Epidemiological Trends, Clinical Characteristics and Outcomes of Ovarian Germ Cell Tumours at a Tertiary Hospital in Port Harcourt, Southern Nigeria

Abstract

Background: Ovarian germ cell tumours originate from the germ cell of the ovary. They are usually benign tumours, but occasionally can be malignant. The tumours are rare and commonly seen in young women. Aim: To determine the prevalence of ovarian germ cell tumours at the University of Port Harcourt Teaching Hospital (UPTH). Materials and Methods: This was a retrospective study of all cases of ovarian germ cell tumours managed at UPTH from 1st January 2013 to 31st December 2022. The case notes of the patients were retrieved, and data on socio-demographic characteristics, surgical options and management outcome, and the histopathology report was extracted and analysed. Results: There was a total of 5,322 gynaecological admissions over the study period, 515 of these admissions were ovarian tumours. There were 68 cases of ovarian germ cell tumours and of these, 61 patients’ case records were retrieved, giving the case retrieval rate of 89.7%. The prevalence of ovarian germ cell tumour was 13.2% and accounted for 1.3% of all the gynaecological admissions. The mean age of the patients was 27.15±7.60 years and the peak age of the disease was between 20 and 29 years which was 26 (42.6%) of the cases. The disease was highest amongst nulliparous women, 44 (72.1%). The most frequent presenting complaints were abdominal pain, 28 (45.9%) and abdominal swelling, 23 (37.7%). The condition involved the left ovary in 21 (34.4%) cases and the right in 20 (32.8%) cases. Twenty (32.8%) of cases involved both ovaries. Only 5 (8.2%) cases were malignant, while mature cystic teratoma accounted for 56 (91.8%) cases. The malignant variants were the immature cystic teratoma and yolk sac tumour, which accounted for 4 (6.6%) and 1 (1.6%) respectively.  Conclusion: The mature cystic teratomas were the commonest germ cell tumour seen in our environment and the most frequent presenting complaint was abdominal pain. It is important to emphasize that doctors should have a very high index of suspicion, whenever women present with recurrent gastrointestinal symptoms.