The primary function of intraoperative frozen consultation is to provide an as accurate and prompt diagnosis as possible during surgery and to guide the surgeon in further management. However, the evaluation of frozen section (FS) is sometimes difficult because of suboptimal tissue quality and frozen artifacts compared with routinely processed tissue section. The pathologist responsible for the FS diagnosis requires experience and good judgment. Ovarian tumors are a heterogeneous group of tumors including primary surface epithelial tumors, germ cell tumors and sex cord-stromal tumors, secondary tumors, and other groups of tumors of uncertain histogenesis or nonspecific stroma. Intraoperative FS is a very important and reliable tool that guides the surgical management of ovarian tumors. In this review, the diagnostic key points for the pathologist and the implication of the FS diagnosis on the operator’s decisions are discussed.
Artifacts ; Diagnosis ; Frozen Sections ; Judgment ; Neoplasms, Germ Cell and Embryonal ; Sex Cord-Gonadal Stromal Tumors

Sclerosing stromal tumor (SST) of the ovary is a rare tumor derived from the sex cord stroma. This tumor was first described by Chalvaridjian and Scully in 1973. SST of the ovary is prevalence of 1.5% to 6% of ovarian stromal tumors. Patients are most commonly diagnosed in their 20s and 30s. There have been reports of SST postmenopausal women aged 65-, 67-, and 71 in the Republic of Korea; however, no report of this disease has been reported in women older than 80. In this study, we would like to report an 80-year-old postmenopausal woman who did not previously complain of any symptoms, and was finally diagnosed with SST. She was involved in a traffic accident, and huge pelvic mass was found during the evaluation of intra-abdominal hemorrhage. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed ; a final pathologic diagnosis reported SST.
Accidents, Traffic ; Aged* ; Aged, 80 and over ; Diagnosis ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Ovary ; Postmenopause ; Prevalence ; Republic of Korea ; Sex Cord-Gonadal Stromal Tumors

Adult ; Breast Neoplasms ; metabolism ; pathology ; secondary ; Carcinoid Tumor ; metabolism ; pathology ; surgery ; Carcinoma, Adenoid Cystic ; pathology ; Carcinoma, Lobular ; metabolism ; pathology ; secondary ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Keratins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology ; Synaptophysin ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology ; surgery

Steroid cell tumor, not otherwise specified (NOS), are rare ovarian tumor, in addition, it is more rare in children. The majority of these tumors produce several steroid hormones, particularly testosterone. Estrogen also secreted by steroid cell tumor, NOS, but it is uncommon. Furthermore, hypertension is an infrequent sign in steroid cell tumor, NOS. An 8.5-yr-old girl with hypertension and frequent vaginal spotting visited at our clinic. On laboratory evaluation, secondary hypertension due to an elevated plasma renin level and isosexual pseudoprecocious puberty was diagnosed. Right solid ovarian mass was detected in radiologic tests. She underwent a right ooporectomy and it revealed renin and progesterone receptor positive steroid cell tumor, NOS. After operation, her blood pressure returned to normal level and vaginal bleeding disappeared. Even though this case is very rare, when hypertension coincides with virilization or feminization, a renin-secreting ovarian steroid cell tumor, NOS, should be considered.
Child ; Female ; Humans ; Hypertension/*etiology ; Ovarian Neoplasms/complications/*diagnosis/pathology ; Puberty, Precocious/enzymology/*etiology ; Receptors, Cell Surface/metabolism ; Receptors, Progesterone/metabolism ; Renin/blood ; Sex Cord-Gonadal Stromal Tumors/complications/*diagnosis/pathology ; Steroids/biosynthesis ; Tomography, X-Ray Computed ; Vacuolar Proton-Translocating ATPases/metabolism

Adenoma ; metabolism ; pathology ; surgery ; Aged ; Diagnosis, Differential ; Endodermal Sinus Tumor ; pathology ; Female ; Humans ; Immunohistochemistry ; Neprilysin ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Sex Cord-Gonadal Stromal Tumors ; pathology ; Stromal Cells ; metabolism ; pathology ; Vimentin ; metabolism

