Rajiv Gandhi University of Health Sciences Karnataka



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA

BANGALORE

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

|1 |Name of the candidate and address ( in block letters) |: |DR.SAVITA.PATIL, |

| | | |DEPARTMENT OF PATHOLOGY, |

| | | |MAHADEVAPPA RAMPURE MEDICAL, COLLEGE,GULBARGA-585105 |

| |Permanent address |: |DR.SAVITA.PATIL, |

| | | |C/O.N.D.PATIL, |

| | | |H.NO:10-3/49, |

| | | |N.V.LAYOUT,VITTAL NAGAR, |

| | | |GULBARGA-585103 |

|2 |Name of the institution |: |H.K.E. SOCIETY’S MAHADEVAPPA |

| | | |RAMPURE MEDICAL COLLEGE, |

| | | |GULBARGA – 585105 |

|3 |Course of study and subject |: |M.D.PATHOLOGY |

|4 |Date of admission to the course |: |10TH JUNE 2011 |

|5 |Title of Topic |: |“STUDY OF HISTOMORPHOLOGICAL FEATURES OF OVARIAN TUMOURS” |

|6 |Brief Resume of the intended work |

| |6.1 |Need for the study |

| | |Ovaries are one of the commonest sites of neoplastic lesions and ovarian cancer is the sixth most common cancer and the |

| | |seventh leading cause of cancer deaths among women worldwide. Ovarian cancer has the worst prognosis among all gynaecological|

| | |malignancies. (1) |

| | |Among cancers of the female genital tract, the incidence of ovarian cancer ranks below only carcinomas of the cervix and the |

| | |endometrium . (2) |

| | |As per the surveillance epidemiology and end results (SEER) cancer statistics based on the rates from 2007-2009, about 1 in |

| | |every 72 women have a life time risk of developing ovarian cancer.( 3) |

| | | |

| | |Ovarian tumours include a complex wide spectrum of neoplasm involving a variety of histological diagnosis ranging from |

| | |epithelial tissues, connective tissues, specialized hormone secreting to germinal and embryonal cells, Histomorphological |

| | |classification of ovarian tumours forms an integral part of the evaluation of these neoplasms.(2,4) |

| | | |

| | |This study was chosen, with special interest to learn the histomorphological spectrum of ovarian tumours and aims at |

| | |diagnosis and finding the incidence of these diseases with respect to different age groups. |

| |6.2 |Review of Literature |

| | |Ovary is a complex organ in terms of its embryology, histology, steroidogenesis and malignancy( 5). |

| | | |

| | |The pathogenesis of ovarian cancer is multifactorial, hereditary causes account for 5%-10% of the total cases. The remaining |

| | |90% of ovarian cancer cases are sporadic and occur in a predominantly older,postmenopausal population. .Multiple factors |

| | |that affect prognosis include tumor stage,histologic type,tumor grade,amount of residual disease after the initial |

| | |cytoreductive surgery,and patient characteristics such as age,performance status .Histological classification of ovarian |

| | |tumours along with clinical stage forms an integral part of evaluation of optimum mode of therapy( 6). |

| | | |

| | |1973 saw a major development in the form of the world health organization (WHO) classification of ovarian tumours based on |

| | |the histogenesis . Microscopic examination is critical for predicting tumor behaviour and deciding the best therapeutic |

| | |approach.such examination includes the assessment of specific histologic type ,extent of disease and the grading of tumor |

| | |differentiation.(7) |

| | | |

| | |Diagnosis of ovarian tumors can be difficult due to a variety of pathologic conditions that can affect the ovaries and |

| | |present with similar clinical and radiologic manifestations, knowledge of morphology and age-specific characteristics can |

| | |help refine the diagnosis( 8). |

| | | |

| | |A 10-year study comprising 957 cases of ovarian tumor,showed most benign tumors occurring between 20 &40 yrs of age ,while |

| | |the malignant lesions presented between 41 & 50 yrs ,germ cell tumors were encountered in younger age group( median age 19 |

| | |yrs),the most common histologic type was serous cystadenoma, serous cystadenocarcinoma predominated the malignant group |

| | |,dysgerminoma predominated the malignant germ cell group.serous tumor was the commonest borderline epithelial |

| | |tumor.metastatic tumors were found to involve the bilateral ovaries in 72% cases( 8). |

| |6.3 |Objectives of the study |

| | | |

| | |To classify different types of tumors of ovary as benign, borderline and malignant . |

| | |To study the histomorphology of various types of benign, borderline and malignant ovarian neoplasms. |

| | |To study the age and distribution of ovarian neoplasm. |

|7 |Materials and methods |

| |7.1 |Source of data |

| | |Surgical specimens of oophorectomy and pan-hysterectomy received in the department of pathology, M.R.Medical college, |

| | |Gulbarga, from Basaweshwar Teaching and General Hospital, Sangameshwar hospital, peripheral hospitals and other private |

| | |hospitals and laboratories in Gulbarga. |

| | | |

| |7.2 |Methods of collection of data |

| | |All specimens of ovarian tumors will be reviewed ,clinical and morphological details will be taken from records ,the |

| | |specimens will be processed by routine histopathological techniques. The excised specimens will be fixed in 10% neutral |

| | |buffered formalin and processed using automatic tissue processor and embedded in paraffin ,tissue sections of 3-5microns |

| | |thick will be cut and stained by haematoxylin and eosin in all cases and special stains will be done wherever necessary. |

| | |The histopathological diagnoses will be based on morphological features and the tumors will be classified according to WHO|

| | |classification. |

| | | |

| | |Duration of study: |

| | | |

| | |The study includes 2 years retrospective (June 2010 to May 2012) and 1 year prospective (June 2012 to May 2013) –total 3 |

| | |year study. |

| | | |

| | |Inclusion criteria: |

| | | |

| | |All surgical specimens of oophorectomy and pan-hysterectomy from all age groups. |

| | | |

| | |Exclusion criteria: |

| | | |

| | |The normal ovaries and ovaries with non specific finding like follicular cyst, cystic follicles, surface inclusion cysts, |

| | |hemorrhagic inclusion cysts, endometriosis, all extra ovarian tumors, tumor like lesions such as luteoma of pregnancy, |

| | |stromal hyperthecosis, stromal hyperplasia , fibromatosis, massive oedema of ovary. |

| | | |

| | |Sample size: |

| | | |

| | |All surgical specimens of oophorectomy and pan-hysterectomy received during the period of study (June 2010-May 2013) will |

| | |be included. Minimum of 50 cases will be included. |

| | |Does the study require any investigation or intervention to be conducted on patients or other humans or animals? if so |

| |7.3 |please describe briefly |

| | |Yes, surgery and histopathological examination will be performed as part of routine protocol for treatment, pathologic |

| | |assessment and planning further management. No additional investigations or interventions will be done specially for the |

| | |purpose of dissertation. |

| | | |

| |7.4 |Has ethical clearance been obtained from your institution in case of 7.3 ? |

| | | |

| | |Yes. Ethical clearance has been obtained from “Ethical clearance committee” of the institution. |

| 8 |List of References |

| |Kuladeepa AVK, Muddegowda PH, Lingegowda JB, Doddikoppad MM, Baswaraja PK, Hiremath SS. Histomorphological study of 134 primary |

| |ovarian tumors Adv Lab Med Int.2011;1(4):69-82. |

| |Pradhan.A,Sinha.A.K,Upreti.Histopathological patterns of ovarian tumours at BPKIHS. Health Renaissance 2012; vol 10(No.2):87-97. |

| |Howlander N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975-2009, National cancer institute. Bethesda, MD, |

| |–pops 09/. |

| |Verma K, Bhatia A. Ovarian Neoplasms –A Study of 403 tumors . J obstet. Gynaec. India1981; |

| |31:106-111 |

| |K.P.Umadevi. Retrospective and prospective histopathological study of ovarian tumours a three year study (Dissertation) Mysore; Rajiv|

| |Gandhi university of health sciences .2009. |

| |Woodward. Paula, Hosseinzadek. Keyanoosh .Radiologic staging of ovarian carcinoma with pathological correlation. AFIP Archives. |

| |Radiographics 2004; 24:225-246. |

| |Chen. Vivien, Rulz. Bernardo, Killeen. Jeffrey. Pathology and classification of ovarian tumours. The American Cancer Society. Cancer |

| |supplement May 15,2003/vol 97/No 10.2631-2642. |

| |Mondal SK, Banyopadhyay R, Nag DR, Roychowdhury. Histologic pattern, bilaterality and clinical evaluation of 957 ovarian neoplasms:|

| |A 10-year study in a tertiary hospital of eastern India. J can .Res Ther 2011;7:433-7. |

| | |

| | | |

|9 |Signature of Candidate | |

| | | |

|10 |Remarks of guide |This study is carried out as per the stipulation of the university. |

| | | | |

|11 |11.1 |Name and designation of the | |

| | | |DR.S.S.INAMDAR |

| | |Guide |M.D |

| | | |PROFESSOR |

| | | |DEPARTMENT OF PATHOLOGY |

| | | |M.R. MEDICAL COLLEGE,GULBARGA. |

| | | | |

| |11.2 |Signature | |

| | | | |

| |11.3 |Co- guide (if any) | |

| | | | |

| |11.4 |Signature | |

| | | |Dr. S.K. ANDOLA |

| |11.5 |Head of the Department |M.d. dcp. ficp. fiams. miac |

| | | |PROFESSOR AND HOD |

| | | |DEPARTMENT OF PATHOLOGY |

| | | |M.R.MEDICAL COLLEGE, GULBARGA |

| | | | |

| |11.6 |Signature | |

| | | | |

|12 |12.1 |Remarks of the Chairman and Principal | |

| | | | |

| |12.2 |Signature | |

| | | | |

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