Surgical Pathology Cancer Case Summary

UPPER AERODIGESTIVE TRACT:             Report

UPPER AERODIGESTIVE TRACT: Resection

MACROSCOPIC (check all that apply)

SPECIMEN TYPE: ______________________________

TUMOR SITE

___ Lip

___ Oral cavity

___ Pharynx

___ Oropharynx

___ Hypopharynx

___ Nasopharynx

___ Larynx

___ Supraglottis

___ Glottis

___ Subglottis

___ Maxillary sinus

___ Ethmoid sinus

___ Salivary gland (specify: ____________________)

___ Unknown

TUMOR SIZE: _____ x _____ x _____

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Squamous cell carcinoma

___ Verrucous squamous cell carcinoma

___ Spindle cell carcinoma

___ Adenoid squamous cell carcinoma

___ Basaloid squamous cell carcinoma

___ Adenocarcinoma

___ Acinic cell carcinoma

___ Mucoepidermoid carcinoma

___ Adenoid cystic carcinoma

___ Carcinoma in pleomorphic adenoma

___ Epithelial-myoepithelial carcinoma

___ Clear cell carcinoma

___ Adenosquamous carcinoma

___ Giant cell carcinoma

___ Salivary duct carcinoma

___ Carcinoid tumor

___ Atypical carcinoid tumor

___ Small cell carcinoma

___ Lymphoepithelial carcinoma

___ Undifferentiated carcinoma

___ Other (specify: ____________________________)

HISTOLOGIC GRADE

___ GX: Cannot be assessed

___ G1: Well differentiated

___ G2: Moderately differentiated

___ G3: Poorly differentiated

___ G4: Undifferentiated

EXTENT OF INVASION (see appropriate site below)

Lip and Oral Cavity

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

___ T1: Tumor < 2 cm in greatest dimension

___ T2: Tumor > 2 cm but < 4 cm in greatest dimension

___ T3: Tumor > 4 cm in greatest dimension

___ T4: Lip: Tumor invades adjacent structures (cortical bone, inferior alveolar nerve, floor of mouth, skin of face
Oral Cavity: Tumor invades adjacent structures (cortical bone, deep (extrinsic) muscle of tongue, maxillary sinus, skin)

Pharynx

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

Oropharynx

___ T1: Tumor < 2 cm in greatest dimension

___ T2: Tumor > 2 cm but < 4 cm in greatest dimension

___ T3: Tumor > 4 cm in greatest dimension

___ T4: Tumor invades adjacent structures (pterygoid muscles, mandible, hard palate, deep muscle of tongue, larynx)

Hypopharynx

___ T1: Tumor limited to one subsite of hypopharynx and < 2 cm in greatest dimension

___ T2: Tumor invades more than one subsite of hypopharynx or an adjacent site, or measures > 2 cm but < 4 cm in greatest dimension, without fixation of hemilarynx

___ T3: Tumor measures > 4 cm in greatest dimension, or with fixation of hemilarynx

___ T4: Tumor invades adjacent structures (thyroid/cricoid cartilage, carotid artery, soft tissues of neck, prevertebral fascia/muscles, thyroid and/or esophagus)

Nasopharynx

___ T1: Tumor confined to nasopharynx

___ T2: Tumor extends to soft tissue of oropharynx and/or nasal fossa

___ T2a: without parapharyngeal extension

___ T2b: with parapharyngeal extension

___ T3: Tumor invades bony structures and/or paranasal sinuses

___ T4: Tumor with intracranial extension and/or involvement of cranial nerves, infratemporal fossa, hypopharynx or orbit

Supraglottis

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

___ T1: Tumor limited to one subsite of supraglottis with normal vocal cord mobility

___ T2: Tumor invades muscosa of more than one adjacent subsite of supraglottis or glottis or region outside the supraglottis, (muscosa of base of tongue, vallecula, medial wall of piriform sinus) without fixation of the larynx

___ T3: Tumor limited to larynx with vocal cord fixation and/or invades any of the following: postcricoid area, pre-epiglottic tissues, deep base of tongue

