Diagnostic accuracies of intraoperative frozen section and permanent section examinations for histological grades during open biopsy of bone tumors

Int J Clin Oncol. 2021 Mar;26(3):613-619. doi: 10.1007/s10147-020-01836-1. Epub 2020 Nov 23.


Background: A histological diagnosis obtained from an intraoperative frozen section (FS) during biopsy confirms the adequacy of tumor tissue in the specimen. However, some cases show a discrepancy among the intraoperative FS diagnosis, permanent section (PS) diagnosis of the biopsy specimen, and the final diagnosis of the excised tumor specimen. In this study, we retrospectively investigated the diagnostic accuracy of the FS and PS for different types of bone tumors.

Methods: This study included 377 patients with 411 bone tumors who underwent tumor excision after an open biopsy with intraoperative FS diagnosis. FS, PS, and final diagnoses of the patients were classified into benign tumors/tumor-like lesions, intermediate malignancies, and malignant tumors. To assess diagnostic accuracy, the histological grades in FS and PS diagnoses were compared with those in the final diagnoses.

Results: The overall diagnostic accuracies of FS and PS were 93% and 97%, respectively. The accuracy of FS and PS for histological grade was 84% and 93% for chondrogenic tumors, 90% and 96% for osteogenic tumors, 97% and 98% for osteoclastic giant cell-rich tumors, 100% and 100% for tumors of undefined neoplastic nature, and 95% and 99% for other bone tumors, respectively.

Conclusion: These data suggest that surgical planning based on PS diagnosis is recommended for chondrogenic and osteogenic tumors.

Keywords: Accuracy; Bone tumor; Frozen section diagnosis; Histological grade.

MeSH terms

  • Biopsy
  • Bone Neoplasms* / surgery
  • Frozen Sections*
  • Humans
  • Retrospective Studies