Surgical Pathology Cancer Case Summary

TROPHOBLAST:             Report

TROPHOBLAST: Dilatation and curettage

MACROSCOPIC (check all that apply)

TUMOR SIZE: ___ x ___ x ___ cm

LARGEST VESICLE SIZE: ___ cm

FETAL TISSUE

___ Absent

___ Present

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Hydatidiform mole

___ Complete

___ Partial

___ Invasive hydatidiform mole

___ Choriocarcinoma

___ Placental site trophoblastic tumor

___ Trophoblastic lesion

___ Exaggerated placental site

___ Placental site nodule and plaque

___ Unclassified trophoblastic lesion

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Implantation site

___ Fetal tissue(s)

___ Cord

___ Amnion

___ Chorion

___ Yolk sac

___ Fetal anomalies (specify: __________________)

___ Other (specify: ___________________________)

COMMENT

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