32 4.4.4 Secondary ovarian tumours
Secondary ovarian tumours constituted the least number, (47) comprising 13.3% of malignant ovarian tumours and 5.4% of all ovarian tumours (Fig.15 & 16). Metastatic carcinoma was the commonest secondary ovarian tumour constituting (30) 63.9% of secondary tumour and 3.5% of total ovarian neoplasms followed by Burkitt Lymphoma which constituted (15) 31.9% of secondary tumour and 1.7% of total ovarian tumour (Table 9).
33 between 5 and 14 years of age. There was no case of malignant childhood ovarian neoplasm between 0 and 4 years of age.
The age distribution of the childhood ovarian tumours was as follows: four (16.7%) were found between 0-4 years, 6 (25%) between 5-9 years and 14 (58.3%) between 10- 14 years (Table10). The frequency of occurrence of the childhood ovarian tumours increased with increasing age, with the highest 14 (58.3%) occurring between 10-14 years age group.
34 Figure 1- Age distribution of 868 patients with ovarian neoplasms
35 Figure 2. Photomicrograph showing Mucinous Cystadenoma. Cysts lined by columnar cells with apical mucin. (Haematoxylin and eosin, X400)
36 Figure 3. Photomicrograph showing benign Brenner Tumour with nests of transitional epithelial cells (arrow) within the fibrocollagenous stroma. (Haematoxylin and eosin, X400)
37 Figure 4. Photomicrograph showing Borderline Serous Tumour (Haematoxylin and eosin, X100)
38 Figure 5: Photomicrograph showing Papillary Serous Cystadenocarcinoma disposed predominantly in papillary pattern (Haematoxylin and eosin, X400)
39 Figure 6: Photomicrograph showing Papillary Serous Cystadenocarcinoma disposed predominantly in papillary and cystic patterns with psammoma bodies (arrow) (Haematoxylin and eosin, X100)
40 Figure 7. Photomicrograph of a case of Mucinous Cystadenocarcinoma of the ovary showing extracellular mucin (arrow). (Haematoxylin and eosin, X100).
41 Figure 8. Photomicrograph of a case of Malignant Brenner Tumour of the ovary showing nests and sheet of malignant transitional epithelial cell within the fibrocollageneous ovarian stroma (Haematoxylin and eosin, X400).
42 Fig 9. Photomicrograph of a case of Mature Cystic Teratoma showing various tissue components- hair follicles, sebaceous glands, sweat glands and cartilage. (Haematoxylin and eosin, X100)
43 Figure 10. Photomicrograph of a case of Struma Ovarii showing presence of thyroid tissue in ovarian stroma. (Haematoxylin and eosin, X100)
44 Figure 11. Photomicrograph of a case of Choriocarcinoma showing a malignant
syncytiotrophoblastic and cytotrophoblastic cells with areas of haemorrhage and necrosis. (Haematoxylin and eosin, X100)
45 Figure 12. Photomicrograph of a case of Dysgerminoma showing tumour cells that are separated by fibrous septa containing mature lymphocytes (arrow). (Haematoxylin and eosin, X100)
46 Figure 13. Photomicrograph of a case of Yolk Sac Tumour showing tumour cells
arranged in microcystic and macrocystic patterns with Schiller-Duval body (arrow).
Haematoxylin and eosin, X100).
47 Figure 14. Photomicrograph of a case of Granulosa Cell Tumour showing tumour cells arranged in sheets punctuated by small follicle-like structures (Call-Exner bodies) (arrow). There are nuclear grooves. (Haematoxylin and eosin, X400)
48 Figure 15. Photomicrograph of a case of Metastatic Adenocarcinoma of the ovary
showing malignant tumour being composed predominantly of glandular pattern lined by columnar epithelial cells (Haematoxylin and eosin, X400).
