Ovary and Fallopian Tube

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.KeywordsLeydig CellNuclear AtypiaAdnexal MassBorderline TumorGranulosa Cell TumorThese 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.