Surgical Pathology Cancer Case Summary

FALLOPIAN TUBE:             Report

Surgical Pathology Cancer Case Summary

FALLOPIAN TUBE: Unilateral salpingectomy or salpingo-oophorectomy, Hysterectomy with salpingo-oophorectomy with or without pelvic exenteration

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Right fallopian tube

___ Left fallopian tube

___ Right salpingo-oophorectomy

___ Left salpingo-oophorectomy

___ Hysterectomy with salpingo-oophorectomy

___ Without pelvic exenteration

___ With pelvic exenteration

PRIMARY TUMOR SITE

___ Right fallopian tube

Relationship to ovary

___ Not fused

___ Fused

Status of fimbriated end

___ Open

___ Closed

___ Left fallopian tube

Relationship to ovary

___ Not fused

___ Fused

Status of fimbriated end

___ Open

___ Closed

TUMOR LOCATION

___ Fimbria(e)

___ Ampulla

___ Isthmus

___ Interstitial portion

___ Combination

TUMOR SIZE: ___ x ___ x ___ cm

OTHER ORGANS (if applicable, see optional Extended Synopsis)

___ None

___ Right ovary

___ Left ovary

___ Uterine cervix

___ Uterine corpus

___ Vagina

___ Vulva

___ Right fallopian tube

___ Left fallopian tube

___ Urinary bladder

___ Rectum

___ Other(s) (specify: ______________)

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Carcinoma in situ

___ Serous carcinoma

___ Mucinous carcinoma

___ Endometrioid carcinoma

___ Clear cell carcinoma

___ Transitional cell carcinoma

___ Squamous cell carcinoma

___ Undifferentiated carcinoma

___ Other (specify: ____________________________)

HISTOLOGIC GRADE

___ Not applicable

___ GX: Cannot be assessed

___ G1: Well differentiated

___ G2: Moderately differentiated

___ G3: Poorly differentiated

___ G4: Undifferentiated

EXTENT OF INVASION

TNM (FIGO)

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

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

___ Tis (0): Carcinoma in situ (limited to tubal mucosa)

___ T1 (I): Tumor limited to fallopian tube(s)

___ T1a (IA): Tumor limited to one tube without penetrating the serosal surface: no ascites

___ T1b (IB): Tumor limited to both tubes without penetrating the serosal surface: no ascites

___ T1c (IC): Tumor limited to one or both tube(s) with extension into or through the tubal serosa; or with malignant cells in ascites or peritoneal washings

___ T2 (II): Tumor involves one or both tube(s) with pelvic extension

___ T2a (IIA): Extension and/or metastasis to the uterus and/or ovaries

___ T2b (IIB): Extension to other pelvic structures

___ T2c (IIC): Pelvic extension (T2a or b) with malignant cells in ascites or peritoneal washings

___ T3 and/or N1 (III): Tumor involves one or both tube(s) with peritoneal implants outside the pelvis and/or regional lymph node metastasis

___ T3a (IIIA): Microscopic peritoneal metastasis beyond pelvi

___ T3b (IIIB): Macroscopic peritoneal metastasis beyond pelvis < 2 cm in greatest dimension

___ T3c (IIIC): Peritoneal metastasis beyond pelvis > 2 cm in greatest dimension and/or regional lymph node metastasis

MARGIN(S), IF APPLICABLE

___ 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 (IV): Distant metastasis (site(s):________)

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Salpingitis (type: ________________________)

___ Dysplasia

___ Other (specify: _________________________)

COMMENT

___________________________________________

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