한국인 난소종양의 임상 및 병리조직학적 검색

Abstract

[한글]

Clinico-pathologic studies on ovarian tumors among Koreans

Jung Sil Cho

Department of Medical Science, The Graduate School Yonsei University

(Directed by Prof. Yoo Bock Lee, Dong Sik Kim,M.D.)

The ovary is complex structure from an embryologic, anatomic, and

functional-???ndpoint. Therefore, it is not surprising that tumors origination in

this organ are diverse, complicated, and often histogenetically poorly understood.

As a corollary, many ovarian tumors are difficult to diagnose. The complexity of

ovarian tumors becomes more understandable when it is realized that there is not

yet universal agreement as to the origin of such essential structures as germinal

epithelium, primordial germ cell, or graafian follicle wall. Tumors are the most

common type of lesion encountered in the ovary, and they are a common form of

neoplasia in women. Ovarian cancer ranks below only carcinoma of the breast, colon,

cervix, endometrium and stomach in the list of common malignancies in the female.

With respect to the reproductive tract alone, ovarian cancer accounts for about

one-fifth of malignant tumors that occur in this system. The classification of

these lesions presents a problem on which there is no unaminity of opinion. The

classification differ, depending upon whether the oriteria employed are based upon

the macroscopic architecture, clinical behavior or histogenesis of the tumors. It

is no, however, fundamentally different from classifications in recent studies on

this subject.

Pathologist is expected not only to make a correct microscopic diagnosis using

modern terminology but also to supply accruate information about the natural

history of a given tumor, there by guaranteeing the possibility of optimal

treatment. This collective review will emphasize current trends in the

classification of ovarian tumors, their incidence among Koreans, and comparative

incidence in other reports.

Materials and Method :

Primary and metastatic ovarian tumors were collected that occurred in 454

patients of all age during the period of 12 years from 11961 to 1972. All specimins

were fixed in 10% formalin. Gross observations were focused on the size of tumors,

cystic or solid in consistency, and papillary growth and locularity of epithelial

tumous.

for histologic examination, paraffin embedded blocks were out in 6M thickness and

sections were stained by routine hemato-xylin-sosin method. The classification of

ovarian tumors was based largely on current concepts and criteria for diagnosis.

It includes recognition of the relatively new category of borderline tumors in

the serous and mucinous categories.

Frequency of psammoma bodies in serous and mucinous tumors were examined for

comparison. Age, chief complaints, duration of symptoms and laterality were

analysed by means of clinical charts. Also ovarian tumors associated with pregnancy

and other lesions were accessioned.

Results and Summary:

Clinical and histopathological studies were made on 454 cases of primary and

metastatic ovarian tumors, that were submitted to the Department of Pathology,

Yonsei University, College of Medicine, during the period of 12 years, from 1961 to

1972.

1. Among 454 cases, 357(78.9%) were benign and 96(21.1%) were malignant.

Metastatic tumors were 19 cases(4.2%)

2. In histologic types. cystic teratomas(175, 38.5%) ranked first followed by

mucinous cystadenomo(93 cases) and serous cystadenoma and serous cystadenocarcinoma

in order of frequency.

3. Benign ovarian tumors showed mean size of 11.0cm in maxium diameter, and

malignant tumors was 12.4cm.

4. To Bite predilection was identified with bilsterality in 22 cases(6.4%)of

benign and 14 cases(31.3%) of malignant tumors.

5. Psammoma bodies and papillary growth were more frequently found in serous

types than in mucinous types.

6. Mean age of benign ovarian tumors was 35.2 years and malignant one was 41.9

years.

7. Clinical symptoms were abdominal pain, abdominal mass & menstrual distrubance,

in order of frequency.

8. There were 31 intrauterine & 4 ectopic pregnancieswhich were associated with

ovarian tumors. Among them, cystic teratomas were 26 cases.