49 Figure 16- Photomicrographs of a case of Burkitt Lymphoma showing classical starry sky appearance and neoplastic small non-cleaved lymphoid cells interspersed by histiocytes (Haematoxylin and eosin, X400)
50 Table 1- Age distribution of 821 patients with primary ovarian neoplasms (p=0.001) Age
(years)
Surface Epithelial Tumours
Germ Cell Tumours
Sex cord-Stromal Tumours
Malignant Mixed Mullerian Tumour
Total (%)
0-9 0 5 2 0 7 (0.9)
10-19 6 34 8 0 48 (5.8)
20-29 58 108 31 0 197 (24)
30-39 75 92 37 0 204 (24.8)
40-49 77 44 20 1 142 (17.3)
50-59 72 16 23 0 111 (13.5)
60-69 48 11 21 2 82 (10)
70 -79 19 3 1 0 23 (2.8)
80-89 4 0 1 0 5 (0.6)
90-99 0 0 2 0 2 (0.2)
Total (%) 359 (43.7) 313 (38.1) 146 (17.8) 3 (0.4) 821 (100)
51 Table 2- Age Distribution of 47 patients with secondary ovarian neoplasms (p=0.001) Age
(years)
Metastatic Carcinoma
Burkitt Lymphoma
Malignant Mixed Mullerian Tumour
Metastatic Leiomyosarcoma
Total (%)
0-9 0 2 0 0 2 (4.3)
10-19 0 10 0 0 10 (21.3)
20-29 2 2 1 0 5 (10.6)
30-39 9 1 0 1 11(23.4)
40-49 7 0 0 0 7 (14.9)
50-59 6 0 0 0 6 (12.8)
60-69 2 0 0 0 2 (4.3)
70-79 4 0 0 0 4 (8.5)
Total (%)
30 (63.9) 15 (31.9) 1 (2.1) 1 (2.1) 47 (100)
52 Table 3- Age distribution of 516 patients with benign/borderline ovarian neoplasms (p=0.000)
DIAGNOSIS
AGE (YEARS)
0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 Total Mature Cystic
Teratoma
4 25 95 88 40 14 10 3 0 279
Serous Cystadenoma 0 1 23 31 23 11 7 3 1 100
Mucinous Cystadenoma
0 4 12 13 8 6 2 1 0 46
Fibrothecoma 1 1 12 9 3 1 4 1 0 32
Fibroma 0 1 5 8 1 1 0 0 0 16
Brenner Tumour 0 0 1 2 1 5 5 0 0 14
Serous
Cystadenofibroma
0 0 4 1 2 5 0 0 1 13
Thecoma 0 0 2 2 0 0 1 0 0 5
Brenner Tumour and Mucinous
Cystadenoma
0 0 0 0 0 0 0 1 0 1
Carcinoid 0 0 0 0 1 0 0 0 0 1
Struma Ovarii 0 1 0 0 0 0 0 0 0 1
Leydig Cell Tumour 0 0 0 0 1 0 0 0 0 1
Sertoli Cell Tumour 0 0 1 0 0 0 0 0 0 1
Total Benign 5 33 155 154 80 43 29 9 0 510
Borderline serous tumour
0 0 1 1 0 0 1 0 0 3
Borderline mucinous tumour
0 0 1 0 1 0 0 0 0 2
Borderline Brenner tumour
0 0 0 1 0 0 0 0 0 1
Total Borderline 0 0 2 2 1 0 1 0 0 6
53 Table 4- Age distribution of 352 patients with malignant ovarian neoplasms (p=0.000)
DIAGNOSIS
AGE (YEARS)
0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 Total Serous
Cystadenocarcinoma
0 0 9 15 27 31 26 9 0 0 117
Granulosa Cell Tumour
1 6 11 18 15 21 16 1 0 2 91
Mucinous
Cystadenocarcinoma
0 1 7 10 14 11 2 5 1 0 51
Yolk Sac Tumour 1 5 5 2 1 0 0 0 0 0 14
Endometrioid Carcinoma
0 0 0 0 1 3 4 1 0 0 9
Immature Teratoma 0 1 3 1 0 1 1 0 0 0 7
Choriocarcinoma 0 1 3 1 1 0 0 0 0 0 6
Dysgerminoma 0 1 1 0 1 0 0 0 0 0 3
Primary MMMT 0 0 0 0 1 0 2 0 0 0 3
Malignant Brenner Tumour
0 0 0 1 0 0 0 0 0 0 1
Malignant Brenner and Mucinous Cystadenocarcinoma
0 0 0 0 0 0 1 0 0 0 1