___ T4: Tumor invades through thyroid cartilage, and/or extends into soft tissues of the neck, thyroid, and/or esophagus

Glottis

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

___ T1: Tumor limited to vocal cord(s) (may involve anterior or posterior commissure) with normal mobility

___ T1a: Tumor limited to one vocal cord

___ T1b: Tumor involves both vocal cords

___ T2: Tumor extends to supraglottis and/or subglottis, and/or with impaired vocal cord mobility

___ T3: Tumor limited to larynx with vocal cord fixation

___ T4: Tumor invades through thyroid cartilage and/or extends to other tissues beyond the larynx (trachea, soft tissues of neck, thyroid, pharynx)

Subglottis

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

___ T1: Tumor limited to subglottis

___ T2: Tumor extends to vocal cord(s) with normal or impaired mobility

___ T3: Tumor limited to larynx with vocal cord fixation

___ T4: Tumor invades through cricoid or thyroid cartilage and/or extends into other tissues beyond the larynx (trachea, soft tissues of neck, thyroid, esophagus)

Maxillary Sinus

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

___ T1: Tumor limited to the antral mucosa with no erosion or destruction of bone

___ T2: Tumor causing bone erosion or destruction, except for the posterior antral wall, including extension into hard palate and/or middle nasal meatus

___ T3: Tumor invades any of the following: bone of posterior wall of maxillary sinus, subcutaneous tissues, skin of cheek, floor or medial wall of orbit, infratemporal fossa, pterygoid plates, ethmoid sinuses

___ T4: Tumor invades orbital contents beyond the floor or medial wall including apex and/or any of the following: cribriform plate, base of skull, nasopharynx, sphenoid sinus, frontal sinus

Ethmoid Sinus

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Tis: Carcinoma in situ

___ T1: Tumor confined to ethmoid with or without bone erosion

___ T2: Tumor extends into nasal cavity

___ T3: Tumor extends to anterior orbit and/or maxillary sinus

___ T4: Tumor with intracranial extension, orbital extension including apex, involving sphenoid and/or frontal sinus and/or skin of nose

Salivary Glands

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ T1: Tumor < 2 cm in greatest dimension without extraparenchymal extension

___ T2: Tumor > 2 cm but < 4 cm in greatest dimension without extraparenchymal extension

___ T3: Tumor having extraparenchymal extension without seventh nerve involvement, and/or > 4 cm but < 6 cm in greatest dimension

___ T4: Tumor invades base of skull, seventh nerve, and/or exceeds 6 cm in greatest dimension

MARGINS

___ Margins uninvolved by tumor

Distance of tumor from closest margin: ___ cm

(Specify margin: __________________________

_________________________________________)

___ Margin(s) involved by tumor

Specify location(s): _______________________

BLOOD/LYMPHATIC VESSEL INVASION

___ Absent

___ Present

___ Indeterminate

REGIONAL LYMPH NODES (see appropriate site)

All Sites Except Nasopharynx

___ NX: Cannot be assessed

___ N0: No regional lymph node metastasis

___ N1: Metastasis in a single ipsilateral lymph node, < 3 cm in greatest dimension

___ N2: Metastasis in a single ipsilateral lymph node > 3 cm but < 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none > 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none > 6 cm in greatest dimension

___ N2a: Metastasis in a single ipsilateral lymph node, > 3 cm but < 6 cm in greatest dimension

___ N2b: Metastasis in multiple ipsilateral lymph nodes, none > 6 cm in greatest dimension

___ N2c: Metastasis in bilateral or contralateral lymph nodes, none > 6 cm in greatest dimension

___ N3: Metastasis in a lymph node > 6 cm in greatest dimension

Nasopharynx

___ NX: Cannot be assessed

___ N0: No regional lymph node metastasis

___ N1: Unilateral metastasis in lymph node(s) > 6 cm in greatest dimension, above supraclavicular fossa

___ N2: Bilateral metastasis in lymph node(s) > 6 cm in greatest dimension, above supraclavicular fossa

___ N3: Metastasis in lymph node(s)

___ N3a: > 6 cm in dimension

___ N3b: extension to supraclavicular fossa

DISTANT METASTASIS

___ MX: Cannot be assessed

___ M0: No distant metastasis

___ M1: Distant metastasis (site(s):______________

__________________________________________)

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Inflammation (specify type: _________________)

___ Epithelial hyperplasia

___ Epithelial dysplasia

___ Other (specify: ____________________________)

COMMENT

___________________________________________

___________________________________________

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