Cytopathology and Fine-Needle Aspiration in Ovarian Tumours: Its Utility in Diagnosis and Management

Abstract

Malignant ovarian tumours are often at an advanced stage when initially diagnosed. Exploratory laparotomy and histological examination are the accepted approach in evaluating pelvic masses. Cytopathology has had a minor role historically in the diagnosis and management of pelvic masses of unknown aetiology. That role usually consisted of examination of ascitic fluid or fluid obtained through culdocentesis for the presence of malignant cells. The study of culdocentesis samples in asymptomatic women has been of little help in the early diagnosis of ovarian cancer (Floyd et al. 1969; Funkhouser et al. 1975; Graham et al. 1964; Keettel et al. 1974; McGowan et al. 1966). Furthermore, malignant cells in culdocentesis fluid may be derived from organs other than the ovary. Other cytological techniques more useful in the diagnosis and management of ovarian tumours include peritoneal lavage at the time of laparoscopy (Creasman and Rutledge 1971; Keettel et al. 1974; Yoshimura et al. 1984), cul-de-sac cytology after surgery for ovarian cancer (Goldberg et al. 1985; Venesmaa et al. 1986), and fine-needle aspiration biopsy.