Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2023; 12(02): 148-152
DOI: 10.1055/s-0042-1743421
Original Article
Genitourinary Cancer

Concordance of Frozen Section Diagnosis of Epithelial Ovarian Neoplasm and Discussing the Diagnostic Pitfalls: An Institutional Experience

Jagannath D. Sharma
1   Department of Pathology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
,
Lopa M. Kakoti
1   Department of Pathology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
,
Shiraj Ahmed 
1   Department of Pathology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
,
Anupam Sarma
1   Department of Pathology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
,
Debabrat Barman
2   Department of Gynaec Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background Ovarian neoplasm is the third most common malignancy in Indian women. Intraoperative diagnosis becomes the critical guiding tool for the surgeons to take the decisions on the extent of surgery specially when preserving fertility has to be considered.

Aims and Objective The aim of this study is to evaluate the concordance of intraoperative diagnosis of frozen section (IFS) of ovarian epithelial neoplasm at our institute and to review and discuss the diagnostic pitfalls along with the review of literature.

Materials and Methods Data were archived from departmental record and the detailed clinical data of the patients were retrieved from hospital record system. The discordant cases were reviewed again in an attempt to address the pitfalls.

Statistical Analysis Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value of IFS of ovarian neoplasm were analyzed.

Results The overall frozen section diagnosis was concordant with final histopathology in 36 out of 44 cases (81%). The sensitivity of IFS diagnosis was found to be 100% for benign and borderline tumors, whereas 88.9% for malignant epithelial tumors, but the correctness of diagnosis is high only for benign and malignant tumors (high positive predictive value) in compared with borderline ones. The diagnostic pitfalls were identified individually in discordant cases.

Conclusion An accurate interpretation of IFS in ovarian epithelial malignancy can be achieved in benign and malignant cases, but limited in borderline tumors. Awareness of the artifacts and the limitations in mind and the IFS diagnosis can be of great help for proper management of the ovarian neoplasm.

Keywords

frozen - intraoperative - ovarian - neoplasm - pitfalls - accuracy


Publication History

Article published online:
02 March 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 National cancer registry program three year report of population based cancer registries: 2012–2014: report of 27PBCRs in India. Indian Council of Medical Research
  • 2 Zanetta G, Rota S, Chiari S, Bonazzi C, Bratina G, Mangioni C. Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol 2001; 19 (10) 2658-2664
    CrossrefPubMedSearch in Google Scholar
  • 3 Maheshwari A, Gupta S, Kane S, Kulkarni Y, Goyal BK, Tongaonkar HB. Accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms: experience at a tertiary oncology center. World J Surg Oncol 2006; 4: 12
    CrossrefPubMedSearch in Google Scholar
  • 4 Medeiros LR, Rosa DD, Edelweiss MI. et al. Accuracy of frozen-section analysis in the diagnosis of ovarian tumors: a systematic quantitative review. Int J Gynecol Cancer 2005; 15 (02) 192-202
    CrossrefPubMedSearch in Google Scholar
  • 5 Geomini P, Bremer G, Kruitwagen R, Mol BW. Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a metaanalysis. Gynecol Oncol 2005; 96 (01) 1-9
    CrossrefPubMedSearch in Google Scholar
  • 6 Baker P, Oliva E. A practical approach to intraoperative consultation in gynecological pathology. Int J Gynecol Pathol 2008; 27 (03) 353-365
    CrossrefPubMedSearch in Google Scholar
  • 7 Seidman JD, Cho KR, Ronnett BM, Kurman RJ. Surface epithelial tumors of the ovary (Chapter 14). In: Kurman RJ, Ellenson LH, Ronnett BM. eds. Blaustein's Pathology of the Female Genital Tract 6th ed. New York:: Springer;; 2011: 680e772
    Search in Google Scholar
  • 8 Buza N. Frozen section diagnosis of ovarian tumor. Arch Pathol Lab Med 2019; 143: 47-4
    CrossrefPubMedSearch in Google Scholar
  • 9 Shih KK, Garg K, Soslow RA, Chi DS, Abu-Rustum NR, Barakat RR. Accuracy of frozen section diagnosis of ovarian borderline tumor. Gynecol Oncol 2011; 123 (03) 517-521
    CrossrefPubMedSearch in Google Scholar
  • 10 Usubütün A, Altinok G, Küçükali T. The value of intraoperative consultation (frozen section) in the diagnosis of ovarian neoplasms. Acta Obstet Gynecol Scand 1998; 77 (10) 1013-1016
    CrossrefPubMedSearch in Google Scholar
  • 11 Menzin AW, Rubin SC, Noumoff JS, LiVolsi VA. The accuracy of a frozen section diagnosis of borderline ovarian malignancy. Gynecol Oncol 1995; 59 (02) 183-185
    CrossrefPubMedSearch in Google Scholar
  • 12 Kayikçioglu F, Pata O, Cengiz S. et al. Accuracy of frozen section diagnosis in borderline ovarian malignancy. Gynecol Obstet Invest 2000; 49 (03) 187-189
    CrossrefPubMedSearch in Google Scholar
  • 13 Brun J-L, Cortez A, Rouzier R. et al. Factors influencing the use and accuracy of frozen section diagnosis of epithelial ovarian tumors. Am J Obstet Gynecol 2008; 199 (03) 244.e1-244.e7
    CrossrefPubMedSearch in Google Scholar
  • 14 Houck K, Nikrui N, Duska L. et al. Borderline tumors of the ovary: correlation of frozen and permanent histopathologic diagnosis. Obstet Gynecol 2000; 95 (6 Pt 1): 839-843
    PubMedSearch in Google Scholar
  • 15 Tangjitgamol S, Jesadapatrakul S, Manusirivithaya S, Sheanakul C. Accuracy of frozen section in diagnosis of ovarian mass. Int J Gynecol Cancer 2004; 14 (02) 212-219
    CrossrefPubMedSearch in Google Scholar
  • 16 Wang KG, Chen TC, Wang TY, Yang YC, Su TH. Accuracy of frozen section diagnosis in gynecology. Gynecol Oncol 1998; 70 (01) 105-110
    CrossrefPubMedSearch in Google Scholar
  • 17 Wootipoom V, Dechsukhum C, Hanprasertpong J, Lim A. Accuracy of intraoperative frozen section in diagnosis of ovarian tumors. J Med Assoc Thai 2006; 89 (05) 577-582
    PubMedSearch in Google Scholar
  • 18 Tempfer CB, Polterauer S, Bentz EK, Reinthaller A, Hefler LA. Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: a retrospective analysis of 96 cases and review of the literature. Gynecol Oncol 2007; 107 (02) 248-252
    CrossrefPubMedSearch in Google Scholar