Sclerosing stromal tumor (SST) of the ovary is a rare, benign tumor. The most common clinical symptom is menstrual irregularity. Diagnosis of SST is often made by postoperative pathologic examination. The important differential diagnoses are other sex cord stromal tumors including fibroma, thecoma and etc. We present four cases of SST of the ovary during 10 years with a brief review of the literature.
Diagnosis, Differential ; Female ; Fibroma ; Ovary ; Sex Cord-Gonadal Stromal Tumors ; Thecoma

Aged ; Biomarkers ; metabolism ; Carcinoid Tumor ; metabolism ; pathology ; Carcinoma, Endometrioid ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Granular Cell Tumor ; metabolism ; pathology ; Humans ; Hysterectomy ; methods ; Keratin-7 ; metabolism ; Keratins ; metabolism ; Krukenberg Tumor ; metabolism ; pathology ; Middle Aged ; Mucin-1 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Sertoli Cell Tumor ; metabolism ; pathology ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology ; surgery

OBJECTIVEIn order to improve the preoperative diagnostic accuracy, the computed tomographic (CT) features of ovarian Brenner tumor were described and analyzed.

METHODSCT image and clinical data of nine patients with pathologically confirmed Brenner tumor were collected and analyzed retrospectively. There were 8 benign lesions and 1 borderline lesion.

RESULTSAll lesions in the nine cases were unilateral, round, lobulated or irregular in shape and well defined, in a mean diameter of 7.8 cm. Among the nine cases, 5 were benign tumors with uniform structure, 3 were benign tumors accompanied with other pathological components, and 1 was borderline tumor. On the CT images, the 5 uniform benign lesions showed to be solid tumor of low density (lower than that of muscle) or with small cyst inside, two of the 5 lesions had calcification, and other 2 lesions showed slightly heterogeneous enhancement after enhanced scanning. The 3 benign Brenner tumors accompanied with other pathological structures were solid-cystic or cystic, with a clear demarcation of solid and cystic components. The density of solid parts was lower than that of muscle, and slight enhancement, and one of them had calcification. The one borderline tumor was a heterogeneous solid one and its density was higher than that of muscle, with a large proportion of low density and large calcification, and moderately enhanced after enhancing. None of the 9 cases had metastasis or effusion.

CONCLUSIONOvarian Brenner tumors are usually unilateral and often accompanied with other type of tumor components. When a tumor is of uniform component, the CT imaging often shows a homogeneous solid tumor with homogeneous or heterogeneous density. When a tumor is accompanied with other tumor components, it may be solid-cystic or cystic and has partial calcification. After enhancing, a benign Brenner tumor is slightly enhanced, while the borderline one is moderately/highly enhanced.

Aged ; Brenner Tumor ; diagnosis ; diagnostic imaging ; Carcinoma, Transitional Cell ; diagnosis ; Cystadenoma, Mucinous ; diagnostic imaging ; Cystadenoma, Serous ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; diagnostic imaging ; Ovary ; diagnostic imaging ; Sex Cord-Gonadal Stromal Tumors ; diagnosis ; Tomography, Spiral Computed ; methods

12E7 Antigen ; Antigens, CD ; metabolism ; CD56 Antigen ; metabolism ; Calbindin 2 ; Carcinoma, Endometrioid ; metabolism ; pathology ; Cell Adhesion Molecules ; metabolism ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Inhibins ; metabolism ; MART-1 Antigen ; metabolism ; Neprilysin ; metabolism ; Ovarian Neoplasms ; diagnosis ; metabolism ; S100 Calcium Binding Protein G ; metabolism ; Sertoli-Leydig Cell Tumor ; metabolism ; pathology ; Sex Cord-Gonadal Stromal Tumors ; diagnosis ; metabolism ; Steroidogenic Factor 1 ; metabolism ; WT1 Proteins ; metabolism

Adenocarcinoma, Mucinous ; metabolism ; pathology ; Calbindin 2 ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; methods ; Inhibins ; metabolism ; Keratin-7 ; metabolism ; Mucin-1 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; S100 Calcium Binding Protein G ; metabolism ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology