title: Clinical assessment, gross examination, frozen section of ovarian masses: do patients benefit?
abstract: OBJECTIVE
  The overall risk of malignancy in ovarian neoplasm is 13% in premenopausal women and 45% in postmenopausal women. Differentiating benign and malignant disease with frozen section is possible during operation; however, information on patients' history, physical examination, paraclinical criteria (tumour markers, imaging) and gross examination of tumour can also be helpful in planing the surgery.
  
  
  METHODS
  This study was conducted on 150 women who underwent laparotomy due to adnexal mass between April 2003 and October 2005 at Vali-e-Asr Hospital, Tehran, Iran. Sensitivity and specificity of clinical assessment (history, tumour marker and imaging), gross examination and frozen section were calculated.
  
  
  RESULTS
  Based on our findings frozen section had the highest sensitivity for diagnosing malignant tumour comparing with other methods of diagnosis (88.9%). Sensitivity was 71.3% for preoperative clinical examination, 83% for ultrasonography, 89.8% for CT scan, 70% for CA125 and 84.1% for gross examination, likewise the highest specificity was seen for frozen section (93.5%).
  
  
  CONCLUSIONS
  This data confirm that frozen section diagnosis is a reliable method for the surgical management of patients with an ovarian mass, but history of disease, Para clinical criteria and gross examination can help to surgeon to perform on appropriate operation in the areas where frozen section is not possible.
authors.affiliation: Gynecology Oncology Department of Vali-e-Asr Hospital, Tehran University of Medical Sciences, Keshavarz blvd., Imam Khomeini Hospital Complex, Vali-e-Asr Hospital Reproductive Health Research Centre, Tehran, Iran. ftghaemmagh@yahoo.com
authors.forename: Fatemah
authors.initials: F
authors.lastname: Ghaemmaghami
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Fakour
authors.forename: Mojgan
authors.initials: M
authors.lastname: Karimi Zarchi
authors.forename: Nadereh
authors.initials: N
authors.lastname: Behtash
authors.forename: Mitra
authors.initials: M
authors.lastname: Modares Gilani
authors.forename: Azamsadat
authors.initials: A
authors.lastname: Mousavi
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
mesh_terms: D001706:Biopsy; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections; D006651:Histocytochemistry; D006801:Humans; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010808:Physical Examination; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards; D014463:Ultrasonography
chemical_list: D018394:CA-125 Antigen