OVARIAN TUMOURS

Abstract

Objectives: To correlate preoperative diagnosis with operative findings
regarding the type of ovarian tumours. Material and Methods: Setting: Gynaecology Unit-I, Nishtar Hospital, Multan.
Sample size: 50 patients. Duration: One year from October 2001 to October 2002. Study Design: A prospective
analytical study. Results: Most common age group in benign tumours was 20-40 years. 50% of patients with malignant
tumours were between 30-50 years. Out of 50 patients, 33.3% benign tumours were in unmarried girls. Only 5% of
cancers were in nullipara, while 80% of patients had two or more children. Most common presenting symptom was
abdominal/pelvic pain. Abdominal distension was present in 75% of malignant cases. Pressure effects, metastatic
symptoms and general symptoms were more frequently seen in malignant than benign cases. On ultrasonography,
benign tumours were cystic in 83.3% of patients and 46% of these cystic tumours had either internal septations or
echoes. 85% of malignant tumours were either solid or mixed. Ascites was detected in 60% of cancers. Abdominal
ascites was found in 75% of malignant cases intra-operatively. Irregular tumours and those with surface adhesions
were more likely to be malignant. The accuracy of preoperative diagnosis was found to be 84%, 5 cases initially
considered malignant were later on found to be benign, while 3 cases diagnosed as benign preoperatively proved
malignant. Out of 50 cases, 46 (92%) cases were diagnosed as epithelial cell tumour on histopathology, while 4 cases
(8%) were germ cell tumours. Conclusion: It was concluded that identification of risk factors, detailed enquiry of the
presenting symptoms and proper clinical examination of the tumour provide important information about the type of
ovarian tumour. Ultrasonography is the best preoperative technique available to differentiate benign from malignant
ovarian tumours.