The importance of frozen section analysis in head, neck, and endocrine pathology

The diagnosis of head, neck, and endocrine (HNE) malignancies involves the correlation of histologic features with clinical and radiological findings and, ideally, in a multidisciplinary approach. Frozen section examination of HNE lesions from the oral cavity, sinonasal area, pharynx and larynx, salivary gland, or thyroid gland provides an immediate intraoperative evaluation for a tissue diagnosis, specimen margin assessment, tumor depth of invasion, and determining other important histologic features. Frozen sections of the salivary gland tumors help to differentiate benign from malignant and low-grade from high-grade tumors and evaluate lymph node involvement. Advances in diagnostic modalities, including updates in the WHO 5th edition, have enhanced pathologists' ability to navigate these challenging diagnoses. This review highlights the frequently encountered frozen section requests in daily HNE practice and discusses diagnostic challenges and differential diagnosis.