Evaluation of Concordance Between Intraoperative Frozen Section and Final Histopathology in Adnexal Masses

INTRODUCTION: The aim of this study was to evaluate the concordance between intraoperative frozen-section diagnosis and final paraffin-embedded histopathological examination in patients operated for adnexal masses, in order to assess the reliability of frozen-section analysis for intraoperative decision-making.
METHODS: Data from 50 patients who underwent surgery between September 2024-November 2025, for adnexal masses at the Gynecology Department of Gaziantep City Hospital and had intraoperative frozen-section evaluation followed by final pathology were retrospectively analyzed. Demographic, clinical, radiological, laboratory (tumor markers), surgical (laparoscopy vs. laparotomy), and pathological data (frozen and final diagnoses) were collected.
RESULTS: The median age of patients was 47.8 years (range 34–74), and the median BMI was 32.4 kg/m² (range 24–42). The median preoperative blood CA-125 level was 86 U/mL (range 8–760), with 60% of patients exceeding 35 U/mL. Median tumor size was 13.7 cm (range 6–32), and 80% of masses were unilateral. Intraoperative frozen-section diagnosed 52% as benign, 20% as borderline (“most likely,” borderline or “at least borderline”), and 16% as malignant. Final histopathology revealed 60% benign, 16% borderline, and 24% malignant tumors. The majority of surgeries were performed via laparotomy (72%).
DISCUSSION AND CONCLUSION: In this cohort, frozen-section diagnosis demonstrated a high rate of agreement with final pathology for benign and malignant adnexal masses supporting its role as a valuable intraoperative tool for guiding surgical management.

Keywords: Adnexal Mass, Frozen Section, Histopathology, Ovarian Neoplasms, Gynecologic Oncology