Role of Frozen Section in the Diagnosis of Ovarian Masses: An Institutional Experience

Abstract

Background: A pre-operative diagnosis of the nature of ovarian tumors is not always reliable. Frozen section is a valuable diagnostic tool in rapid intraoperative categorization of ovarian masses and thereby helps in planning the surgical management. Objective: To categorize ovarian neoplasms into benign, borderline and malignant on frozen sections. To determine the accuracy of the frozen diagnosis by comparing with that of the paraffin hematoxylin and eosin stained sections. Materials and Methods: Frozen sections on 49 clinically and radiologically diagnosed as ovarian tumors were compared with final histopathogic diagnosis over a period from September 2013 to July 2016 in the Department of Pathology. Results: Frozen section diagnosis of 49 ovarian specimens, showed 31 (63.2%) benign tumors, 11 (22.4%) borderline tumors and 7 (14.2%) as malignant tumors. The final histopathologic diagnosis revealed 29 (59%) as benign tumors, 08 (16.3%) as borderline tumors and 11 (24.4%) as malignant tumors. The sensitivity and specificity for benign, borderline and malignant tumors on frozen section were 93.5%, 72.7%, 58.3% and 90%, 100%, 100%, respectively. The positive and the negative predictive value for benign, borderline and malignant tumors were 100%, 100%, 100% and 90%, 92.6%, 88%, respectively. The overall accuracy was (44/49) 89.7%. There were no false-positive cases but 5 cases were false negative on frozen. All the 5 discordant cases were mucinous ovarian neoplasms with mean diameter of 26 cm. Conclusion: With an overall accuracy of 89.7% frozen section is valuable for intraoperative diagnosis of ovarian tumors but has limitations in large mucinous tumors. KEY WORDS: Accuracy in frozen section, frozen section in ovarian neoplasms, Intraoperative frozen section of ovarian masses 1 Professor,