Frequency and clinicopathological presentation of gynaecological malignancies

To describe the frequency and clinicopathological presentation of malignancies of the female genital tract presenting to a tertiary care hospital. This descriptive study was carried out at Department of Obstetrics and Gynaecology, Unit A of Khyber Teaching Hospital, Peshawar from January 2008 to December 2012. A total of 4657 patients were admitted during the study period and all the patients having genital tract malignancies were included. Detailed history was taken and relevant examinations and investigations were carried out. Surgical procedures were performed where needed and specimens were sent for histopathology. Clinical and surgical staging was also carried out. All the details were noted down on a semi-structured proforma. There were 43 cases of gynaecological malignancies with mean age of 43.74 +/- 15.51 years. Ovarian cancer was the most common [n=22, 51.22%] followed by uterine cancer [n=10, 23.33%]. The majority of patients diagnosed with ovarian cancers [n=9/22, 40.94%] were nulliparous, whereas the majority of uterine and cervical cancers were multiparous [n=7/10, 70.0%] and grand multiparous [n=7/9, 77.78%], respectively. Ovarian cancers mostly presented with an abdominal mass [n=16/22, 72.7%] while uterine and cervical cancer presented with irregular cycles [n=7/10, 70.0%] and post coital bleeding [n=4/10, 40%]. Advanced stage cancer cases were 19/43 [44.22%]. Serouscystadeno carcinoma was the most common ovarian malignancy [n=16/22, 72.73%] while endometrioid adenocarcinoma [n=9/10, 90%] was the most common uterine carcinoma and squamous cell carcinoma was the most common cervical carcinoma [n=7/9, 77.88%].Conclusions: Ovarian cancer was the most commonly encountered malignancyal though all gynaecological malignancies are rare

Detection of abnormal cervical cytology by Pap smears

Cervical intra-epithelial neoplasia and cervical cancer remain important health problems for women worldwide. Cervical cytology by Papanicolaou stained smears is an effective means of screening for cervical pre-malignant and malignant conditions. This study was designed to determine the prevalence of cervical intra epithelial neoplasia in this region and the role of pap smears for its detection. It was hospital based study on patients who attended the Out Patient Department of Lady Reading Hospital, Peshawar, Pakistan, from January to September 1997. Patients presenting with vaginal discharge, dyspareunia, post-coital bleeding, backache or pain hypogastrium were included. Patients having vaginal bleeding other than post-coital, were excluded from the study. Relevant information was obtained from the patients and recorded. Samples were collected and transferred to glass slides, fixed and stained by Papanicolaou stain. Each slide was carefully examined. Three hundred patients were included in this study. One hundred and twenty three [41%] patients had complaints of vaginal discharge, 39 [13%] post-coital bleeding, 108 [36%] dyspareunia and 30 [10%] backache and /or pain hypogastrium. Regarding contraception, 37 [12.33%] patients were pill users, 31 [10.33%] were on injectable contraceptives, 32 [10.67%] were using barrier method of contraception, 34 [11.33%] patients were having an intrauterine contraceptive device and 160 [55.33%] patients were not using any method of contraception. Pap smears revealed that 8 [2.67%] patients were having cervical intra-epithelial neoplasia. Among these patients, 1 [12%] had intra-uterine contraceptive device, 3 [38%] were on oral contraceptive pill, while 4 [50%] were not using any contraceptive method. One hundred and seventy eight [59.33%] patients were having past history of genital infection where as 128 [42.67%] patients had no such history. Age at first coitus was below 20 years in 268 [89.33%] patients whereas it was above 20 years in only 32 [10.67%] patients. All these patients belonged to poor socio-economic class. Cervical intra epithelial neoplasia is not uncommon in our set up. It can be diagnosed early by Pap smears