Teratocarcinoma 0 0 0 0 0 1 0 0 0 0 1
Yolk Sac Tumour and Teratoma
0 0 1 0 0 0 0 0 0 0 1
Secondary Tumours 2 10 5 11 7 6 2 4 0 0 47
Total 4 25 45 59 68 75 54 20 1 2 352
54 Table 5. Correlation between location of Ovarian Neoplasms and age (p=0.287)
Age (years) Location Total (%)
Unilateral Bilateral
Right Left
0-9 3 5 1 9 (1.0)
10-19 27 20 10 57 (6.6)
20-29 89 69 43 201 (23.2)
30-39 89 73 53 215 (24.8)
40-49 57 49 43 149 (17.2)
50-59 51 44 23 118 (13.6)
60-69 36 28 21 85 (9.8)
70-79 6 7 14 27 (3.1)
80-89 3 1 1 5 (0.6)
90-99 1 1 0 2 (0.2)
Total (%) 362 (41.7) 297 (34.2) 209 (24.1) 868 (100)
55 Table 6. Frequency of Surface epithelial tumours (SET)
Histological subtypes
Frequency (% of SET)
% Total OT
Benign
Serous Cystadenoma Mucinous Cystadenoma Brenner Tumour
Serous Cystadenofibroma
Mixed Brenner Tumour and Mucinous Cystadenoma
174 (48.5) 100 (27.9)
46 (12.8) 14 (3.9) 13 (3.6) 1 (0.3)
20 11.5 5.2 1.6 1.4 0.1 Borderline
Borderline Serous Tumour Borderline Mucinous Tumour Borderline Brenner Tumour
6 (1.7) 3 (0.8) 2 (0.6) 1 (0.3)
0.7 0.3 0.2 0.1 Malignant
Serous Cystadenocarcinoma Mucinous Cystadenocarcinoma Endometrioid Carcinoma Malignant Brenner Tumour
Mucinous Cystadenocarcinoma and Malignant Brenner Tumour
179 (49.9) 117(32.6) 51 (14.2) 9 (2.5) 1(0.3)
1 (0.3)
20.6 13.5 5.9
1.0 0.1
0.1
Total 359 (100) 41.4
56 Table 7- Frequency of Germ Cell Tumours
Histological subtypes Frequency
(%GCT)
% Total ovarian tumour
Benign
Mature Cystic Teratoma
Carcinoid
Struma Ovarii
281 (89.8) 279 (89.2)
1 (0.3)
1 (0.3)
32.4 32.2
0.1
0.1
Malignant Yolk Sac Tumour
Immature Teratoma
Choriocarcinoma
Dysgerminoma
Mature Teratoma with squamous carcinoma
Mixed Yolk Sac Tumour with Mature Cystic Teratoma
32 (10.2) 14 (4.5)
7 (2.2)
6 (1.9)
3 (1.0)
1(0.3)
1 (0.3)
3.7 1.6
0.8
0.7
0.3
0.1
0.1
Total 313 (100) 36.1%
57 Table 8. Frequency of Sex Cord Stromal Tumours
Histological types Frequency (%
SCST)
% of Total ovarian tumour
Benign Fibrothecoma
Fibroma
Thecoma
Leydig Cell Tumour
Sertoli Leydig Cell Tumour
55 (37.7) 32 (21.9)
16(11)
5 (3.4)
1 (0.7)
1 (0.7)
6.3 3.7 1.8 0.6 0.1 0.1 Malignant
Granulosa Cell Tumour
Adult Granulosa Cell Tumour
Juvenile Granulosa Cell Tumour
91 (62.3) 91 (62.3)
80 (54.8)
11 (7.5)
10.5 10.5 9.2 1.3
TOTAL 146 (100) 16.8
58 Table 9. Frequency of Primary and Secondary Ovarian neoplasms
Ovarian neoplasms Frequency Percentage
Primary
Surface Epithelial Tumours
Germ Cell Tumours
Sex Cord-Stromal Tumours
Malignant Mixed Mullerian Tumours
821 359 (43.7)
313 (38.1)
146 (17.8)
3 (0.4)
94.6 41.4
36.1
16.8
0.4
Secondary
Metastatic Carcinoma
Metastatic Malignant Mixed Mullerian Tumour
Metastatic Leiomyosarcoma
Burkitt Lymphoma
47 30 (63.9)
1 (2.1)
1 (2.1)
15 (31.9)
5.4 3.5
0.1
0.1
1.7
Total 868 100.0
