Gross Pathology and Intraoperative Consultation

There is no distinctive gross appearance of ovarian clear cell carcinoma (CCC), which usually is recognizable as malignant but not specifically as CCC. Identification of the tumor grossly as occurring in association with an endometriotic cyst usually narrows the differential diagnosis down to CCC or endometrioid carcinoma as the most likely possibilities. At intraoperative pathologic consultation as well, the diagnosis of malignancy is generally easy to make, but specific clear cell features may be less obvious, and may actually be identified more easily on cytopathologic (tumor scrapes or imprints) than histopathologic (frozen section) preparations.