Indications

The main purpose of an intraoperative biopsy processed as a frozen section is to enable the surgeon to make decisions that may change the therapeutic course of action during surgery.29,30 Two primary reasons for frozen section in tumor-containing orbits and adnexa are to provide histopathologic diagnosis for the clinically abnormal tissue and to determine the surgical excision margins of tumor specimens to ensure the adequacy of the excision.31,32 Lesser indications for the frozen section technique include the following: to confirm the adequacy of the tissue amount and/or nature for permanent processing; to identify inadvertent excision of a normal structure such as the lacrimal gland, peripheral nerve, or sinus mucosa; and to confirm the appropriateness of the tissue obtained for ancillary studies such as electron microscopy, im-munohistochemistry, or molecular genetic studies.33 Another very useful application of frozen section in the orbit is to differentiate inflammatory lesions from neoplastic ones. Once the lesion has been determined to be an inflammatory or infectious process, specimens are obtained for cultures, polymerase chain reaction (PCR), and other studies, and the surgery is completed.

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