Case 24

A 40-year-old women with a 4.5 cm ovary mass. Here is the frozen:

1. How you would call the frozen? Which big category?

Answer

The correct answer is malignancy/carcinoma, defer to permanent.

2. Here are the permanent sections and after the frozen diagnosis was called, the surgeon said the patient has extensive endometriosis. What's your diagnosis?

Answer

It's a case of clear cell carcinoma with extensive tubular pattern. However, there are not some much clear cytoplasm and the nuclei atypia requires careful high power looking in frozen section.

Clear cell carcinoma warrants an aggressive surgical staging during the operation, which usually involves removing the affected ovary, fallopian tube, uterus; pelvic and para-aortic lymph nodes, and performing peritoneal biopsies to determine the extent of the cancer and plan appropriate further treatment based on the stage of the disease.

Reference:

Frozen section diagnosis of ovarian epithelial tumours: a practical guide for pathologists, Ralte, Angela Mercy, Diagnostic Histopathology, Volume 28, Issue 8, 341 - 352

Case credit: UCSD Pathology

Author: Wangpan Jackson Shi, MD