The value of intraoperative consultation (frozen section) in the diagnosisof ovarian neoplasms

Background. Frozen Section is an important diagnostic tool to determine the nature of ovarian masses. However, like other diagnostic tools, frozen sec tion also has some pitfalls. We aimed to discuss the source and the nature of inaccuracies associated with this procedure. Methods. In this retrospective study 360 cases of ovarian masses examined b y frozen section were re-evaluated. The sensitivity, specificity and predic tive values of frozen section diagnosis of ovarian tumors were calculated. The reasons for the erroneous frozen-section diagnoses were discussed. Results. Overall diagnostic agreement for ovarian lesions was 94.2%. Disagr eements were found in nine cases (2.5%). Diagnosis was deferred to permanen t sections in 12 cases (3.3%). The sensitivity for malignant tumors was 93. 1% and specificity was 99.2%. The sensitivity for benign tumors was 99.2% a nd specificity was 92.1%. Most problematic cases were mucinous tumors, foll owed by tumors resembling fibrothecomas, in addition sections without viabl e tissue fragments or presence of extensive hemorrhage and necrosis also ob scured the frozen diagnosis. Another factor was the lack of an effective co mmunication between the surgeon and the pathologist. Conclusions. For an effective usage of this method not only the pathologist but also the surgeons must know the pitfalls of this method and also there must be good communication between the pathologist and the surgeon. Especi ally deferred cases should be minimized by good communication. In fact it's an intraoperative consultation method that enables the pathologist to gath er all the preoperative, intraoperative findings and to be familiar with th e further treatment plan of the patient.