Value of frozen sections in uropathology.

Abstract

The indications of frozen section diagnosis in uropathology are quite specific, and this explains the fact that they amount to a mere 7.3% of the frozen sections performed in general hospitals. Generally speaking, frozen sections are not warranted to identify the nature of a tumoral mass, with the following exceptions: (1) renal masses of a doubtful parenchymal origin or located in the urinary tract, (2) testicular neoplasias, when the possibility of a conservative treatment arises, and (3) determination of the presence of a prostate adenocarcinoma in an organ donor with high serum prostate-specific antigen (but even in these circumstances the need is widely controversial). Intraoperative determination of surgical margins is particularly useful in (1) partial nephrectomies (it may be limited to inspection after dyeing the margin with India ink; bed freezing is very seldom needed) and (2) partial penectomies (always studying the urethral margin and the cavernosal and spongiosal corpora margins). The study of the nodes is a widely debated issue, and except for those cases in which unexpectedly increased node size is found, systematic frozen sections are indicated neither of the bladder nor of the prostate. The situation regarding penis carcinoma is different, as in the groups with intermediate and high risk of node metastasis; frozen section is recommended, particularly of radioisotope-marked sentinel nodes.