Background: Ovarian tumor and tumor like conditions are seen in women from early childhood to post-menopausal age. The ovaries are a pair of female sex glands responsible for the germ cell maturation, storage and release; cyclically. It also plays an important role in steroidogenesis. The ovaries are a totipotential structure and hence, neoplasms from all 3 germinal layers can be seen arising from it and manifesting clinically as ovarian tumors and tumor like conditions with its occurrence more during the late reproductive life. Ovarian tumors represent about 30% of all cancers of the female genital system. They manifesting in a wide spectrum of clinical, morphological and histological features.Methods: This is retrospective observational study where analysis of all cases which were encountered surgically during the period Mar 2012 to Mar 2017. The cases diagnosed as ovarian tumors were subjected to thorough investigation by CA125, ultrasound (USG) abdomen and pelvis and Computerised Tomography (CT) scan. Emergency presentations with twisted cysts were operated in emergency setting and histopathological examination (HPE) done to identify the nature of tumor. IHC was done wherever necessary to sub classify and confirm the histological diagnosis. Surgeries were done either by conventional laparotomy or by laparoscopy.Results: We have analyzed 175 cases retrospectively after histopathological diagnosis. The commonest lesions were ovarian cysts, out of which 63 cases (36%) were simple serous cyst adenomas followed by mucinous cyst adenomas 30 cases (17.14%). Germ cell tumors with struma ovarii were 34 cases (19.42%). The interesting part of the study was that we had a very high incidence of large endometriomas diagnosed as ovarian cysts before surgery 16 cases (9.4%). Two cases (1.14%) of ovarian malignancy were detected.Conclusions: The above study has revealed a spectrum of ovarian tumors over a wide age range from adolescent to late reproductive to menopausal and late menopausal age group. The incidence of malignancy was (1.14%).
Bilateral primary fallopian tube carcinoma is a very rare case scenario. Approximately, its incidence is 0.02% of all the gynecological malignancy. A 40-year-old female patient visited the hospital with complaints of lower abdominal pain for 3 months. Ultrasound of the pelvis shows complex bilateral adnexal lesions with ORADS score 4 – intermediate risk. The serum CA-125 is elevated. The provisional diagnosis of bilateral pyosalpinx was made. The uterus with bilateral ovaries and fallopian tubes was removed. On histopathology, thus, the final diagnosis of primary bilateral papillary serous carcinoma of the fallopian tube was made. Bilateral primary fallopian tube carcinoma is a very rare case scenario. Intraoperative frozen study is to be done to diagnose this entity. The high degree of suspicion is required to diagnose a case of bilateral fallopian tube carcinoma as it is a very rare case scenario and usually confused for pyosalpinx.
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