Histopathological Profile of Primary Ovarian Lesions in Nnewi, Nigeria: A 5 Year Retrospective Study

Abstract

Background: This is the first base line research on different primary ovarian lesions in Histopathology department, Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi since the institution of the hospital.
Objectives: To determine the different patterns of ovarian lesions in relation to age and histopathological features and compare these patterns with local and international studies. The study will also highlight the most common histologic variants in our environment and make recommendations depending on the outcome of the research.
Methodology: The pathology report forms of all the gynaecological lesions in histopathology department NAUTH, Nnewi, were studied. The processed tissue and the slides stained with regular histochemical stain (Haematoxylin and Eosin) technique in this 5-year study period were reviewed by the researchers using multi-headed microscope (CARL ZEISS®).
Results: Of the 130 cases that were analysed, 91 (70.0%)cases were neoplastic while 39(30.0%) cases were non-neoplastic lesions. Benign neoplasms were the most common neoplasm and accounted for 56.0% (51 cases) followed by invasive malignant neoplasms with 31.9% (29 cases) while borderline and indeterminate tumours, were 3.3% (3 cases) and 8.8% (8 cases). respectively. Among the benign neoplastic lesions, mature cystic teratoma was the most common tumour (no= 22, 16.9%) with the patients’ mean age of 33.1 ±SD 13.0, followed by serous cystadenoma (no=15, 11.5%) with a mean age of 33.4 ±SD 12.9. However, high grade papillary serous cystadenocarcinomas (no=13, 9.8%) were the highest recorded invasive malignant lesions with a mean age of 49.8 ± SD 15.9) followed by choriocarcinoma (no.=5, 3.8%) with a mean age of 35.3 ±SD 9.7. Immature teratoma and mucinous cystadenocarcinoma were 4 (3.1%)cases each with mean ages of 20.8 ± SD 13.9 and 55.3 ± SD 14.3, respectively. Malignant germ cell tumours; immature teratoma and choriocarcinoma, formed only 28.1% of all germ cell tumours. Of the non-neoplastic lesions, corpus luteum cyst and follicular cyst were the most common with 11 cases (8.5%) and 10 cases (7.7%), respectively.
Conclusion: Ovarian neoplasia are quite diverse, and in our environment, benign lesions of the ovary were far more common than malignant cases and tend to occur at the reproductive age group. Surface –epithelial neoplasms were more common than germ-cell tumours with a ratio of 1.4:1. Majority of invasive malignant cases were high grade serous cystadenocarcinoma.

Keywords: Corpus luteum cyst, Follicular cyst, Teratoma, Cyst adenoma, Borderline tumour, Serous cystadenocarcinoma