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 cri...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2008-09, Vol.278 (3), p.209-213
Main Authors: Ghaemmaghami, Fatemah, Fakour, Fereshteh, Karimi Zarchi, Mojgan, Behtash, Nadereh, Modares Gilani, Mitra, Mousavi, Azamsadat, Shariat, Mamak
Format: Article
Language:English
Subjects:
Biopsy
CA-125 Antigen - blood
Diagnosis, Differential
Endocrinology
Female
Frozen Sections
Gynecology
Histocytochemistry
Human Genetics
Humans
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Original Article
Ovarian cancer
Ovarian Diseases - diagnosis
Ovarian Diseases - diagnostic imaging
Ovarian Diseases - pathology
Ovarian Diseases - surgery
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - diagnostic imaging
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
Physical Examination
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed - standards
Ultrasonography
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Summary: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%). Conclusion 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.
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-007-0553-8