DECODING OVARIAN NEOPLASMS: A HISTOMORPHOLOGICAL SPECTRUM FROM A TERTIARY CARE CENTRE IN NORTH KARNATAKA, INDIA

Background: Ovarian neoplasms represent one of the most morphologically diverse groups of tumours in gynaecologicalpathology, arising from epithelial, germ cell, and sex cord–stromal components. Global burden data indicate approximately314,000 new ovarian cancer cases and 207,000 deaths annually, with a projected 55–70% rise in incidence and mortality by2050. In India, ovarian cancer ranks as the third most common gynaecological malignancy, frequently presenting at advancedstages owing to non-specific symptomatology, limited screening infrastructure, and reduced healthcare access in ruralpopulations. The objective is to determine the frequency and age distribution of ovarian neoplasms, to evaluate the completehistomorphological spectrum including benign, borderline, and malignant lesions, and to classify all tumours according to theWHO 2020 Classification of Female Genital Tumours. Materials and Methods: A retrospective descriptive study wasconducted at the Department of Pathology, M.R. Medical College, Kalaburagi, Karnataka, from June 2024 to June 2025. Atotal of 64 ovarian neoplasms with complete clinical details and adequate histopathological material were analysed. Specimenswere processed through standard formalin fixation, paraffin embedding, microtomy (4–5 μm sections), and Haematoxylin &Eosin (H&E) staining. Tumours were classified per the WHO 2020 system based on cell of origin and microscopic features.Results: The age of patients ranged from 11 to 70 years; the 21–30 year group was most commonly affected (32.8%). Benigntumours predominated (78.1%; n=50) over malignant lesions (21.9%; n=14). Surface epithelial tumours formed the largestcategory (71.9%; n=46), followed by germ cell tumours (9.4%; n=6), sex cord–stromal tumours (7.8%; n=5), borderlinetumours (7.8%; n=5), and metastatic tumours (3.1%; n=2). Serous cystadenoma was the most common benign tumour (n=26;52% of epithelial tumours), and high-grade serous carcinoma was the dominant malignancy (n=6). Unilateral involvement wasobserved in 93.7% of cases. Conclusion: The morphological spectrum of ovarian neoplasms at our tertiary centre closelyparallels established national and international patterns. Epithelial tumours, particularly serous subtypes, dominate across allcategories. The predominance of benign tumours in young women of reproductive age underscores the importance of timely,accurate histopathological diagnosis in guiding clinical management.