Utility of frozen section in pediatric and adolescent malignant ovarian nonseminomatous germ cell tumors: A report from the children’s oncology group

Dicken BJ, Billmire DF, Rich B, Hazard FK, Nuño M, Krailo M, Fallahazad N, Pashankar F, Shaikh F, Frazier AL. Utility of frozen section in pediatric and adolescent malignant ovarian nonseminomatous germ cell tumors: A report from the children’s oncology group. Gynecol Oncol. 2022 Sep;166(3):476-480. doi: 10.1016/j.ygyno.2022.06.013. Epub 2022 Jun 22. Review. PubMed PMID: 35750503; PubMed Central PMCID: PMC9514449.

In adult women, most malignant ovarian tumors are epithelial in origin. The use of intra-operative frozen section to distinguish between benign and malignant histology is reliable in guiding operative decision-making to determine the extent of surgical staging required. Pediatric and adolescent patients with ovarian masses have a much different spectrum of pathology with most tumors arising from germ cell precursors. This review was undertaken to assess the concordance between the intra-operative frozen section and the final diagnosis as an aid to guide extent of surgical staging in a group of pediatric and adolescent patients with malignant ovarian germ cell tumors. Records of patients aged 0 to 20 years with malignant ovarian germ cell tumors enrolled on Children’s Oncology Group study AGCT0132 were reviewed. Pathology reports from patients who had both intra-operative frozen section diagnosis and final paraffin section diagnosis were compared using descriptive statistics. By inclusion criteria for the study, all patients had a final diagnosis of malignancy with required yolk sac tumor, choriocarcinoma or embryonal carcinoma histology. Available central review of pathology final paraffin section slides were compared with final institution pathology reports.