59 Table 10. Age distribution of Childhood ovarian neoplasms (p=0.361)
Histological subtypes Age (years) Total (%)
0-4 5-9 10-14 Benign
Mature Cystic Teratoma
Fibrothecoma
4 3
1
2 2
0
8 8
0
14 (58.3) 13 (54.2)
1 (4.1)
Malignant
Burkitt Lymphoma
Yolk Sac Tumour
Granulosa Cell Tumour
0 0
0
0
4 2
1
1
6 2
2
2
10 (41.7) 4 (16.7)
3 (12.5)
3 (12.5)
Total (%) 4 (16.7) 6 (25) 14 (58.3) 24 (100)
60 Table 11- Comparison of distribution of benign, borderline and malignant ovarian neoplasms seen in the present study with other studies
Author (year) Location of study Number Type of tumour Benign
(%)
Borderline (%)
Malignant (%) Sabageh et al
(2012)22
Ile-Ife, Nigeria 69 69.6 - 30.4
Onyiaorah et al (2011)18
Lagos, Nigeria 203 80.3 - 19.7
Pilli et al (2002)31 India 282 75.2 2.8 21.9
Ahmad et al (2000)23
Uttarakhand, Pakistan
855 59.2 3.3 40.8
Hassan et al (2014)16
Indian 131 66.4 9.2 24.4
Yasmin et al (2008)5 Peshawar, Pakistan 68 89.7 - 10.3
Swamy et al (2010)2 Chitwan, Nepal 120 71.6 3.3 25.1
Pradhan et al (2012)24
Dharan, Nepal 83 79.5 2.4 18.1
Nabi et al (2011)15 Lahore, Pakistan 150 74 1.3 24.7
Abdullah et al (2012)26
Jedda, Saudi Arabia
382 72.8 5.2 22
Makwana et al (2014)32
Gurarat, India 140 77.1 3.6 19.3
Ashraf et al (2012)30 Lahore, Pakistan 127 64.6 - 35.4
Jha et al (2008)27 Nepal 161 83.9 2.8 16.1
Gupta et al (2007)28 Meeru, India 96 72.9 4.1 22.9
Present study Ibadan, Nigeria 868 58.8 0.7 40.6
61 Table12. Comparison of Histological types seen in the present study with other studies Author (year) Number
of cases
Surface epithelial
Germ cell Sex cord stromal
Secondary Other tumours Sabageh et al
(2012)22
69 43.5% 40.6% 11.6% 4.3% -
Onyiaorah et al (2011)18
203 27.6% 52.7% 15.8% 3.9%
Pilli et al (2002)31
282 70.9% 21.2% 6.7% 0.7%
Ahmad et al (2000)23
855 63.5% 27.1% 5.8% 2.5% 1.1%
Hassan et al (2014)16
131 67.2% 26.7% 6.1% -
Yasmin et al (2008)5
68 70.9% 21.2% 6.7% 0.7%
Swamy et al (2010)2
120 61.6% 21.7% 11.7% 5.0%
Pradhan et al (2012)24
83 47% 45.8% 3.6% 3.6%
Nabi et al (2011)15
150 61.3% 32% 6% 0.7%
Abdullah et al (2012)26
382 61.0% 28.0% 7.6% 3.4%
Makwana et al (2014)32
140 65.7% 22.9% 9.3% 2.1%
Ashraf et al (2012)30
127 52.8% 43.3% 3.2% 0.8%
Jha et al (2008)27
161 52.2% 42.2% 3.1% 2.4%
Gupta et al (2007)28
96 48.8% 23.9% 8.3% 2.0%
Present study 868 41.4% 36.1% 16.8% 5.4% 0.4%
62 Table 13. Relative frequencies of the eight commonest benign ovarian tumours in the present study compared with other studies
Benign Ovarian neoplasms
Sabageh et al22
Ahmad et al 23
Pilli et al31
Hassan et al 16
Muzaffar et al 33
Nabi et al15
Abdullah et al 26
Makwana et al 32
Present study
Mature Cystic Teratoma
37.7% 20.8% 17% 25.8% 29% 26% 24.6% 18.6% 32.1%
Serous Cystadenoma
23.2% 34.3% 42.9% 19.8% 13.1% 28.7% 32.5% 35% 11.5%
Mucinous Cystadenoma
