A DESCRIPTIVE STUDY ON OVARIAN MASSES IN ADOLESCENTS IN MCH, KOTTAYAM

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A DESCRIPTIVE STUDY ON OVARIAN MASSES IN ADOLESCENTS IN MCH, KOTTAYAM

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 93

Abstract

BACKGROUND It is recommended that greater use of imaging of the pelvis and tumour markers preoperatively is essential for evaluation of adolescent ovarian masses. There should be greater use of conservative expectant management or ovarian-sparing surgery in view of the low risk of malignancy in adolescent age group. The practice of removing ovaries for benign cysts may be overcome by appointing more gynaecologists with advanced training skills training in paediatric and adolescent gynaecology. The objectives of the study are1. To study the age related proportion, clinical and sonographic morphology of various ovarian masses in adolescence. 2. To correlate clinical, sonographic with Doppler velocimetry, tumour marker status, operative findings and the histopathology. 3. To identify the role of preoperative sonographic evaluation in deciding on the management. 4. To study the role of sonography in morphologic characterisation of benign versus malignant tumours of ovary and the extent to which it has influenced the management. MATERIALS AND METHODS The study which is an observational case series study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, during the period from January 2011 - June 2014. The age, sex and IP no. of adolescents of age 10 - 19 yrs. presenting at OPD and casualty with sonological evidence of ovarian masses are noted. If found with suspicious features, then only tumour markers and Doppler velocimetry are mentioned. The conservative or surgical managements done for them are recorded. If surgically managed, HPR are collected and analysed. RESULTS A total of 46 patients were included in the study. More number of cases fall in the age group of 17 - 19 yrs. and the most common presenting complaint was pain abdomen. 50% of the study group has a mass abdomen. Majority are benign masses and the commonest type was serous cystadenoma, which appear as simple cystic in USG. 87% of the solid and cystic masses in sonography came out as malignancy. Multiloculated cyst in USG turned out to be teratoma (60%) and mucinous type (30%). Only 50% of dermoid cyst correlated with ultrasound. Doppler was done in 33.3% of malignancies and was abnormal. Only 66.7% of abnormal results of tumour markers depicted malignancies. The intraoperative and pathological report correlate most in endometriotic cyst and yolk sac tumour (50%) and least with serous tumours (20%). 54.3% of them were benign epithelial tumours. All malignant tumours were germ cell tumours. Yolk sac tumours and mucinous tumours were distributed in early adolescence and teratoma and serous in late period. CONCLUSION Sonography is a simple, quick and non-invasive investigation found to be most accurate among the other tests for accounting the type of tumours. Most common histologic type in my study is serous cystadenoma. Clinical examination can clinch the diagnosis only to some extent in this age group.

Authors and Affiliations

Ranimol V. V, Deepa Mathews, Kunjamma M. A

Keywords

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EP ID EP279579
DOI 10.14260/jemds/2017/1467
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