Advertisement

Ovary and Fallopian Tube

  • Donna M. Coffey
  • Ibrahim Ramzy
Chapter
Part of the Frozen Section Library book series (FROZEN, volume 11)

Abstract

Ovarian cancer is the fourth most frequent cause of cancer death in women. It accounts for 5% of all cancer deaths, with a mortality rate that exceeds the combined rates of cervical and endometrial carcinoma. Early detection is elusive as many cases present with nonspecific symptoms and are identified late in the course of the disease. A wide variety of non-neoplastic functional, inflammatory lesions of the ovary, the tube, and the broad ligament also result in the development of adnexal masses. Surgical exploration is indicated in many of these cases in order to clarify the nature of the lesions and manage the disease (Table 6.1). Gross and frozen section consultations are often needed to establish the neoplastic nature of an ovarian mass and help in differentiating benign tumors from borderline or malignant ones. Although a detailed discussion of the pathology of ovarian tumors is beyond the scope of this text, consideration of the different types is important, since handling such specimens should be tailored to the suspected tumor type, size, and the clinical presentation, with an emphasis on answering questions that will have an impact on the type and extent of surgery. Interpretation by frozen sections is also utilized to determine the presence of peritoneal spread and differentiation of primary from metastatic malignancies (Table 6.2). The status of the pelvic lymph nodes plays only a minor role in the immediate intraoperative decision-making in the case of ovarian lesions; thus, lymph node sampling for frozen section consultation is not routinely requested. Rarely, a biopsy is performed in cases of ovarian failure, and such cases require consultation with the surgeon prior to the procedure, to ensure proper handling of the specimen.

Keywords

Leydig Cell Nuclear Atypia Adnexal Mass Borderline Tumor Granulosa Cell Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Recommended Reading

  1. Baker P, Oliva E. A practical approach to intraoperative consultation in gynecological pathology. Int J Gynecol Pathol. 2008;27:353–65.PubMedCrossRefGoogle Scholar
  2. Barakat RR, Bevers MW, Gershenson DM, Hoskins WH, editors. MD Anderson Cancer Center and Memorial Sloan-Kettering Cancer Center Handbook of gynecologic oncology. 2nd ed. London: Martin Dunitz; 2002.Google Scholar
  3. Berek JS, Neville HF, editors. Berek and Hacker’s gynecologic oncology. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.Google Scholar
  4. DiSaia PJ, Creasman WT. Clinical gynecologic oncology. 7th ed. Philadelphia, PA: Moby-Elsevier; 2007.Google Scholar
  5. Hart WR. Mucinous tumors of the ovary: a review. Int J Gynecol Pathol. 2005;24:4–25.PubMedGoogle Scholar
  6. Hoskins W, Perez CA, Young RC. Principles and practice of gynecologic oncology. 3rd ed. Philadelphia, PA: Lippincott William & Wilkins; 2000.Google Scholar
  7. Ismiil N, Ghorab Z, Nofech-Mozes S, et al. Intraoperative consultation in gynecologic pathology: a 6 year audit at a tertiary care medical center. Int J Gynecol Cancer. 2009;19:152–7.PubMedCrossRefGoogle Scholar
  8. Khonamornpong S, Settakorn J, Sukpan K. Mucinous tumor of low malignant potential (“borderline” or “atypical proliferative” tumor) of the ovary: A study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion. Internat J Gynecol Pathol. 2011;30:218–30.PubMedCrossRefGoogle Scholar
  9. Kikkawa F, Ishikawa H, Tamakoshi K, et al. Squamous cell carcinoma arising from mature cystic teratoma of the ovary: a clinicopathologic analysis. Obstet Gynecol. 1997;89:1017–22.PubMedCrossRefGoogle Scholar
  10. Menzin AW, Rubin SC, Noumoff JS, LiVolsi VA. The accuracy of a frozen section diagnosis of borderline ovarian malignancy. Gynecol Oncol. 1995;59:183–6.PubMedCrossRefGoogle Scholar
  11. Michael CW, Lawrence WD, Bedrossian CW. Intraoperative consultation in ovarian lesions: a comparison between cytology and frozen section. Diagn Cytopathol. 1996;15:387–94.PubMedCrossRefGoogle Scholar
  12. Nucci MR, Oliva E. Gynecologic pathology. London: Elsevier Churchill Livingstone; 2009 (Volume in the series foundations in diagnostic pathology).Google Scholar
  13. Obiakor I, Maiman M, Mittal K, et al. The accuracy of frozen section in the diagnosis of ovarian neoplasms. Gynecol Oncol. 1991;43:61–3.PubMedCrossRefGoogle Scholar
  14. Ramzy I. Signet-ring stromal tumor of ovary: histochemical, light and electron microscopic study. Cancer. 1976;38:166–72.PubMedCrossRefGoogle Scholar
  15. Robboy SJ, Anderson MC, Russell P. Pathology of the female reproductive tract. London: Churchill Livingstone; 2002.Google Scholar
  16. Segal GH, Hart WR. Ovarian serous tumors of low malignant potential (serous borderline tumors). The relationship of exophytic surface tumors to peritoneal “implants”. Am J Surg Pathol. 1992;16: 577–83.Google Scholar
  17. Siedman JD, Kurman RJ, Ronnett BM. Primary and metastatic mucinous adenocarcinomas in the ovaries: Incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol. 2003;27:985–93.CrossRefGoogle Scholar
  18. Silva EG, Deavers MT, Malpica A. Patterns of low-grade serous carcinoma with emphasis on the nonepithelial-lined spaces pattern of invasion and the disorganized orphan papillae. Internat J Gynecol Pathol. 2010;29:507–12.PubMedCrossRefGoogle Scholar
  19. Snyder RR, Norris HJ, Tavassoli F. Endometrioid proliferative and low malignant potential tumors of the ovary. Am J Surg Pathol. 1988;12:661–71.PubMedCrossRefGoogle Scholar
  20. Stewart C, Brennan B, Hammond I, et al. Intraoperative assessment of ovarian tumors: a 5 year review with assessment of discrepant diagnostic cases. Int J Gynecol Pathol. 2006;25(3):216–22.PubMedGoogle Scholar
  21. Taskiran C, Erdem O, Onan A, et al. The role of frozen section evaluation in the diagnosis of adnexal mass. Int J Gynecol Cancer. 2008;18:235–40.PubMedCrossRefGoogle Scholar
  22. Tempfer C, Polterauer S, Bentz EK, et al. Accuracy of intraoperative frozen section analysis in borderline tumors of the ovary: a retrospective analysis of 96 cases and review of the literature. Gynecol Oncol. 2007;107:248–52.PubMedCrossRefGoogle Scholar
  23. Usubutun A, Altinok G, Kucukali T. The value of intraoperative consultation (frozen section) in the diagnosis of ovarian neoplasms. Acta Obstet Gynecol Scand. 1998;77:1013–6.PubMedCrossRefGoogle Scholar
  24. Young R. From Krukenberg to today: the ever present problems posed by metastatic tumors in the ovary. Part II. Adv Anat Pathol. 2007;14:149–77.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Pathology and Genomic Medicine The Methodist HospitalWeill Medical College of Cornell UniversityHoustonUSA
  2. 2.University of CaliforniaIrvineUSA

Personalised recommendations