In summary, these findings are comparable to other reports both in Korea and in

other countries, except that most frequent histologic type of all ovarian tumors in

this review, cystic teratoma(38.5%) ranks 3rd or 4th on other reports, & mean age

of malignant ovarian tumors, 41.9 years is much younger than that of other

reports(50 years).

[영문]

The ovary is complex structure from an embryologic, anatomic, and functional-???ndpoint. Therefore, it is not surprising that tumors origination in this organ are diverse, complicated, and often histogenetically poorly understood.

As a corollary, many ovarian tumors are difficult to diagnose. The complexity of ovarian tumors becomes more understandable when it is realized that there is not yet universal agreement as to the origin of such essential structures as germinal epithelium, primordial germ cell, or graafian follicle wall. Tumors are the most common type of lesion encountered in the ovary, and they are a common form of neoplasia in women. Ovarian cancer ranks below only carcinoma of the breast, colon, cervix, endometrium and stomach in the list of common malignancies in the female.

With respect to the reproductive tract alone, ovarian cancer accounts for about one-fifth of malignant tumors that occur in this system. The classification of these lesions presents a problem on which there is no unaminity of opinion. The

classification differ, depending upon whether the oriteria employed are based upon the macroscopic architecture, clinical behavior or histogenesis of the tumors. It is no, however, fundamentally different from classifications in recent studies on

this subject.

Pathologist is expected not only to make a correct microscopic diagnosis using modern terminology but also to supply accruate information about the natural history of a given tumor, there by guaranteeing the possibility of optimal treatment. This collective review will emphasize current trends in the

classification of ovarian tumors, their incidence among Koreans, and comparative incidence in other reports.

Materials and Method :

Primary and metastatic ovarian tumors were collected that occurred in 454 patients of all age during the period of 12 years from 11961 to 1972. All specimins were fixed in 10% formalin. Gross observations were focused on the size of tumors,

cystic or solid in consistency, and papillary growth and locularity of epithelial tumous.

for histologic examination, paraffin embedded blocks were out in 6M thickness and sections were stained by routine hemato-xylin-sosin method. The classification of ovarian tumors was based largely on current concepts and criteria for diagnosis.

It includes recognition of the relatively new category of borderline tumors in the serous and mucinous categories.

Frequency of psammoma bodies in serous and mucinous tumors were examined for comparison. Age, chief complaints, duration of symptoms and laterality were analysed by means of clinical charts. Also ovarian tumors associated with pregnancy and other lesions were accessioned.

Results and Summary:

Clinical and histopathological studies were made on 454 cases of primary and metastatic ovarian tumors, that were submitted to the Department of Pathology, Yonsei University, College of Medicine, during the period of 12 years, from 1961 to

1972.

1. Among 454 cases, 357(78.9%) were benign and 96(21.1%) were malignant. Metastatic tumors were 19 cases(4.2%)

2. In histologic types. cystic teratomas(175, 38.5%) ranked first followed by mucinous cystadenomo(93 cases) and serous cystadenoma and serous cystadenocarcinoma in order of frequency.

3. Benign ovarian tumors showed mean size of 11.0cm in maxium diameter, and malignant tumors was 12.4cm.

4. To Bite predilection was identified with bilsterality in 22 cases(6.4%)of benign and 14 cases(31.3%) of malignant tumors.

5. Psammoma bodies and papillary growth were more frequently found in serous types than in mucinous types.

6. Mean age of benign ovarian tumors was 35.2 years and malignant one was 41.9 years.

7. Clinical symptoms were abdominal pain, abdominal mass & menstrual distrubance, in order of frequency.

8. There were 31 intrauterine & 4 ectopic pregnancieswhich were associated with ovarian tumors. Among them, cystic teratomas were 26 cases.

In summary, these findings are comparable to other reports both in Korea and in other countries, except that most frequent histologic type of all ovarian tumors in this review, cystic teratoma(38.5%) ranks 3rd or 4th on other reports, & mean age

of malignant ovarian tumors, 41.9 years is much younger than that of other reports(50 years).