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The intraoperative frozen section is a well established procedure for rapid diagnosis that helps in making therapeutic decisions.Assessment of the accuracy of frozen section diagnosis and analysis of the causes of its discordance.A retrospective review of 1695 surgical specimens performed in 1207 patients between January 2002 and April 2005. Frozen section results were compared with the final diagnoses in paraffin sections.The frozen section diagnosis was benign in 84.2%, malignant in 10.2% and borderline in 0.4% of all cases. The frozen section result was deffered to permanent section in 5.2%. The sensitivity, specificity, positive and negative predictive values were 84.6%, 99.8%, 98.2% and 97.8% respectively. Overall diagnostic agreement was 97.5% (Kappa=0.88). Frozen section diagnosis was incorrect in 2.5% of cases. Most of the discrepancies were false negative cases frequently due to sampling errors and misinterpretation. False positive cases were always related with misinterpretation.The frozen section evaluation is highly accurate and reliable. However, the surgeon and the pathologist must be aware of its limitations.

Odontogenic myxoma is an uncommon tumor that represent less than 0,5% of all bone tumors and only 3 to 6% of odontogenic tumors. The aim of this article was to catalogue the clinical cases diagnosed microscopically as odontogenic myxoma and to describe their clinical and radiographic characteristics, comparing these to the data found in the current literature.Histological and immunocytochemical examinations were performed on odontogenic myxomas from four Tunisian patients in a period of 23 years.In the present series, two were male and two female. The age at diagnosis ranged from 19 to 38 years. Three tumors involved the mandible and one occurred in the maxilla. In all cases with radiographic records, lesions presented with a multilocular and osteolytic appearance. Histologically, odontogenic myxomas were mainly composed of spindled or stellate-shaped cells in a mucoid-rich intercellular and alcian blue positive matrix. All cases were treated by tumor-enucleation. There was no evidence of recurrence after 2 to 8 years.Clinical and radiological aspects of odontogenic myxomas are not conclusive; a histopathological examination of the lesion is mandatory in order to make the right diagnosis. Because of its high rate of recurrence, surgical treatment through bone resection is the most indicated treatment modality, and the patient must be followed-up closely for years.

The purpose of this study was to assess the value of intraoperative frozen section diagnosis in thyroid surgery and determine its limitations.This retrospective study examined the results of 409 frozen sections of thyroid specimens analyzed over the 4-year period and their correlations with the final histological examination.In our series, frozen section diagnosis was concordant with subsequent histopathological examination in 96.6% of cases, discordant in 3.4%. All discordances were due to false-negative diagnoses. Non-false-positive result was found. The global specificity of frozen section analysis for all histological subtypes was 100% and its sensitivity was 68.2%.The frozen section evaluation of thyroid neoplasm is highly accurate and specific. A high degree of specificity with an acceptable sensitivity is requested. However, the frozen section examination has still some limits in the diagnosis of microfollicular lesions.

Suprasellar germinomas are frequent in childhood and adolescence, particularly in male sex. The clinical and neuroendocrine abnormalities depend of tumor localization: Increased intracranial pressure, visual disturbances, hypopituitarism, Parinaud syndrome. We report two cases of suprasellar germinoma in young male patients (16 and 18 years old). The first patient hrad corticotorpin insufficiency and clinical signs of hypothyroïdism and hypogonadism. The second had central hypocorticism, hypothyroïdism and hypogonadism associated with central diabetes insipidus and hyperprolactinemia. The diagnosis of germinoma was confirmed after surgery by anatomopathologic examination in the first case and by stereotaxic biopsy in the second case. Treatment by radiotherapy improves prognosis of this disease.

Mycosis fungoides is an epidermotropic cutaneous T lymphoma. It's a non Hodgkinian lymphoma. We report the results of a retrospective review of 11 mycosis fungoide seen during 22 years. The frequency of MF was about 39.3% among all cutaneous lymphoma. Six patients were male and 5 were female; the mean age was about 56 years. Mean delay between diagnostic and the first manifestation was about 25 months. All patients had the progressive form: 4 had infiltrate plaques and 7 were at the tumoral phase. Lymph nodes and medullar metastases were noted respectively in 1 and 2 cases. Treatment was mono or polychemotherapy associated in 6 cases with topical drug. Three patients died of their diseases According to our experience and after reviewed the literature, we notice that our patients are slightly younger without male predominance. The diagnostic was done tardily and this may explain the pejorative prognostic.