Is the Frozen Section Still Effective for Identifying Thyroid Lesions?
A 6-Year Retrospective Study in a Tertiary Hospital
Rr. Shinta Ananda Dwiyanti1,2*, Nila Kurniasari1,2, Alphania Rahniayu1,2
Abstract
Background: Thyroid nodules are highly prevalent, with malignancy risk increasing in nodules >4 cm. Intraoperative Frozen Section (FS) is crucial for real-time surgical management. This study evaluated FS diagnostic accuracy and discrepancies in thyroid specimens. Method: A single-center, retrospective study was conducted using 30 eligible thyroid specimens from Dr. Soetomo General Academic Hospital (2019–2024). Diagnostic performance (accuracy, sensitivity, specificity, PPV, NPV) was calculated, excluding 8 cases with an indeterminate FS diagnosis (follicular neoplasm) from the benign/malignant categorization. Result: FS achieved a high overall diagnostic accuracy of 95.45%. Specificity and PPV were both 100%, confirming high reliability for positive diagnoses. However, sensitivity was 75% and NPV was 94.74%. A single false-negative case of Papillary Thyroid Carcinoma (PTC) and the high deferral rate for follicular neoplasm (8/30 cases) were the main sources of error. Discussion: The high specificity (100%) and PPV (100%) confirm that FS is excellent at ruling in malignancies. However, the 25% false-negative rate and the high proportion of deferred diagnoses highlight the FS’s major limitations: difficulty in recognizing subtle PTC nuclear features in frozen tissue and the impossibility of assessing capsular or vascular invasion in follicular lesions intraoperatively. These limitations necessitate confirmation by a permanent section in ambiguous cases, restricting FS’s role in definitive one-stage surgery for indeterminate nodules. Conclusion: FS is a highly specific and accurate tool, effectively guiding surgical management. Yet, its use must be cautious for follicular patterned lesions due to the risk of deferred diagnosis and potential for false-negative results.
Keywords
thyroid nodule; frozen section; diagnostic accuracy; follicular neoplasm; papillary thyroid carcinoma.
Cite This Article
Dwiyanti, Rr. S. A., Kurniasari, N., Rahniayu, A. (2025). Is the Frozen Section Still Effective for Identifying Thyroid Lesions? A 6-Year Retrospective Study in a Tertiary Hospital. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 6: Nov – Dec 2025, Pages 994-999 URL: https://www.ijscia.com/wp-content/uploads/2025/11/Volume6-Issue6-Nov-Dec-No.964-994-999.pdf
Volume 6 | Issue 6: Nov – Dec 2025
