Do women with benign versus malignant ovarian masses demonstrate variable clinical presentation?

Authors

  • Nilajkumar D. Bagde Department of Obstetrics and Gynecology, AIIMS, Raipur, Chhattisgarh, India
  • Madhuri Bagde Department of Gynecology, New Life clinic, Nagpur, Maharashtra, India
  • Sarita Agrawal Department of Obstetrics and Gynecology, AIIMS, Raipur, Chhattisgarh, India
  • Zamir A. Lone Department of Obstetrics and Gynecology, AIIMS, Raipur, Chhattisgarh, India
  • Nighat Hussain Department of Pathology, AIIMS, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205757

Keywords:

Ovarian tumors, Clinical features, Cancer, Oncology, Gynecology, Gynec-oncology

Abstract

Background: Early diagnosis of ovarian tumors is a challenge due to variable presentation. Early diagnosis of ovarian cancers aids in timely management and better clinical outcomes. Aim of study was to determine the different clinical presentations of ovarian tumors and compare those in benign tumors versus malignancies.

Methods: Clinical data of all women operated for ovarian masses was extracted from case files at a tertiary care centre and evaluated and clinical features compared in women with benign versus malignant tumors.  

Results: We found 50 cases of ovarian tumors with 26% malignancies. The mean age was 38.48+14.9 years. Malignancies were significantly common in menopausal than menstruating (χ2=13.57, p=0.001, fishers exact). Pain was the commonest symptom and combined lumbar and iliac pain was reported in 67% cases. The location of pain was not significantly different in women with malignancy compared to those with benign tumors (likelihood ratio χ2=7.93, p=0.24). The odds of reporting a mass in abdomen were significantly greater in women with cancers than benign tumors (OR= 4.9, 95%CI 1.07-24.06, p=0.01). More women with cancer had history of distension of abdomen compared to women with benign tumors (χ2=9.43, p=0.002).

Conclusions: Lumbar pain is most frequent complaint in women with ovarian pathology. Symptoms of distension in abdomen or presence of lump in abdomen are a significant guide to alert the physician regarding possibility of malignancy must be evaluated without delay.

Author Biographies

Nilajkumar D. Bagde, Department of Obstetrics and Gynecology, AIIMS, Raipur, Chhattisgarh, India

Associate Professor, Department of Obstetrics and Gynecology

Madhuri Bagde, Department of Gynecology, New Life clinic, Nagpur, Maharashtra, India

Consultant Gynecologist, Department of Obstetrics and Gynecology

Sarita Agrawal, Department of Obstetrics and Gynecology, AIIMS, Raipur, Chhattisgarh, India

Professor, Department of Obstetrics and Gynecology

Zamir A. Lone, Department of Obstetrics and Gynecology, AIIMS, Raipur, Chhattisgarh, India

Resident student, Department of Obstetrics and Gynecology

Nighat Hussain, Department of Pathology, AIIMS, Raipur, Chhattisgarh, India

Department of Pathology

References

Hassan AY, Ellatif a AAA, Darweesh FF. Two-dimensional ultrasound and doppler in assessment of adnexal masses in correlation to histopathological analysis. Acad J Cancer Res. 2014;7(1):8-18.

Takiar R. Status of Ovarian Cancer in India. EC Gynaecol. 2019:358-64

Murthy NS, Shalini S, Suman G, Pruthvish S, Mathew A. Changing trends in incidence of ovarian cancer - the Indian scenario. Asian Pac J Cancer Prev. 2009;10(6):1025-30.

Sharadha SO, Sridevi TA, Renukadevi TK, Gowri R, Binayak D, Indra V. Ovarian masses: changing clinicohistopathological trends. J Obstet Gynaecol Ind. 2015;65(1):34-8.

Topuz S, Saygili H, Akhan S, Yavuz E, Turfanda A, Berkman S. Differentiation of benign and malignant adnexal masses: value of a morphologic scoring system. Eur J GynaecolOncol. 2005;26(2):209-12.

Margaret PF, Kirubamani VNH. Clinical correlation of ovarian mass with ultrasound findings and histopathology report. Int J Reproduct Contracept Obstet Gynecol. 2020;2017:5230-4.

Okugawa K, Hirakawa T, Fukushima K, Kamura T, Amada S, Nakano H. Relationship between age, histological type, and size of ovarian tumors. Int J Gynecol Obstet. 2001;74:45-50.

Simsek HS, Tokmak A, Ozgu E, Doganay M, Danisman N, Erkaya S et al. Role of a risk of malignancy index in clinical approaches to adnexal masses. Asian Pac J Cancer Prev. 2014;15(18):7793-7.

Cramer DW. Epidemiologic aspects of early menopause and ovarian cancer. Ann N Y Acad Sci. 1990;592:363-75;390-4.

Chirdchim W, Wanichsetakul P, Phinyo P, Patumanond J, Suwannarurk K, Srisomboon J. Development and Validation of a Predictive Score for Preoperative Diagnosis of Early Stage Epithelial Ovarian Cancer. Asian Pac J Cancer Prev. 2019;20(4):1207-13.

Ghartimagar D, Ghosh A, KC G, Ranabhat S, Talwar O. Surface epithelial tumors of ovary - an analysis in a tertiary referral hospital. J Psychiat Neurosci. 2013;3(5):397-02.

Kanthikar S, Dravid N, Deore PN, Nikumbh D, Kishor S. Clinico-Histopathological Analysis of Neoplastic and Non-Neoplastic Lesions of the Ovary: A 3-Year Prospective Study in Dhule, North Maharashtra, India. J Clinic Diagnost Res. 2014;8.

Baru L, Patnaik R, Singh K. Clinico pathological study of ovarian neoplasms. Int J Reproduct Contracept Obstet Gynecol. 2017;6(8):3438-44.

Radhamani S, Akhila MV. Evaluation of Adnexal Masses - Correlation of Clinical, Sonological and Histopathological Findings in Adnexal Masses. Int J Scientif Stud. 2017;4(11):88-92

Kuladeepa AVK, Muddegowda PH, Linegowda JB, Doddikoppad MM, Basavaraja PK, Hiremath SS. Histomorphological study of 134 primary ovarian tumors. Adv Lab Int Med. 2011;1(4):69-82.

Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. J Am Med Assoc. 2004;291(22):2705-12.

Ebell MH, Culp MB, Radke TJ. A Systematic Review of Symptoms for the Diagnosis of Ovarian Cancer. Am J Prev Med. 2016;50(3):384-94.

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Published

2020-12-26

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Original Research Articles