Tayyiba Wasim, Ashraf Majrroh, Saqib Siddiq.
Comparison of clinical presentation of benign and malignant ovarian tumours.
J Pak Med Assoc Jan ;59(1):18-21.

Objective: To compare clinical presentation of benign and malignant ovarian tumours and to enlist and identify symptoms that could lead to early diagnosis of ovarian carcinoma. Methods: It was a consecutive case series study. All patients who on abdominal or bimanual examination and abdominal U/S were found to have ovarian cyst or tumour, and later underwent laparotomy were included. Results: The study included 110 patients, of whom 80 (72%) had benign and the rest malignant disease. Mean age of patients with malignancy was 49.07±18.5 years and for benign 36.95±8.2 years (p= 0.0001). Eleven patients with benign tumours were asymptomatic, while 66% had abdominal pain. On the other hand 70% patients with ovarian malignancy had abdominal symptoms with abdominal pain in (76%). Abdominal enlargement and abdominal mass were significantly more in malignant tumours (p=0.003, p= 0.005). Gastrointestinal symptoms were present in both groups but more significant in malignant group (p=0.004). Constitutional symptoms like loss of appetite and weight loss were only present in malignant group (p=0.001). Seventy percent of the malignant tumours presented at late stage (III & IV). Histopathology of benign tumours revealed follicular/luteal cyst in 32% cases while serous cyst adenoma in 23%. Histopathology of malignant tumours showed serous cyst carcinoma in 46.7% and mucinous cyst carcinoma in 26% cases. Conclusions: Ovarian malignancy is a silent killer, especially affecting women above 50 years. Although presentation is often vague and non specific, symptoms are definitely present. Therefore a proper bimanual examination and appropriate investigations should be done at the outset in post menopausal women (JPMA 59:18; 2009).

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com