Ovarian tumors (OTs) are one of the major gynecological diseases. These represent the greatest clinical challenge, frequent site for primary and metastatic tumors. OTs constitute 25% of gynaecological malignancies. Worldwide, OTs are the 7 most common malignancy and 5^th most common cause of carcinomas death. [1]. For better treatment, histological classification along with the staging of OTs is considered. USG findings and CA-125 levels and age when combined and correlated together has shown to be more effective in predicting the risk of malignancy when compared with individual parameters alone. [2]. The risk of Malignancy Index (RMI) score is one such scoring system. This is also used to evaluate the OTs, developed by Jacobs et al. [3]. RMI was calculated by considering menopausal score and ultrasound score. With this background, a study was considered to correlate the clinical study of OTs and assessment of RMI scoring and correlating with the histopathological examination report, with the following objectives to find the incidence and distribution of various OTs, pre-operative RMI scoring and postoperative examination of the histopathological report and calculate the diagnostic value of RMI.

Settings: The study was conducted in the department of Obstetrics and Gynecology, Mamata Medical College, Khammam.

Duration and type of study: This was a prospective and observational study conducted over 24 months, from January 2012 to Dec 2014. 

Sampling method: Random sampling was considered in this study.

Sample size calculation: All the eligible members who satisfy the inclusion criteria were considered in this study. 

Inclusion criteria: Women aged > 18 years, who attended the department of Obstetrics and Gynecology and were diagnosed with OTs >6cm in size were included in this research.

Exclusion criteria: Women with unilateral, unilocular, thin-walled cysts with regular borders and no solid areas and <6cms, OTs diagnosed as

Total 70 (100%) OTs were studied in research. Age wise, Age wise, 21.4% (15) tumors were diagnosed between 21 – 30 years, 38.6% in 31 – 40 years, 18.6% in 41 – 50 years, 10% each in 51 – 60 and <20 years groups. OTs were more common between 21 – 50 years group. Maximum number (35.7%; 25) of benign tumors (BTs) were diagnosed in 31 – 40 years group followed by 21 – 30 years group (21.4%; 15), 41 – 50 years (15.7%; 11), <20 years (10%; 7) and > 60 years (1.4%; 1). In this study, 2.85% (2) each MTs were diagnosed in 31 – 40, 41 – 50 and 51 – 60 years groups, respectively; statistically there was no significant difference (Table 1).

The OTs were more commonly seen in parous women with para 2, para 3 and the above groups, constituted 38.6% and 32.8%, respectively. In this research, 17.1% of tumours were diagnosed in nulliparous women. From these it was observed that there was no association between them (Table 2). 

In this study, epithelial tumors were the highest (88.57%; 62) followed by germ cell tumors (5.71%; 4), sex cord stromal tumors (4.3%; 3) and krukenberg tumor (1.4%; 1). The mean age of BTs was 36.3 and 48 years for the MTs.

Out of the 6 MTs, 4 (5.6%) were diagnosed in those with M score 3 and 2 (2.8%) in M score with 1. Out of 64 (91.4%) BTs, the rate of diagnoses was 54 (77.1%) and 10 (14%), respectively. Statistically there was significant difference between M score and tumour (Table 3).

In this research, the incidence of MTs were increased with the ultra sound score. Whereas the BTs were decreased with the ultra sound score. The BTs were 45.7% (32), 35.7% (25) and 10% (7), respectively with the scores 0, 1 and 3. Statistically there was a significant difference (Table 4). 

The age of the study members was ranged between 16 – 65 years. The majority of the women with BTs was diagnosed in the 31 – 40 years group and > 35 years was the common age group for the MTs. The mean age for the participants with BTs was 36.34 years and the SD was 11.30; whereas for those diagnosed with MTs, 48 years was the mean age and 9.6 was the SD. The results in this research were comparable with the studies reported by Tahereh Ashrafgangooei et al., 37 and 50.8 years were the mean ages respectively for BT and MT. [4]. Whereas, there was some disparity in reports published by Jacobs et al.  [3]. and Ulusov S et al. [5]. There was no significant difference in race and ethnicity between the two groups in the present study and all patients belonged to the rural area. Even concerning the parity also there was no significant difference in both benign and malignant groups. OTs were seen more commonly in parous women when compared with nulliparous or women with low parity. This is contrary to previous studies reported by Chakraborthy DK et al. [6]. and Whittemore AS et al. [90]. On histological examination, 91.4% had benign disease and 8.6% had malignant disease. This was comparable with published reports by Tahereh Ashrafgangooei et al. [4]. Petronella A et al. [7]. But there was a difference in the incidence of these in the other studies. The incidence was 19.85% and 9.52% by Yuen et al. [8], 31.5% and 64% by Jadhav et al. [9], BTs and MTs, respectively. But the exact reasons were not mentioned in the literature. But we may declare that technological advancement may be the cause for this. When the data was correlated with the M score, the percentage of MTs was high (66.67%) and the difference between the two groups was statistically significant in the present study. This was comparable in the data published by Andersen et al. [10]. and Moolthiya W et al. [11]; the incidence was reported to be 80.5%, and 60.8%, respectively. This indicates that the incidence of MTs increases with advanced age. The M score specificity was 84.37% which was higher in this research compared to sensitivity in the diagnosis of OTs. The specificity was reported to be 67.9% by Ulusoy S et al. [5]