Diagnostic accuracy and replicability of Frozen section diagnosis in Ovarian Masses- A Tertiary health care institutional experience

Abstract

Introduction: Ovarian neoplasms are a composite group of tumors including surface epithelial, germ cell and sex cord stromal tumors. A subgroup of neoplasms, borderline tumors are also present. The surgical management of each group of neoplasm is varied. Since preoperative diagnosis is arbitrary, the role of the intraoperative frozen section has become beneficial. Purpose: In our study, we aimed to evaluate the diagnostic accuracy of the frozen section by comparing it with the definitive histopathological report. Methods: This was a 5 years retrospective study (June 2018 to June 2023). Data of the patients have been retrieved from archives of Histopathology from the Department of Pathology. The specimens received, after gross examination few blocks have been prepared on the frozen section and finally processed for routine paraffin sections for the final histopathological report. Then the results of the frozen section and H&E sections were compared and categorized as benign, borderline and malignant to get the accuracy of frozen section. Results: Out of 75 frozen section diagnoses included in our study, benign contributed 58.7%, borderline- 13.3% and malignant- 28%. The final paraffin sections revealed benign tumors- 57.3%, borderline- 10.7% and malignant- 32%.  There were 7 discordant cases among which 2 were overdiagnosed and 5 were underdiagnosed. Conclusion: The overall accuracy rate of our study was 93.7% which is within the limit of the accuracy range reported in the literature. Hence, the intraoperative frozen section is an important diagnostic tool for surgeons in determining the treatment of ovarian masses with certain limitations.