarian lesions. Specimens included resected ovarian masses, biopsies, and hysterectomy samples with salpingo-oophorectomy. Standard histological processing and haematoxylin-eosin staining were performed. Clinical data were retrieved from case sheets and histopathology records. Statistical analysis was carried out using Microsoft Excel to compute frequencies and percentages. Observations and Results: The majority of patients were aged 40–59 years, with pelvic pain and abdominal discomfort as predominant symptoms. Non-neoplastic lesions constituted 58.1% of cases, followed by malignant (27.7%), benign (10.7%), and borderline tumors (3.6%). Cystic morphology was most common, particularly in malignant tumors. Among neoplastic lesions, surface epithelial tumors were most frequent (68.1%), followed by germ cell tumors (23.4%) and sex cord stromal tumors (8.5%). Mature teratomas, endometrioid adenocarcinomas, and granulosa cell tumors were notable subtypes. CA-125 levels ≥35 U/ml were observed in 11.6% of cases, and biomarker/genetic testing was performed in 40.2% of patients. Conclusion: Non-neoplastic ovarian lesions were predominant, yet a substantial proportion of neoplastic cases occurred in the perimenopausal age group. Histopathological evaluation remains indispensable for accurate diagnosis and management. The study underscores the importance of integrating clinical, gross, and microscopic findings, with mature teratomas and sex cord stromal tumors emerging as key neoplastic entities in this regional cohort. These findings advocate for vigilant diagnostic protocols and timely intervention to improve patient outcomes Keywords: Ovarian lesions, Ovarian cysts, serous cystadenoma, CA-125