Surface integrals in ECEF coordinates?

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I was doing some general thinking about mathematics and calculus, and I was wondering if it is possible to find the surface area of any place on Earth using integration in the Earth-Centered, Earth-Fixed (ECEF) Coordinate System.

I was thinking along the lines of doing so in spherical and cylindrical coordinate systems, but I am confused because of the elliptical shape of the Earth. Thank you for any help you can provide!