Malignant eyelid tumors: Are intra-operative rapid frozen section and permanent section diagnoses of surgical margins concordant?

Purpose: To study the concordance between intra-operative rapid frozen section and permanent section diagnoses of surgical margins following wide surgical excisional biopsy of malignant eyelid tumors.

Methods: This is a retrospective study of 120 cases and 429 frozen section slides.

Results: Of 120 cases, 75 (63%) had sebaceous gland carcinoma, 34 (28%) had basal cell carcinoma, and 11 (9%) had squamous cell carcinoma. All cases with these malignant eyelid tumors underwent wide surgical excisional biopsy under frozen section control of surgical margins. A total of 429 frozen section slides were reviewed for rapid frozen section diagnosis. Eyelid reconstruction was performed in all cases after clearance was obtained by rapid frozen section diagnosis of surgical margins as negative for tumor infiltration. Permanent section diagnosis of surgical margins was positive for tumor infiltration in 5 (1%) slides, which were reported as negative on rapid frozen section diagnosis of surgical margins, and was negative for tumor infiltration in 3 (< 1%), which were reported as positive on initial rapid frozen section diagnosis of surgical margins. The sensitivity, specificity, and accuracy of intra-operative rapid frozen section diagnosis of surgical margins for malignant eyelid tumors were 89%, 99%, and 98%, respectively.

Conclusion: The concordance between the intra-operative rapid frozen section and permanent section diagnoses of surgical margins following wide surgical excisional biopsy of malignant eyelid tumors is excellent at 98%.