Surgical Pathology Cancer Case Summary
ANUS: Report
MACROSCOPIC (check all that apply)
TUMOR SITE
___ Unknown
___ Anterior wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Posterior wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Right wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Left wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Anal margin
ADEQUACY OF SPECIMEN
___ Satisfactory
___ Limited (see COMMENT)
___ Unsatisfactory (see COMMENT)
COMMENT
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MICROSCOPIC (check all that apply)
HISTOLOGIC TYPE
___ Cannot be determined
___ Squamous cell carcinoma
___ Adenocarcinoma
___ Small cell carcinoma
___ Other:___________________
HISTOLOGIC GRADE (if applicable to tumor type)
___ Cannot be determined
___ GX: Cannot be assessed
___ G1: Well differentiated
___ G2: Moderately differentiated
___ G3: Poorly differentiated
___ G4: Undifferentiated