Clinical assessment, gross examination, frozen section of ovarian masses: do patients benefit?
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.
Ghaemmaghami
Fatemah
F
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
Fakour
Fereshteh
F
Karimi Zarchi
Mojgan
M
Behtash
Nadereh
N
Modares Gilani
Mitra
M
Mousavi
Azamsadat
A
Shariat
Mamak
M
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
D018394:CA-125 Antigen