Clinico-pathological survey on ovarian tumors at Severance hospital
Ovarian tumors are one of the many neoplasms seen in the practice of Gynecology. Because of the various types no basic etiology has been established. Numerous classifications have been devised based on etiology, histology and embryology but no one has been universally accepted by gynecologists or pathologists.
Only a few statistical surveys on ovarian tumors have been reported in Korea and even the small numbers of reports show great variation in their results.
The author undertook this study because of the importance of a clinico-pathologic survey of ovarian tumors as observed in Korea.
A clinico-pathological as well as statistical survey was made on a series of 230 ovarian tumors admitted, operated upon and confirmed with post-operative histopathological study at th Department of Obstetrics & Gynecology and Department of Surgery, Severance Hospital, Yonsei University during a period of 5 years and 7 months from January, 1961 to July, 1966.
The results obtained are as follows:
1. The incidence of benign tumors was 87.4% of all ovarian tumors while that of malignant ones 12.6%.
2. Age distribution of benign tumors was between 26-46 (Average 36 years), while that of malignant ones 31-59 (Average 45 years).
3. Menstruation was regular in 57.8%, irregular in 11.7% and the rest were amenorrheic. Patients with benign tumors had regular cycle in 59.7%, irregular in 11.4% while those with malignant tumors were regular in 44.8%, irregular in 11.7%.
4. Among the subjective symptoms complained of by the patient, 51.3% noticed a lower abdominal mass, 47.4% complained of lower abdominal pain and 15.6% had backache.
5. As to the objective signs among the ovarian tumors, ascites were observed in 27 cases (11.7%), cachexia in 6 cases (2.6%). In malignant tumors ascites and cachexia were noted in 65.5%, 20.7% respectively while in benign ones none had cachexia and only 3.9% had ascites.
6. The gross size of benign and malignant ovarian tumors were average 11 cm, 10.5 cm respectively while that of non-neoplastic cyst among the benign tumors was average 9.9 cm.
7. Of all the ovarian tumors 45.9% were noted in the right ovary, 33.8% in the left. Benign tumors were observed 51.3% in right ovary, 37.8% in left while among the malignant tumors 24.1% were in right, 17.2% in left. We can see the greater occurrence of tumors in right ovary in both the benign and malignant category.
8. The order of incidence of the benign tumors was dermoid cyst 30.4%, pseudomucinous cystadenoma 15.4%, simple cyst 14.4% and serous cystadenoma 11.4% while the incidence of the malignant ones was serous papillary cystadenocarcinoma 34.5%, Krukenberg tumor 24.1% and pseudomucinous cystadenocarcinoma 20.7%.
9. Among the neoplastic ovarian cysts dermoid cysts were bilateral in 14.8%, serous cystadenoma in 8.7% and pseudomucinous systadenoma in 6.4%.
10. The incidence of malignancy in the serous neoplasms, pseudomucinous ones and dermoid cysts was 43.5%, 19.4% and 1.6% respectively while the malignancy of all the ovarian tumors was 12.6%.