The ovary is a complex structure from an embryologic, anatomic, and functional
stand-point. Therefore, it is not surprising that tumors originating 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 criteria employed are based upon the macroscopic
appearance, microscopic architecture, clinical behavior or histogenesis of the tumors. It is
not, 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 accurate information about the natural history of
a given tumor, thereby guaranteeing the possibility of optimal treatment. This collective
review will emphasize current treads 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 cases of all
age during the period of 12 years from 1961 to 1972. All specimens were fixed in 10%
formalin.
Gross observations were focused on the size of tumors, cystic or solid in consistency,
and capillary growth and locularity of epithelial tumors.
For histologic examination, paraffin embedded blocks were cut in 6 M thickness and
sections were stained by routine hematoxylin-eosin 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 mutinous 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, 358(78.991) were benign and 96(21.1%) wire malignant.
Metastatic tumors were 19 cases(4.2%) .
2. In histologic types, cystic teratomas(175, 38.5%) ranked first followed by mucinous
cystadenoma (93cases) and serious cystadenoma and serous cystadengcarcinoma in order
of frequency.
3. Benign ovarian tumors showed mean size of 11.0cm in maximum diameter, and
malignant tumors was 12.4cm.
4. No site predilection was identified with bilaterality 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 disturbance,
in order of frequency.
8. There were 31 intrauterine & 4 ectopic pregnancies which 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 in other reports, and mean age of
malignant of brian tumors, 41.9 years, is much younger than that of other reports(50
years).
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