Histopathological Spectrum of Ovarian Lesions at a Tertiary Care Hospital in Dhaka, Bangladesh

Abstract

Background: Ovarian lesions encompass a diverse range of non-neoplastic functional cysts and neoplastic tumors, arising from epithelial, germ cell, and stromal origins, posing diagnostic challenges due to their varied presentations mimicking pelvic masses. In developing countries like Bangladesh, underreporting limits data despite rising incidence trends observed in similar regions. Objective: This study aimed to evaluate the histopathological spectrum of both benign and malignant ovarian lesions in a tertiary care hospital in Dhaka, Bangladesh, to contribute valuable local and global data on their prevalence, age distribution, laterality, and clinical-pathological correlations. Materials and Method: A retrospective analysis of 274 histopathological reports from ovarian specimens (oophorectomies or salpingo-oophorectomies) was conducted at the Pathology Department, Medical College for Women and Hospital, Dhaka, using data from January 2023 to December 2024. Inclusion criteria encompassed adequate Hematoxylin and Eosin-stained slides with confirmed diagnoses and basic clinical data (age, side); exclusions were non-diagnostic, autolyzed, or non-ovarian cases. Data on demographics, clinical diagnoses, and pathology were analyzed descriptively using frequencies, percentages, and chi-square tests via SPSS version 26.0, following ethical approval. Results: The mean age was 35.45 ± 11.06 years, with 33.2% in the 40-49 group; lesions were left-sided (43.1%), right-sided (33.2%), or bilateral (23.7%). Pathologically, non-neoplastic cysts dominated: follicular (19.7%), corpus luteal (19.0%), endometriotic cyst (19.0%); benign tumors included serous cystadenoma (15.7%) and mature teratoma (12.8%). Benign lesions comprised 98.2% (269 cases), malignant 1.8% (5 cases, e.g., spindle cell sarcoma); a significant age association existed (p=0.013), with most under 50 years. Clinically, 53.6% were undiagnosed preoperatively. Conclusion: Functional cysts were predominant, followed by surface epithelial benign tumors; malignancies were rare, likely due to underreporting and lower life expectancy limiting elderly cases. Histopathological evaluation remains crucial for accurate diagnosis and management; further prospective studies with molecular markers are recommended to enhance ovarian lesion classification and awareness in Bangladesh.

J Med Coll Women Hosp.2026; 22(2): 148-158