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Dr. Arfahiza Selimin

Frozen section in Gynae Pathology

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Case 1:

27 y.o, Malay, nulliparous with huge ovarian mass
Intraoperative :

- Huge right ovarian tumour

- cystic in nature

- FT and uterus : normal

Case 2:

21 y.o, Malay, Para 1, LCB : >6 yrs ago
Abdominal distension x 2/52
LOA with significant LOW
TAS :

- Multilobated right ovarian mass, 15x12cm

- Partly thick septae

- No papillary projection

- Minimal ascites

CT TAP :

- Large multiseptated intraabdominal cystic mass likely arising from ovary

Intraoperative :

- Right ovarian mass, 20x15cm

- Capsule intact

- Minimal ascites

CA125, AFP and CEA : Normal limit.

Case 3:

45 y.o, nulliparous
Underlying DM and HPT
Incidental finding of palpable mass about 30 wks size during admission for Rt DFU
CT TAP :

- Large well defined pelvic mass, possibly arising from left adnexa, 13.8 x 15.3 x 16cm.

Intraoperative :

- Huge Lt ovarian tumour, twisted x2

CA125 : 46 u/ml, CEA : 4.6 ng/ml, LDH : 626 U/L

Case 4:

65 y.o, Malay, Para 4+1
Abdominal mass x 6/12
CT TAP :

- A large cystic lesion arising from Rt adnexa, 12.1 x 21.4 x 17.4cm.

- Enhancing thickened septae.

- Impression : Large adnexal mass with suspicious liver lesion.

DifDx : Ovarian serous cystadenoca, ovarian mucinous cystadenoca

Intraoperative :

- Bilateral ovarian tumour, Rt : 15x20cm, twisted x1, cystic.

Lt ovary : 7x7cm, cystic.

- Uetrus, Rt & Lt FT : Normal.

- No deposit.

- Minimal ascites.

CA125 : 77 u/ml, LDH : 249 U/L, CEA and AFP : Normal.

Case 5:

51 y.o, Chinese, Para 2
Pipelle sampling : Endometrioid adenocarcinoma, FIGO grade 1
Intraoperative :

- Uterus enlarged, 14 weeks size

- Few enlarged Rt and Lt pelvic LN

- Paraaortic LN : not enlarged

- Ovary & fallopian tube : normal

Case 6:

65 y.o, Para 6+1
Post menopausal bleeding x 1 yr
No abdominal pain
No constitutional symptom
Biopsy: Endometrial ca, FIGO grade 1

Case 7:

33 y.o, Para 2+1
Abdominal swelling x 3/12, increasing in size
Intraoperative :

- Rt ovarian tumour, mixed solid cystic component, 30x25cm

- Intact capsule with hypervascular area overlying the capsule

- Tumour adhered to lateral part of uterus, ruptured during manipulation

- containing chocolate fluid material

Case 8:

43 y.o, Para 2, NKMI
Abdominal mass and distension, progressively increased in size.
CT TAP : Solid and cystic ovarian mass, likely left complex ovarian tumour.
Intraoperative :

- Left ovarian tumour, ruptured during manipulation.

- Containing yellowish fluid.

Case 9:

33 y.o, Nulliparous and obese with primary subfertility for 7 yrs.
Abdominal distension x 6/12, LOW.
History of prolonged irregular per vaginal bleeding with uterine fibroid.
Hysteroscopy : VV : NAD, Cervix : Normal, Midcavity : Polypoidal growth at anterior wall.
Pipelle sampling : Atypical polypoid adenomyoma with suspicious early endometrioid adenocarcinoma.
Intraoperative :

- Enlarged, 14 to 16 weeks size.

- Huge multiloculated ovarian tumour, 40x25cm.

Case 10:

22 y.o, nulliparous.
Abdominal mass with rapid increasing in size.
CT TAP : large lobulated pelvic mass most likely ovarian in origin.
CA125 : 110 u/ml, LDH : 3415 U/L, AFP and CEA : normal limit.
Intraoperative :

- large lobulated right solid ovarian tumour, 21x21x10cm.

- moderate adhesion between ovarian tumour and omentum.

- left ovary : normal.

Case 11:

26 y.o, Nulliparous.
Abdominal distension with abdominal discomfort x 1 yr.
CT TAP :

- Huge multiseptated intraabdominal cystic mass likely right ovarian mass.

CA125 : 64 u/ml, AFP and βhCG : normal.
Intraoperative :

- Huge right ovarian tumour, multiseptated, capsule intact.

- minimal ascites.