Correlation of macroscopic and microscopic pathology in risk reducing salpingo-oophorectomy: Implications for intraoperative specimen evaluation

Abstract Objective

A minority of risk-reducing salpingo-oophorectomy (RRSO) specimens from BRCA mutation carriers will contain clinically occult carcinoma that is detectable only using a specialized pathologic evaluation protocol. Although intraoperative detection of cancer may alter immediate surgical management, technical complications impairing pathologic diagnosis may result if fresh tissue dissection and frozen sections are performed on unselected RRSO specimens. We hypothesize that macroscopic specimen findings may predict which RRSO specimens contain cancer and therefore may guide selection of specimens for intraoperative pathologic evaluation. The aim of this study was to correlate the macroscopic and microscopic pathologic findings in RRSO.

 Research highlights

► Most occult carcinomas detected in RRSO specimens were not grossly visible.
► A minority of visible nodules >5 mm in the ovary or tube harbored occult carcinoma.
► No cancer was identified in any of the grossly visible cysts of the ovary or tube.