5.8% 10.8% 25.5% 13.7% 24.3% 14.7% 9.9% 9.3% 5.3%
Fibrothecoma 4.3% - - - - 0.7% - 1.4% 3.7%
Fibroma - 1.8% - - - - 4.7% - 1.8%
Brenner Tumour
- 0.5% - 3.1% 1.9% - - 2.1% 1.6%
Serous cystadeno-fibroma
1.4% 4.4% - - - - - - 1.5%
Thecoma - 0.9% - - - - - 0.6%
63 Table 14. Relative frequencies of the eight commonest malignant ovarian tumours in the present study compared with other studies
Malignant Ovarian neoplasms
Sabageh et al22
Ahmad et al 23
Pilli et al31
Hassan et al 16
Muzaffar et al 33
Nabi et al15
Abdullah et al 26
Makwana et al 32
Present study
Serous
Cystadenocarcinoma
8.7% 12.5% - 3.1% 7.5% 7.3% 7.3% 7.9% 13.5%
Granulosa Cell Tumour
7.2% 2.8% 6.7% 5.6% 1.9% 2.7% 1.8% 7.9% 10.5%
Mucinous
Cystadenocarcinoma
4.3% 6.4% - 13% 13.1% 5.3% 3.4% 3.6% 5.9%
Yolk Sac Tumour - 0.9% 1.8% 1.6% 1.9% 4.0% 1.0% 0.7% 1.6%
Endometrioid Carcinoma
- 4.9% - 4.6% - 2.0% - 2.9% 1.0%
Immature Teratoma - 0.7% - - 1.9% - 0.5% - 0.8%
Choriocarcinoma - 0.1% - - - - - - 0.7%
Dysgerminoma 1.4% 2.7% 2.5% 0.8% - 2.0% 1.0% 0.7% 0.3%
64 CHAPTER FIVE
DISCUSSION 5.1 General Findings
Five hundred and ten (58.8%) of the ovarian neoplasms in the current study were benign, 351 (40.6%) were malignant and 6 (0.7%) were borderline tumours. Similar studies in Ile-Ife, Nigeria carried out by Sabageh et al 22 showed 69.6% benign ovarian neoplasms and 30.4%
malignant tumours. Obed et al 43 from Maiduguri, Nigeria reported 79.3% benign, and 20.7% malignant ovarian neoplasms. In a study done by Onyiaorah et al 18 from Lagos Nigeria, 80.3% of total ovarian neoplasms were benign while malignant ovarian tumours constituted 19.7%. In India, Pilli et al 31 reported 75.2% benign, 21.9% malignant and 2.8%
borderline ovarian neoplasms. Similar studies in India carried out by Hassan et al 16 showed 66.4% for benign, 24.4% for malignant and 9.2% for borderline tumours whereas the figure was 74% for benign, 24.7% for malignant and 1.3% for borderline tumours in study by Nabi et al 15 from Lahore, Pakistan. In Saudi Arabia, Abdullah et al 26 reported 72.8% benign, 22%
malignant and 5.2% borderline ovarian neoplasms. In Nepal, a similar study by Pradhan et al
24 showed 79.5% benign, 18.1% malignant and 2.4% borderline ovarian tumours. Similar findings were also observed in a study done by Jha et al 27 from Nepal which showed 83.9%
benign, 16.1% malignant and 16.1% borderline ovarian tumours. In Uttarahand, Pakistan, similar findings were also reported by Ahmad et al 23 study which showed 59.2% benign, 40.8% malignant and 2.8% borderline ovarian tumours. In Peshawar, Pakistan, Yasmin et al 5 reported 89.7% benign and 10.3% malignant ovarian tumours. Table 11 shows a comparison of the findings in the present study with those of the other studies cited above.
