Histomorphological Evaluation of Tumours of Female Genital Tract and Its Change in Tumour Profile Over a Period of 12yrs in a Tertiary Care Referral Hospital in Chennai.

Abstract

Background: The most common cause of morbidity & mortality among females are due to cancers arising from female reproductive organs next to breast cancers. The most common sites include uterine cervix, corpus uteri & ovary followed by least common sites like vulva, vagina, fallopian tubes and gestational trophoblastic diseases. Aim of the study: 1. To evaluate the trend in the prole of benign, premalignant & malignant lesions of female genital tract (FGT) tumours at primary tertiary care hospital in Chennai. 2. To study frequency, age distribution & diverse histomorphological spectrum of tumours of female genital tract. 3. To compare and analyze our data with other published studies in the literature. Materials & Methods: This cross sectional retrospective observational study was conducted at tertiary care gynaecological center at Chennai over a period of 12 years from Jan 2008 to Dec 2019. The medical records were retrieved, data analyzed and the results were expressed in descriptive statistics. Results: During the study period we received 44752 histopathological specimens out of which 12477 cases were gynaecological malignancies. Cervix uteri (66.38%) was the most common site followed by ovary (16.65%), corpus uteri (10.71%), gestational trophoblastic disease (4.13%), vulva (0.82%), vagina (0.36%), fallopian tube (0.02%), and vault carcinoma (0.93%). Squamous cell carcinomas were most common type of malignancy in cervix (93.15%), vulva (91%), vagina (82%) & vault (78%). Endometrial adenocarcinomas (81%) were more frequent tumour in corpus uteri while surface epithelial tumours constitute 78.72% of cases in ovary. For gestational trophoblastic disease, 78.25% of cases had complete molar pregnancy. 41-50yrs of age groups were commonly affected for cervical, ovarian & endometrial malignancies where as in vulval lesions the most common age group was 61-70yrs. In case of gestational trophoblastic disease the majority of patients were presented at 21-30yrs of age. Conclusion: This is one of the largest studies conducted with more than 10000 cases being reported in female genital tract. Cervical carcinomas are the leading gynecological malignancy followed by ovary & corpus uteri at our institute. There is a declining trend in the distribution of cases among cervical cancers were as there is an increasing trend in distribution of cases in other site like ovary & corpus uteri.