Clinicopathological Analysis of 358 Ovarian Tumors from a Sub-Saharan African Country

Ovarian tumors are classified into 4 main groups: epithelial tumors, germ cell tumors (GCT), sex cord-stromal tumors (SCST) and metastatic tumors. Their clinicopathological features and biological behavior vary largely across age groups and World regions.

We retrospectively collected 358 cases of ovarian tumors diagnosed at our Pathology service in a tertiary care hospital (February 2020 - March 2024). We performed statistical comparison between clinical and histopathological groups (Student's t-test, Fisher exact and chi-square tests). We also performed logistic regression analysis to identify clinicopathological factors associated with malignancy in ovarian tumors (using odds ratio (OR) and 95% confidence interval (CI)).

The mean age was 37.1 years ± 15.9 (range of 4-81 years), with 38 cases (10.7%) from pediatric patients. Epithelial tumors and GCT were the most frequent tumors representing 52% and 34.6%, respectively. The majority of ovarian tumors were benign (283 cases, 79.1%) with 72 ovarian cancers (20.1%), representing 41.1% of all gynecological tract malignancies diagnosed at our department. Patients with adnexal torsions were younger than those without torsion and had larger cystic, left-sided tumors (p<0.05), irrespective of biological behavior (p˃0.05). Ovarian cancer was often found in older and post-menopausal women (mean ages of 48.35±16.56 years versus 34.2±14.40 years; 58.8% versus 15.7%; p<0.001). Ovarian malignant tumors were more often larger and heterogenous with mixed macroscopic aspect (mean size of 17.73±11.46 versus 13.40±8.71 cm; p=0.006; 56.9% versus 9.9%; p<0.001). The epithelial histological differentiation (OR = 5.08, 95% CI = 2.12-12.17, p<0.001) and the solid/mixed gross feature (OR = 36.93, 95% CI =14.91-91.47, p<0.001) were significantly associated with tumor malignancy.

We found that the clinicopathological features of ovarian tumors vary widely according to age groups, macroscopic aspects and histological differentiation. Ovarian cancer is often found in post-menopausal women with larger and heterogenous tumors compared to patients with benign tumors.