65 Benign ovarian neoplasms outnumbered malignant ovarian neoplasm in the current study which is similar to what was observed in other studies. 2, 3, 15, 16, 18, 22, 23, 24, 26, 27, 30-32 This is in contrast to what was observed by Tyagi et al 44 where the malignant tumours outnumbered the benign ovarian tumours.
There was a lower figure of 0.7% for borderline ovarian neoplasms compared to what was observed by Hasan et al 16 from India where borderline ovarian tumours constituted 9.2%.
The finding was however similar to what was found by Nabi et al 15 where borderline ovarian tumours constituted 1.3% of total ovarian tumours. There was a higher figure of 40.6% for malignant ovarian neoplasms compared to what were observed by Yasmin et al 5, Jha et al 27 and Pradhan et al 24 where malignant ovarian neoplasms constituted 10.3%, 16.1% and 18.1% respectively. This finding is however similar to what was observed by Ahmad et al 23, Ashraf et al 30 and Sabageh et al 22 where malignant ovarian tumours constituted 40.8%, 35.4% and 30.4% respectively.
Primary ovarian neoplasms were found to be commoner (94.6%) than the secondary ovarian neoplasms (5.4%). This finding is similar to results of other studies. 2, 5, 15, 16, 22-24, 26, 27, 30-32, 43, 45, 46 Surface epithelial tumours constituted majority of the ovarian neoplasms with 359 (41.4%) cases followed by germ cell tumours of 313 (36.1%). Sex cord stromal tumours constituted 146 (16.8%) and 47 (5.4%) cases of secondary ovarian tumours were seen. These findings were similar to the results of many studies 2, 5, 15, 16, 22-24, 26, 27, 30-32, 43, 45, 46 where surface epithelial tumours were found to be the commonest ovarian neoplasms followed by germ cell tumours. These findings are however in contrast to what was observed by Onyiaorah et al 18 where germ cell tumours constituted the commonest (52.7%) ovarian
66 neoplasms followed by surface epithelial tumours constituting 27.6%. Table 12 shows a comparison of histological types of ovarian tumours seen in the present study with those in other studies.
Mature Cystic Teratoma was found to be the most common benign ovarian tumour constituting 54.7% of cases followed by serous cystadenoma comprising 19.6%. Mature Cystic Teratoma is the single commonest ovarian neoplasm constituting 32.1% of total ovarian tumours. The finding is similar to results of studies by Sabageh et al 22 from Ile-Ife, Nigeria and Obed et al 43 from Maiduguri, Nigeria where Mature Cystic Teratoma was found to be the commonest benign ovarian tumour constituting 37.7% and 25.0% of total ovarian neoplasms respectively. In Lagos, Nigeria Onyiaorah et al 18 reported Mature Cystic Teratoma as the commonest benign ovarian tumour constituting 60.1% of benign ovarian tumours.
