Intraoperative frozen section study of ovarian tumours

• Author Details:   
• Priya Garg
• Sheeladevi Chandakavadi Shivalingaiah
• Deepika Gurumurthy ^*
• Shashirekha Basavaraju

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Background: Ovarian neoplasms are a heterogenous group of tumours with diverse treatment for different tumours. Intraoperative frozen section (IFS) is an important diagnostic tool for differentiating benign from malignant ovarian tumours. The precision of diagnosis of ovarian neoplasms by frozen section was observed to vary in various studies and this study attempts to evaluate the diagnostic accuracy of IFS in identifying different ovarian tumours. It helps in guiding the optimal surgical procedure in the management.

Aim and Objective: This study aims to assess the diagnostic performance of IFS in the diagnosis of various ovarian tumours.

Materials and Methods: A retrospective study was undertaken between 2015 to 2020. Sensitivity, specificity and accuracy of IFS were calculated. In discordant cases, the slides were re-evaluated to determine the possible factors for erroneous diagnosis.

Results: Out of 95 cases, majority were epithelial tumours which accounted 87.3%. The diagnostic accuracy was 88.4% and the sensitivity of IFS was 67.9%, 53.85% and 100% for malignant, borderline and benign tumours respectively. The corresponding specificity was 91.04%, 97.56% and 95.9%. All the germ cell tumours were accurately diagnosed. The sensitivity and specificity for sex cord stromal tumours was 100% and 96.6% respectively. The IFS and formalin sections had an 88.4% concordance.

Conclusion: IFS is a reliable technique in the evaluation of patients with ovarian neoplasms. It is most valuable for high accuracy and specificity in diagnosis of ovarian malignancies but caution must be taken when dealing with borderline malignancies. Pathologists should be aware of the pitfalls to avoid inappropriate surgery.

Keywords: Intraoperative Frozen section; Ovarian neoplasms; Diagnostic accuracy