Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a metaanalysis

Geomini, Peggy M.A.J.; Bremer, Gérard L.; Kruitwagen, Roy F.P.M.; Mol, Ben Willem J.

doi:10.1016/j.ygyno.2004.09.042

Cited by 96 publications

(83 citation statements)

References 38 publications

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“…However, frozen section diagnosis of BTO is less reliable than frozen section diagnosis of benign or malignant ovarian tumors. [5][6][7][8][9][10][11][12][13][14] Thus, some investigators have sought to find significant factors related to misdiagnosis. Houck et al 8 found that mucinous histology was the only significant predictor for under-diagnosis by frozen section.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary

Kim

Park

et al. 2009

J Gynecol Oncol

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Objective:We have assessed the accuracy of frozen section diagnosis and the outcomes of misdiagnosis in borderline tumors of the ovary (BTO) according to frozen section. Methods: All pathology reports with BTO in both frozen and permanent section analyses between 1994 and 2008 at Seoul St. Mary's Hospital were reviewed. Frozen section diagnosis and permanent section histology reports were compared. Logistic regression models were conducted to evaluate the correlation of patient and tumor characteristics with diagnostic accuracy. The clinical outcomes of misdiagnosis were evaluated. Results: Agreement between frozen section diagnosis and permanent histology was observed in 63 of 101 patients (62.4%). Among the 76 patients with frozen section proven BTO, under-diagnosis and over-diagnosis occurred in 8 of 76 (10.5%) and 5 of 76 patients (6.6%), respectively. Mean diameter of under-diagnosed tumor was larger than matched BTO (21.0±11.4 vs. 13.7±7.1; p=0.021). Tumor size 20 cm was determined as the optimal cut-off for under-diagnosis (50% sensitivity, 87.3% specificity). Among 8 under-diagnosed patients, no patient relapsed. Among 5 over-diagnosed patients, 2 patients ＜ 35 years of age had fertility-preserving surgery. Conclusion: Although frozen section diagnosis is an important and reliable tool in the clinical management of patients with ovarian tumors, over-diagnosis and under-diagnosis are relatively frequent in frozen proven BTO. Surgical decision-making for BTO based on frozen section diagnosis should be done carefully, especially in large tumors.

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Section: Introductionmentioning

confidence: 99%

Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary

Kim

Park

et al. 2009

J Gynecol Oncol

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“…Correct intra operative histological assessment of an ovarian mass is crucial to select an appropriate surgical procedure to avoid under and over treatment of patients. The results of present study, show that frozen section analysis has a high overall accuracy for the diagnosis of ovarian Neoplasms that is around 90%.Most studies reported between 86 and 97% [5,6,7,8,9] .This figure would obviously depend on the expertise of the pathologists, but the overall accuracy should be consistently less than 10% for this procedure to be useful in large tertiary centers dealing with ovarian Neoplasms. Our study analysis done on 30 patients' shows that test fared well on all 4 conventional indices (sensitivity, specificity, and predictive values) in benign and malignant tumors.…”

Section: Discussionmentioning

confidence: 57%

Role of Frozen Section in the Intra operative management of Ovarian Neoplasms and Comparing with Final Histopathological Diagnosis – A Prospective Study

Maheshwari¹

2017

jmscr

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“…According to various studies, the accuracy of an intraoperative frozen section varies from 80% to >90%. 26 A scrape smear of a struma ovarii shows benign follicular epithelial cells forming follicles of various sizes and a monolayered sheet in a colloidfilled background. 27 A frozen section also shows the classical pattern of variable-sized follicles filled with colloid.…”

Section: Discussionmentioning

confidence: 99%

Struma Ovarii with Pseudo-Meigs’ Syndrome and Raised Cancer Antigen-125 Levels Masquerading as an Ovarian Carcinoma: Case report and literature review

Yadav

Tomar

Verma

et al. 2017

SQUMJ

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S truma ovarii are mature ovarian teratomas derived from one type of germ cell; these monodermal variants account for >5% of mature teratomas and 0.3-1% of ovarian tumours.1 These types of tumours predominantly consist of thyroid tissue (>50% of the overall ovarian mass) and the usual age of presentation is during the fifth and sixth decades of life.1 The reported rate of malignant transformation is 5-37%, in which the struma ovarii transforms into a thyroid-type carcinoma.2 The usual presentation of struma ovarii is as an abdominopelvic mass, although it may present with hyperthyroidism in approximately 5% of cases.3 Radiologically, a benign ovarian mass presenting with ascites and raised cancer antigen (CA)-125 levels can be misdiagnosed as a malignant ovarian tumour. 2,4,5 In such cases, a correct intraoperative diagnosis can prevent extensive surgery. Case ReportA 55-year-old female presented to the Lok Nayak Jai Prakash Narayan Hospital, New Delhi, India, in 2016 with progressively increasing abdominal discomfort, The monodermal teratoma struma ovarii is a rare ovarian tumour; however, struma ovarii presenting with pseudo-Meigs' syndrome and raised cancer antigen (CA)-125 levels is even rarer. In elderly patients, this presentation can potentially lead to a misdiagnosis of a malignant ovarian carcinoma, resulting in unnecessary extensive surgery. We report a 55-year-old female who presented to the Lok Nayak Jai Prakash Narayan Hospital, New Delhi, India, in 2016 with progressive abdominal discomfort, fatigue and abdominal distention. Clinical and radiological features were indicative of a malignant ovarian tumour and ascites. Serum CA-125 levels were elevated at 258 U/mL. A left-sided salpingo-oophorectomy was performed, after which the serum CA-125 levels normalised. There was no evidence of recurrence at a six-month follow-up. A frozen section procedure confirmed the diagnosis of a struma ovarii. This rare condition should be considered as a differential diagnosis in patients presenting with ovarian masses, ascites and raised CA-125 levels.

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Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a metaanalysis

Cited by 96 publications

References 38 publications

Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary

Clinical analysis of intra-operative frozen section proven borderline tumors of the ovary

Role of Frozen Section in the Intra operative management of Ovarian Neoplasms and Comparing with Final Histopathological Diagnosis – A Prospective Study

Struma Ovarii with Pseudo-Meigs’ Syndrome and Raised Cancer Antigen-125 Levels Masquerading as an Ovarian Carcinoma: Case report and literature review

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