title: Accuracy of frozen-section diagnosis of ovarian mucinous tumors.
abstract: OBJECTIVE
  The objective of the study was to evaluate the diagnostic accuracy of intraoperative frozen sections of ovarian mucinous tumors and to identify the features associated with an inaccurate diagnosis.
  
  
  METHODS
  Cases of ovarian mucinous tumors (benign, low malignant potential [LMP] or borderline, primary malignant, and metastatic) diagnosed by frozen section or final histology were recruited. Frozen-section diagnoses were compared with the final histologic diagnoses. Possible variables associated with diagnostic discrepancy were analyzed.
  
  
  RESULTS
  A comparison of the diagnoses was done in 195 cases (102 benign, 61 LMP, 18 primary malignant, and 14 metastatic). Diagnostic agreement was observed in 164 cases (84.1%) and discrepancy in 31 cases (15.9%). The sensitivity of frozen-section diagnosis was low in LMP (67.2%) and malignant tumors (55.6%). The specificity was the lowest in the benign category (78.5%). The positive predictive values of all categories were less than 90% (range, 83.3%-85.7%). Diagnostic discrepancy was associated with tumor size of greater than 13 cm (P = 0.019) and the number of frozen sections of 4 or more (P = 0.035). However, in a multivariate analysis, there was no independent predictor of diagnostic discrepancy. The number of frozen sections 4 or more was strongly associated with tumor size of greater than 13 cm (P = 0.004).
  
  
  CONCLUSIONS
  The sensitivity of frozen-section diagnosis of LMP and malignant mucinous tumors was low. The inaccuracy of a frozen-section diagnosis of ovarian mucinous tumors may be related to a tumor size of greater than 13 cm. Increasing the number of intraoperative samples over 3 sections per case may not effectively increase the accuracy of frozen-section diagnosis in mucinous tumors.
authors.affiliation: Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Tip
authors.initials: T
authors.lastname: Pongsuvareeyakul
authors.forename: Surapan
authors.initials: S
authors.lastname: Khunamornpong
authors.forename: Jongkolnee
authors.initials: J
authors.lastname: Settakorn
authors.forename: Kornkanok
authors.initials: K
authors.lastname: Sukpan
authors.forename: Prapaporn
authors.initials: P
authors.lastname: Suprasert
authors.forename: Sumalee
authors.initials: S
authors.lastname: Siriaunkgul
mesh_terms: D000328:Adult; D000368:Aged; D018291:Cystadenoma, Mucinous / Q000175:diagnosis* / Q000473:pathology; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D005629:Frozen Sections / Q000592:standards; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity