Surgical Pathology Cancer Case Summary

ENDOMETRIUM:             Report

ENDOMETRIUM: Hysterectomy with or without other organs or tissues

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Hysterectomy

___ Radical hysterectomy

___ Pelvic exenteration

TUMOR SITE

___ Unspecified

___ Corpus

___ Fundus

___ Lower uterine segment

___ Right cornu

___ Left cornu

___ Isthmus

TUMOR SIZE: ___ x ___ x ___ cm

CLOSEST MARGIN TO TUMOR

___ Cervical/Vaginal (distance from tumor: ___ cm)

___ Right parametrial (distance from tumor: ___ cm)

___ Left parametrial (distance from tumor: ___ cm)

___ Other (specify:__________________________; distance from tumor: ___ cm)

OTHER ORGANS (if applicable, see optional Extended Synopsis)

___ None

___ Right ovary

___ Left ovary

___ Vagina

___ Vulva

___ Right fallopian tube

___ Left fallopian tube

___ Urinary bladder

___ Rectum

___ Other(s) (specify: ______________)

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Endometrioid carcinoma

___ Adenocarcinoma

___ Secretory (variant)

___ Ciliated cell (variant)

___ Adenocarcinoma with squamous differentiation

___ Adenoacanthoma

___ Adenosquamous carcinoma

___ Serous adenocarcinoma

___ Clear cell adenocarcinoma

___ Mucinous adenocarcinoma

___ Squamous cell carcinoma

___ Mixed carcinoma

___ Undifferentiated carcinoma

___ Other (specify: ______________________)

HISTOLOGIC GRADE, if applicable (Grading system below applies primarily to endometrioid carcinoma)

___ Not applicable

___ GX: Cannot be assessed

___ G1: < 5% non-squamous solid growth

___ G2: 6-50% non-squamous solid growth

___ G3: > 50% non-squamous solid growth

EXTENT OF INVASION

TNM (FIGO)

___ TX (--): Primary tumor cannot be assessed

___ T0 (--): No evidence of primary tumor

___ Tis (--): Carcinoma in situ

___ T1 (I): Tumor confined to corpus uteri

___ T1a (IA): Tumor limited to endometrium

___ T1b (IB): Tumor invades up to or less than one half of the myometrium

___ T1c (IC): Tumor invades to more than one half of the myometrium

___ T2 (II): Tumor invades cervix, but does not extend beyond uterus

___ T2a (IIA): Endocervical glandular involvement

___ T2b (IIB): Cervical stromal invasion

___ T3 (III): Local and/or regional spread as specified in T3a, b, N1 and FIGO IIIA, B, and C below

___ T3a (IIIA): Tumor involves serosa and/or adnexa (direct extension or metastasis) and/or cancer cells in ascites or peritoneal washings

___ T3b (IIIB): Vaginal involvement (direct extension or metastasis)

___ T4 (IVA): Tumor invades bladder mucosa and/or bowel mucosa

___ M1 (IVB): Distant metastasis

MARGINS

___ Uninvolved by tumor

Distance of tumor from closest margin: ___ cm

(Specify margin: ________________________)

___ Involved by tumor

(Specify margin(s):_______________________)

BLOOD/LYMPHATIC VESSEL INVASION

___ Absent

___ Present

___ Indeterminate

REGIONAL LYMPH NODES

___ NX: Cannot be assessed

___ N0: No regional lymph node metastasis

Number examined: ___

___ N1: Regional lymph node metastasis

Number examined: ___

Number involved: ___

DISTANT METASTASIS

___ MX: Cannot be assessed

___ M0: No distant metastasis

___ M1 (IVB): Distant metastasis

(site(s):_______________________________)

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Hyperplasia

___ Simple

___ Complex (adenomatous)

___ Atypical hyperplasia

___ Simple

___ Complex (adenomatous with atypia)

___ Other (specify: _____________________)

COMMENT

___________________________________________

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