Histopathological patterns and molecular alterations in surface epithelial ovarian tumors: A retrospective study from tertiary care centre in central India.

Dr. Aashish  Gupta; Dr. Amod  Kumar; Dr. Payal  Kumari; Dr. Monica; Dr. Sunil  Kumar

doi:10.51168/sjhrafrica.v6i12.2357

Authors

Dr. Aashish Gupta Associate Professor, Department of Pathology, Nalanda Medical College, Patna, Bihar, India.
Dr. Amod Kumar Associate Professor, Department of Pathology, Nalanda Medical College, Patna, Bihar
Dr. Payal Kumari Department of Pathology, Mahavir Cancer Sansthan, Patna, Bihar
Dr. Monica Associate Professor, Department of Microbiology, Motilal Nehru Medical College, Prayagraj, Uttar Pradesh, India.
Dr. Sunil Kumar Professor, Department of Pathology, Nalanda Medical College, Patna, Bihar

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2357

Keywords:

Ovarian, carcinoma, Histopathology, Immunohistochemistry, Tumor protein p53, Breast cancer susceptibility gene, Kirsten rat sarcoma viral oncogene homolog, AT-rich interactive domain-containing protein 1A

Abstract

Background

Surface epithelial ovarian tumors constitute the most common group of ovarian neoplasms and demonstrate marked heterogeneity in morphology, biological behavior, and molecular profile.

Objective

To evaluate histopathological patterns of surface epithelial ovarian tumors and correlate them with immunohistochemical and molecular alterations.

Methods

A retrospective cross-sectional study was conducted at a tertiary care teaching hospital in eastern India. All histologically confirmed surface epithelial ovarian tumors diagnosed between January 2020 and December 2023 were reviewed. Tumors were classified according to the WHO 2020 criteria. Immunohistochemistry panels were applied based on morphological suspicion. Targeted molecular analysis was performed in malignant tumors with adequate tissue to assess TP53, BRCA1/2, KRAS, BRAF, PIK3CA, ARID1A, and CTNNB1 alterations.

Results

Benign, borderline, and malignant tumours made up 32.8%, 14.4%, and 52.8% of the 180 cases, respectively. The most common type of cancer was high-grade serous carcinoma (61.2%). A TP53 mutation was found in 92% of high-grade serous carcinomas, and it was very similar to the abnormal p53 immunostaining. Eighteen percent of high-grade serous carcinomas had BRCA1/2 mutations. KRAS mutations were primarily identified in mucinous and low-grade serous tumours, whereas ARID1A loss and PIK3CA mutations were prevalent in endometrioid and clear cell carcinomas.

Conclusion

Different histomorphological patterns of surface epithelial ovarian tumours are closely linked to certain immunohistochemical and molecular changes. Combining morphology with targeted supplementary testing enhances diagnostic precision and enables tailored therapeutic approaches.

Recommendations

Routine integration of immunohistochemistry with targeted molecular testing is recommended in malignant ovarian tumors.

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