Accuracy of frozen-section (intraoperative consultation) diagnosis of ovarian tumors

Aims and background The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. Methods The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Results Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Conclusions Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.

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The value of frozen section evaluation in the management of borderline ovarian tumors

Journal of Cancer Research and Therapeutics ◽

10.4103/0973-1482.92005 ◽

2011 ◽

Vol 7 (4) ◽

pp. 416 ◽

Cited By ~ 10

Author(s):

Emre Gultekin ◽

Basak Cingillioglu ◽

Muzaffer Sanci ◽

OzgeElmastas Gultekin ◽

Sevil Sayhan ◽

...

Keyword(s):

Frozen Section ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors ◽

Section Evaluation

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An Evaluation of Frozen Section and Lymph Node Dissection Results for Mucinous Ovarian Tumors

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001150 ◽

2018 ◽

Vol 28 (1) ◽

pp. 92-98 ◽

Cited By ~ 4

Author(s):

Marisa R. Moroney ◽

Miriam D. Post ◽

Amber A. Berning ◽

Jeanelle Sheeder ◽

Bradley R. Corr

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Tumor Size ◽

Frozen Section ◽

Ovarian Tumors ◽

Node Dissection ◽

Cross Sectional ◽

Mucinous Histology ◽

Final Pathology ◽

Mucinous Ovarian Tumors

ObjectivesIntraoperative frozen section has greater than 90% accuracy for ovarian tumors; however, mucinous histology has been shown to be associated with increased frozen section inaccuracy. Recent data demonstrate that primary ovarian mucinous carcinomas have no lymph node involvement, even when extraovarian disease is present, and therefore may not require lymph node dissection. Our primary objective is to evaluate the accuracy of identifying mucinous histology on frozen section.Methods/MaterialsA cross-sectional review of mucinous ovarian tumors in surgical patients at one institution from 2006 to 2016 was performed. Cases reporting a mucinous ovarian tumor on frozen section or final pathology were identified. Frozen section results were compared with final diagnosis to calculate concordance rates. Analyses with χ2 and t tests were performed to identify variables associated with pathology discordance.ResultsA total of 126 mucinous ovarian tumors were identified. Of these, 106 were reported as mucinous on frozen section and 103 (97.2%) were concordant on final pathology. Discordant cases included 2 serous and 1 clear cell tumor. Among the 103 mucinous tumors, classification as malignant, borderline, or benign was concordant in 74 (71.8%) of 103 cases, whereas 22 (21.4%) of 103 were discordant and 7 (6.8%) were deferred to final pathology. Lymph node dissection was performed in 33 cases; the only case with lymph node metastasis was a gastrointestinal mucinous adenocarcinoma. Discordance between frozen section and final pathology was associated with larger tumor size and diagnosis other than benign: discordant cases had a mean tumor size of 21.7 cm compared with 14.4 cm for concordant cases (P < 0.001), and 93.5% of discordant cases were borderline or malignant, compared with 30.5% of concordant cases (P < 0.001).ConclusionsIntraoperative identification of mucinous histology by frozen section is reliable with a concordance rate to final pathology of 97.2%. No lymph node metastases were present in any malignant or borderline primary ovarian cases.

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Frozen section in borderline ovarian tumors: is it reliable?

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2014.07.039 ◽

2014 ◽

Vol 181 ◽

pp. 115-118 ◽

Cited By ~ 8

Author(s):

Isin Ureyen ◽

Taner Turan ◽

Derya Akdag Cirik ◽

Tolga Tasci ◽

Nurettin Boran ◽

...

Keyword(s):

Frozen Section ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors

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Frozen section diagnoses of 578 ovarian tumors made by pathologists with and without expertise on gynecologic pathology

Gynecologic Oncology ◽

10.1016/j.ygyno.2011.06.030 ◽

2011 ◽

Vol 123 (1) ◽

pp. 43-46 ◽

Cited By ~ 24

Author(s):

Ozgur Bige ◽

Ahmet Demir ◽

Ugur Saygili ◽

Funda Gode ◽

Turhan Uslu ◽

...

Keyword(s):

Frozen Section ◽

Ovarian Tumors

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OP03.07: Borderline ovarian tumors and frozen section: role of preoperative He4 and ROMA score to increase frozen section accuracy

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.15129 ◽

2015 ◽

Vol 46 ◽

pp. 61-61

Author(s):

S. Gizzo ◽

M. Noventa ◽

A. Vitagliano ◽

M. Quaranta ◽

R. Venturella ◽

...

Keyword(s):

Frozen Section ◽

Ovarian Tumors ◽

Borderline Ovarian Tumors

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Sentinel Node and Ovarian Tumors: A Series of 20 Patients

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000948 ◽

2017 ◽

Vol 27 (4) ◽

pp. 684-689 ◽

Cited By ~ 13

Author(s):

Reita H. Nyberg ◽

Pasi Korkola ◽

Johanna U. Mäenpää

Keyword(s):

Sentinel Node ◽

Ovarian Tumor ◽

Frozen Section ◽

Regional Lymph Node ◽

Ovarian Tumors ◽

Blue Dye ◽

Regional Lymph Nodes ◽

Sentinel Nodes ◽

Suspensory Ligament ◽

Sentinel Node Concept

ObjectiveIntraoperative detection of ovarian sentinel nodes has been shown to be feasible. We examined the detection rate and locations of sentinel nodes in patients with ovarian tumors. We also aimed to assess the reliability of sentinel node method in predicting regional lymph node metastasis.MethodsTwenty patients scheduled for laparotomy because of a pelvic mass were recruited to the study. In the beginning of the laparotomy, radioisotope and blue dye were injected under the serosa next to the junction of the ovarian tumor and suspensory ligament. The number and locations of the hot and/or blue nodes/spots were recorded during the operation. If the tumor was malignant according to the frozen section, systematic lymphadenectomies were performed, the sentinel nodes sampled separately, and their status compared with other regional lymph nodes.ResultsEleven patients had a right-sided ovarian tumor, 7 patients a left-sided tumor, and 2 patients had bilateral tumors. A median of 2 sentinel nodes/locations per patient (range, 1–3) were found. Sixty percent of all sentinel nodes were located in the para-aortic region only, compared with 30% in both para-aortic and pelvic areas and 10% in pelvic area only. Both unilateral and bilateral locations were found. In 83% of the cases with more than 1 sentinel node location, they were located in separate anatomical regions. In 3 patients, systematic lymphadenectomies were performed. One of them had nodal metastases in 2 regions and also a metastasis in 1 of her 2 sentinel nodes in 1 of those regions.ConclusionsIn patients with ovarian tumor(s), the detection of sentinel nodes is feasible. They are located in different anatomic areas both ipsilaterally and contralaterally, although most of them are found in the para-aortic region. The reliability of the sentinel node concept should be evaluated in the framework of a multicenter trial.

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