Histopathological spectrum of ovarian tumors in Jharkhand, India: A retrospective study

Abstract

Background: Ovarian tumors are the most prevalent neoplasms worldwide, affecting women of all ages. According to Globocan's 2022 projections, by 2050, the number of women diagnosed with ovarian cancer worldwide will increase by over 55% to 503,448. The number of women dying from ovarian cancer is projected to increase to 350,956 each year, an increase of almost 70% from 2022.

Aims and objectives: The aim of this study was to analyze the various histopathological spectra of ovarian tumors according to the latest 2020 WHO classification and to assess the age distribution, frequency of incidence, and laterality of different subtypes of ovarian tumors.

Materials and methods: This retrospective study included 190 cases of histopathologically proven ovarian tumors reported by the pathology department from March 2020 to March 2024 at the Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Results: A total of 190 cases were studied, 154 (81.1%) were benign, 8 (4.2%) were borderline, and 28 (14.7%) cases were malignant. Surface epithelial tumors (SETs) were the most common (n = 139, 73.2%), followed by germ cell tumors (GCTs) (n = 38, 20%). Serous cystadenomas (n = 63, 33%) were the most common benign tumors, whereas the most common malignant tumors were serous carcinomas ( n=11, 5.7% ). Most ovarian tumors (n = 45, 23.68%) occurred in the 31-40-year-old age group.

Conclusion: The present study showed various histopathological patterns of ovarian tumors. This study indicated a slight increase in the prevalence of malignant ovarian tumors in the middle-aged group and and a relative increase in the percentage of SETs over GCTs in recent years in our tertiary care center in Jharkhand, India. With limited resources in our institute, histopathological examination remains the mainstay for the early diagnosis of these tumors and their timlely and appropriate management.Categories: Pathology.

Keywords: Germ cell tumors; WHO; histopathological spectrum; ovarian tumors; surface epithelial tumors.

Figure 1

A Flowchart showing the overall methodology of the studyRIMS, Rajendra Institute of Medical Sciences

Figure 2

Distribution of the number of cases of ovarian tumors in different age groups

Image 1

Low grade serous carcinoma (a) H&E, 20X; Papillary pattern with tumor cells showing moderate nuclear atypia and low mitotic index. (b) H&E, 40X; Numerous psammoma bodies

Image 2

Benign brenner tumor (a) H&E, 20X; Nests of transitional epithelial cells surrounded by fibrous stroma. (b) H&E, 40X; A nest of transitional epithelial cells, with cells showing grooved nuclei (coffee bean appearance)

Image 3

Malignant brenner tumor (a) H&E, 20X; (b) H&E, 40X; Stromal invasion by clusters of tumor cells with irregular margins and single cells

Image 4

Yolk sac tumor (a) H&E, 20X; Schiller-Duval body. (b) H&E, 40X; Microcystic pattern: variable sized microcysts lined by primitive tumor cells with varying amounts of clear to eosinophilic cytoplasm. Few cells showing signet ring like morphology

Image 5

Adult granulosa cell tumor (a) H&E, 20X; Diffuse growth of tumor cells with angulated and pale nuclei. (b) H&E, 40X; Diffuse growth of tumor cells with angulated and pale nuclei. Few cells showing nuclear groove

Image 6

Krukenberg tumor (a & b) H&E, 20X; Signet ring cells with cytoplasmic mucin vacuoles infiltrating ovarian stroma

Image 7

Mature cystic teratoma (a) H&E, 20X; Intestinal glands within fibrous stroma. (b) H&E, 40X; Cartilage and fibroadipose tissue

Image 8

Clear cell carcinoma (a) H&E, 20X; Tubulocystic pattern : lined by a single layer of hobnail and cuboidal cells. (b) H&E, 40X; Solid pattern : nested cluster of polyhedral cells separated by delicate septa exhibiting clear to eosinophilic cytoplasm