A study of ultrasonography findings in ovarian tumour at a tertiary health care centre

 

 

Abstract              Background: Ovarian cancer has been described as a silent killer because it is often diagnosed only in advanced stages, when the disease has spread beyond the ovaries. Ultrasound can provide much information about size, location and structure of pelvic masses and hence it is one of the diagnostic modalities in ovarian cancer. Aim and objective: To study the findings of ultrasonography in patients with ovarian tumour Methodology: Present study is a prospective study carried out on 50 patients of ovarian tumours referred to radiology department at a tertiary health care centre. Sociodemographic data, clinical history and clinical examination findings were taken from OBGY department records. Ultrasonography findings were noted. Data analysed with appropriate statistical tests. Results: Majority of the patients 18(36%) were having cystic + solid consistency followed by cystic consistency 16(32%). Benign ovarian tumours were having cystic consistency (47.06%). Most of the malignant tumour were having both cystic and solid consistency (62.5%). Association between tumour type and ultrasonography finding was found to be significant (p<0.001).

Key Word: ovarian tumour.

 

INTRODUCTION

The pathology of ovarian tumour is one of the most complex areas of gynaecology, because the ovaries give rise to greater range and variety of tumours than does any other organ. A female’s risk at birth of having ovarian tumour sometime in her life is 6-7%, of having ovarian cancer is almost 1.5% and dying from ovarian cancer is 1%.¹ A number of non neoplastic and neoplastic lesion occur within the ovaries. They can present from the neonatal age to post menopausal age. Most are functional in nature and fade away with minimal treatment. However, ovarian cyst can herald an underlying malignant process. When cyst are large, persistent, or painful, surgery may be required.^2,3 Benign ovarian cysts are the commonest constituting about 90% of ovarian tumours. Ovarian tumours are generally difficult to detect until they are of advanced stage or large in size. Ultrasonography is a relatively simple and noninvasive diagnostic method that provides clinicians with useful information relevant for determining the optimal management strategy for a given patient. Previous studies observed that Ultrasonography can accurately characterize about 90% of adnexal masses and the reported sensitivity and specificity of US for detecting ovarian malignancies is 88%-96% and 90%-96%, respectively ^4-6. Most of the patients with ovarian cancer remain asymptomatic until the late stage or they present only with vague, non-specific abdominal complaints. By the time diagnosis is made, the malignancy is in advanced stage and very little can be done to improve the prognosis. In such a clinical scenario, there is a genuine need of reliable diagnostic technique for early detection of the ovarian tumour as well as little discrimination of benign and malignant tumours and proper surgical management followed by chemotherapy or radiotherapy should be given.

Aim and objective: To study the findings of ultrasonography in patients with ovarian tumour

 

MATERIAL AND METHODS

Present study is an observational study carried out at a tertiary health care centre. Study population was patients attending OPD of OBGY department NDMC medical college and Hindurao Hospital Malkaganj Delhi 110007 and referred to radiology department for ultrasonography during study period January 2019 to December 2019. Patients having solid ovarian mass and suspected of having ovarian tumour were enrolled in the study.

Inclusion criteria: 1. All patients with solid ovarian mass detected clinically 2. All patients with cystic ovarian lesions more than 6 cms.

Exclusion criteria: 1. Ovarian cyst less than 6 cms with clear cysts 2. Patients not willing to participate in the study

Study was approved by ethical committee of the institute. A valid written consent was taken from the patients after explaining study to them.

All the patients admitted in the obstetrics and gynaecology department with ovarian tumour and referred to radiology department were studied. Data collected with pretested questionnaire. Data regarding sociodemographic data, clinical history and clinical examination were taken from records of OBGY department. All patients underwent ultrasonography of abdomen and pelvis. Ultrasound findings of the ovarian tumours were based on following features: 1.Bilateral lesion 2. Cystic mass 3.Evidence of solid areas 4. Cystic and solid masses 5. Evidence of metastasis. Data regarding histopathology of the tumour collected from department of OBGY.

Statistical analysis will be carried out with the help of SPSS (version 20) for Windows package (SPSS Science, Chicago, IL, USA).

RESULTS

In our study we studied 50 patients of ovarian tumour. In present study, most of the patients (36%) with ovarian tumour were in the age group 51 year old and above, followed by age group of 41-50 years (24%). Mean age of the patient was 46.34±3.2 years. Majority of the patients were para 2(30%) followed by para 3 (26%). Primipara patients were less (6%).

In our study, most common symptom was abdominal pain 46(92%) followed by abdominal mass 33(66%). Backache was seen 15(30%) patients. pressure symptoms were seen in 9(18%) patients. Pressure symptoms included increased frequency of micturation, retention of urine and GI symptoms like constipation. In present study, maximum cases were having unilateral ovarian tumours (64%). Table 3 showed findings of ultrasonography in ovarian tumour patients. Majority of the patients 18(36%) were having cystic + solid consistency followed by cystic consistency 16(32%). Solid consistency on ultrasonography were seen in 14(28%). Liver metastasis was seen in 2(4%) patients. Table 4 showed association of histopathological type of tumour and ultrasonography findings. In present study, based on ultrasonography findings most of the benign ovarian tumours were having cystic consistency (47.06%). Most of the malignant tumour were having both cystic and solid consistency (62.5%). 12.5% of the patients with malignant ovarian tumour had liver metastasis. Association between tumour type and ultrasonography finding was found to be significant (p<0.001).

CONCLUSION

On ultrasonography benign ovarian tumours are having cystic consistency and malignant tumours were having cystic+ solid consistency.

 

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