Similar studies by Hassan et al 16, from India and Muzaffar et al 33 from Pakistan, showed Mature Cystic Teratoma as the commonest benign ovarian neoplasm constituting 25.8% and 29% of total ovarian tumours respectively. However these findings are in contrast to what was found by Ahmad et al 23, Pilli et al 31, Nabi et al 15, Abdullah et al 26 and Makwana et al
32 where Serous Cystadenoma was the commonest benign ovarian tumour constituting 34.3%, 42.9%, 28.7%, 32.5% and 35% of total ovarian tumours respectively. Table 13 shows a comparison of the relative frequencies of the eight commonest benign tumours in the present study with those in other studies.
In the current study, Serous Cystadenocarcinoma was found to be the commonest malignant ovarian tumour constituting 13.5% of total ovarian neoplasms. This finding is similar to the results of studies by Obed et al 34 and Sabageh et al 22 from Nigeria constituting 7.7% and
67 8.7% of total ovarian tumours respectively. Similarly, studies by Onyiaorah et al 18 and Umanah et al 47 showed Serous Cystadenocarcinoma to be the commonest malignant ovarian tumour constituting 42.5% and 50% of malignant ovarian neoplasms respectively. The finding is however in contrast to results of studies by Hassan et al 16 and Muzaffar et al 33 where the commonest ovarian neoplasm was found to be Mucinous Cystadenocarcinoma constituting 13% and 13.1% of total ovarian neoplasms respectively. Endometrioid carcinoma was found in this study to be 1% of total ovarian tumours. This finding showed a relatively lower incidence than what was found by Ahmad et al 23 and Hassan et al 16 where it constituted 4.9% and 4.6% of total ovarian tumours respectively. Table 14 shows a comparison of the relative frequencies of the eight commonest malignant ovarian tumours in the present study, with those in other studies.
The age range of cases in this study is 4-92 years with the mean age being 39.2years. Similar results were reported by Ahmad et al 23 and Pradhan et al 24. Pilli et al 31 and Sabageh et al 22 in their studies reported the youngest patients being 8 months and 12 months respectively.
The peak age of occurrence of ovarian neoplasms is in the fourth decade which is similar to the reports of Hasan et al.16
Benign ovarian neoplasms were found in the youngest patients (two cases of Mature Cystic Teratoma and one case of Fibrothecoma) while the oldest patient had malignant tumour (one case of Granulosa Cell Tumour). This finding is similar to reports from other studies 2, 18, 22, 23, 26 where benign tumours were seen in the youngest patients and malignant tumours in the oldest patients. This finding is however in contrast to what was found by Pradhan et al 24
68 where the youngest patient (10 years) was found to have presented with a Dysgerminoma (malignant) and the oldest patient (86 years) with serous cystadenoma.
The peak age incidence of benign ovarian tumours in this study was 20-29 years age group (3rd decade) with Mature Cystic Teratoma being the most frequent tumour which is similar to the report of Onyiorah et al.18 The peak age incidence of malignant ovarian neoplasms was 50-59 years age group (6th decade) with Serous Cystadenocarcinoma being the most common malignant tumour occurring in this age group. These findings are similar to reports of other studies.15, 22, 23, 26, 31, 32
Unilateral involvement (75.9%) of ovarian neoplasms was more common than bilateral involvement (24.1%) in the current study, and is similar to the findings of other studies.22, 24 Involvement of right ovary was 41.7% and was more than the left (34.2%) and is similar to what was found by Sabageh et al 22 and Tyagi et al. 44 This finding is however in contrast to what was found by Pradhan et al 24 where left ovarian involvement (65%) was more than the right (35%).