Diagnostic Accuracy of Frozen Section in Musculoskeletal Tumors

Abstract

Introduction: Musculoskeletal tumors are rare group of disorders. To reach a diagnosis requires detailed medical history, physical examination, radiological investigations and histopathological correlation. Intra operative consultation plays an important role in the management of soft tissue tumors. However, there is a considerable lack of literature evaluating the diagnostic accuracy of frozen sections in musculoskeletal tumors. This study is aimed because no local data is available on the accuracy of frozen section in musculoskeletal tumors and frozen section allows intraoperative diagnosis. Objective: To evaluate the diagnostic accuracy of intra-operative frozen sections for musculoskeletal tumors i.e, bone and soft tissue benign and malignant. Study Design: Descriptive cross sectional study. Setting: Section of Orthopaedic, Department of Surgery, The Aga Khan University Hospital. Duration of Study: From 12 th October 2018 to 5 th August to 2019. Materials and Methods: A cross sectional descriptive study was designed to evaluate the Diagnostic accuracy of frozen section in musculoskeletal tumors at a tertiary care hospital, Karachi. All the patients meeting the inclusion criteria were enrolled in the study and sensitivity, specificity, PPV, NPV and diagnostic accuracy were calculated for frozen section keeping permanent section as gold standard. Results: Of the total 88 patient 48 (54.54%) were male and 40 (45.45%) were female. Mean age was 30.75 years (5–80 years). 63(71.59%) patients have bone tumors while 25(28.40%) have soft tissue tumors. 50(56.81%) patients have tumour involving lower extremity, 23(26.13%) have upper extremity tumors and 15 (17.04%) have tumour involving pelvis. Overall sensitivity of frozen section for benign and malignant tumour of bone and soft tissue was 96.66%, specificity was 100%, positive predictive value 100%, and negative predictive value 93.33% and accuracy was 97.72%. Conclusion: Frozen section serves as an invaluable and accurate tool in the intraoperative evaluation of musculoskeletal tumors. A diagnosis of musculoskeletal tumor by the frozen section method is highly reliable.