Clinically Suspected Dysgerminoma Sent for Frozen Section Confirmation: A Case With Review and Differential Diagnosis of Clear Cell Carcinoma

Abstract

Clear cell carcinoma accounts for 10% of ovarian cancer in the West and is often associated with endometriosis or adenofibroma, both of which are now considered precursor lesions of clear cell carcinoma and endometrioid carcinoma, with intermediary lesions atypical endometriosis and borderline (atypical proliferative, atypical) adenofibroma. The development of atypical endometriosis or borderline adenofibroma followed by clear cell carcinoma suggests a stepwise progression of neoplasia and is supported by mutational profiling. Clear cell change is common in ovarian surface epithelial tumors, as well as some germ cell tumors, which may obfuscate the diagnosis, particularly in the intraoperative setting. A case is presented of a clinically suspected dysgerminoma in a young patient for which frozen section was performed to confirm the diagnosis. Discussion will focus on ovarian cancers with clear cells with particular emphasis given to clear cell carcinoma.