IJCRR

IJCRR - 7(8), April, 2015

Pages: 71-74

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BENIGN OVARIAN TUMOURS IN A TERTIARY CARE HOSPITAL IN NIGER DELTA, NIGERIA: A 10 YEAR HISTOPATHOLOGICAL STUDY

Author: Udoye Ezenwa Patrick, Kotingo Ebikabowei Lucky

Category: Healthcare

Abstract:Objectives: To determine the relative frequencies, types, subtypes and age distribution of Benign ovarian tumours and to compare the results with other local and international studies. Methodology: A 10 year retrospective analysis of Benign ovarian tumours diagnosed in the Anatomical Pathology Department of University of Port Harcourt Teaching Hospital from January 1998 to December 2007.
Results: Out of a total of 7529 surgical specimens received in the department within the study period, 166 (2.2%) were ovarian tumours. Of these 166 ovarian tumours, 128 (77.1%) were benign neoplasms. These 128 benign ovarian tumours formed 1.7% of the total surgical specimen received. The most common histological group was the germ cell tumours (67.2%), followed by surface epithelial tumours (25.8%) and sex cord-stromal tumours (7%). All the germ cell tumours seen were benign cystic teratoma, 86 (67.2%). The lowest age at which benign ovarian tumours occurred in this study was 4years while the highest age was 82years. Benign ovarian tumours peaked in the 21 \? 30 years age range, followed by 31- 40 years age range.
Conclusion: Ovarian tumours are more commonly benign in our environment with germ cell tumours being the most common histologic group unlike in Caucasians where surface epithelial tumours are more predominant. Benign cystic teratoma is very common in our locale unlike in Europe, North America and some parts of Asia where surface epithelial tumours are more common.

Keywords: Benign ovarian tumours, Cystic teratoma, Neoplasms, Histologic types

Full Text:

INTRODUCTION

The ovaries are female reproductive organs which are normally paired and located at both sides of the uterus, behind the broad ligaments and in front of the rectum1 . Each ovary is covered by a single layer of modified mesothelium known as surface, coelomic or germinal epithelium2 . All primary ovarian tumours tend to originate from one of the four structures that make up the composite ovarian organ notably the surface epithelial cells, the germ cells, the sex cords and the specialized ovarian stroma1,2. Interestingly, no other organ gives origin to a wide range of histogenetic tumours as the ovaries3,4. Benign cystic tumours of the ovaries are the fourth most common gynecological causes of hospital admissions5 . Worldwide figures show that about 80% of ovarian neoplasms are benign, occurring mostly in the 20 – 45 years age range2 . There is likelihood of increase in the incidence of ovarian tumours in the developing countries because of decreasing fertility rate and increasing use of ovulation induction drugs, among other factors, which thus calls for greater effort in the study of this tumour in these regions6 . No previous work has been done exclusively on the histopathological pattern of benign ovarian tumours in the University of Port Harcourt Teaching Hospital. In view of this and the need to have a comprehensive literature on ovarian tumours in Africa which will help us reappraise our dependence on western data, this study was carried out. The purpose of this study was to show the histopathologic pattern and age distribution of benign ovarian tumours and how they compared to results from other centres locally and outside Nigeria with the hope that this work would contribute to the literature on ovarian tumours in this country.

METHODOLOGY

This is a retrospective study based on histopathologically proven cases of benign ovarian neoplasms seen at the department of Anatomical Pathology of University of Port Harcourt Teaching Hospital over 10years. The original request forms and histopathology reports for all the ovarian neoplasms seen within the study period were retrieved and relevant clinical information and biodata were obtained. Clinical information and biodata unavailable on the request forms were obtained from the case files. The original slides of the entire benign neoplastic lesions were also retrieved and reviewed using the simplified version of W.H.O classification of ovarian tumours2 . Fresh sections of the missing slides were also taken from the tissue blocks and stained with Haematoxylin and Eosin, then reviewed. The results obtained were analyzed using simple descriptive statistical methods. Cases of benign ovarian tumours with incomplete biodata or those with missing slides and blocks were excluded. Ethical committee clearance: This study was duly approved by the ethics committee of the University of Port Harcourt

Teaching Hospital.

RESULTS

A total of 7529 surgical specimens were received in the department within the study period, 166 (2.2%) were ovarian tumours while 128 (1.7%) were benign ovarian neoplasms. Of these 166 ovarian neoplasms, 77.1% (128) were benign. The most common histologic group was the germ cell tumours which constituted 67.2% of all the benign ovarian tumours. Benign ovarian tumours were seen between the ages of 4years and 82years in this study and occurred mostly (41.4%) in the third decade (21 - 30years) followed by the fourth decade (31 - 40years) 23.4%. Frequencies for other age ranges are shown in Table 1. All the 86 germ cell tumours seen in this study were Benign cystic teratoma (BCT). BCT was also the most common histologic subtype of the benign ovarian tumours and occurred most in the 21- 30years age range. The surface epithelial tumours 25.8% were the second most common histologic group and were seen most in the 31- 40years age range. Serous cystadenomas (14) were the most common subtype of the surface epithelial tumours and also formed the second most common histologic subtype of all the benign ovarian tumours (10.9%). Other subtypes of surface epithelial tumours and their relative frequencies are also shown in Table 3. The sex cord-stromal tumours (9) were the least occurring histologic group of benign ovarian tumours forming only 7%. Eight out of the nine sex cord-stromal tumours were ovarian fibroma which occurred most in the 11 – 20 years age range.

DISCUSSION

In this study, benign ovarian tumours constituted 1.7% of the total surgical specimen received in the department over the study period, a figure which may suggest that these neoplasms are relatively uncommon in our locale.

Abbreviations

BCT: Benign cystic teratoma

W.H.O: World Health Organization

ACKNOWLEDGEMENTS

The authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. We also acknowledge Prof. S. O. Nwosu of the Department of Anatomical Pathology, University of Port Harcourt Teaching Hospital who supervised this work, a dissertation for the award of Fellowship of the National Postgraduate Medical College of Nigeria, 2011.

Source Of Funding No external source of funding.

Conflict Of Interest None declared.

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