الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Ovarian cancer is a challenging health problem with an estimated count of 313,959 new cases annually (1.6 % of total cancer incidence) and 207,252 annual cancer-related deaths (2.1 % of all cancer-related mortality) (Sung et al., 2021) . It constitutes about 25 % of all gynecological cancer and up to 50% of gynecological cancer-related mortality (Shahmoradi and Arab, 2020). Ovarian cancer rarely occurs before the age of forty and its incidence increases in older age groups, especially in perimenopausal and postmenopausal women. The most important risk factors include positive family history, old age, and nulliparity (Palakkan et al., 2020). The surgical staging for early ovarian cancer includes bilateral salpingo-oophorectomy, hysterectomy, omentectomy, peritoneal biopsy, iliac and paraaortic lymphadenectomy (National Comprehensive Cancer Network, 2021) which can carry more morbidity than oophorectomy. This staging –for malignant ovarian tumors- is important to provide adequate data for the postoperative treatment plan and to help evaluate the prognostic status as well (De Decker et al., 2021). Frozen section –which is a useful intraoperative tool with a rapid result- can help in designing the proper operative plan for the patients with ovarian swellings to avoid any unnecessary surgical steps and avoid the need for a second surgery or empirical chemotherapy as well. The frozen section can differentiate between benign, borderline, and malignant ovarian masses with acceptable accuracy. It hence provides a practical solution to answer the question about the nature of complex ovarian masses with normal tumor markers which can constitute up to 50% of early ovarian cancer as well as avoiding overtreatment in benign ovarian masses with mild reactionary ascites (Sukumaran et al., 2014; Mohammed et al., 2015; Karataşlı et al., 2020; Yoshida et al., 2020; Kumar et al., 2021) The use of frozen section examination in the assessment of complex ovarian masses with normal tumor markers offers an acceptable accuracy with a significant decrease of the operative time, blood loss as well as less hospital stay. It should be offered as a good alternative to comprehensive surgical staging and panhysterectomy in such a group of patients.