Surgical Pathology Cancer Case Summary

VULVA:             Report

Cytology/Biopsy/Resection

 

VULVA: Cytology/Biopsy/Resection

 

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Cytology

___ Biopsy

___ Local excision

___ Wide excision

___ Partial vulvectomy (specify type, if known: __

        _________________________________________)

___ Total vulvectomy (specify type, if known: __

        _________________________________________)

___ Radical vulvectomy

ADEQUACY OF SPECIMEN (if applicable)

___ Satisfactory

___ Limited (see COMMENT)

___ Unsatisfactory (see COMMENT)

LYMPHADENECTOMY

___ Not applicable

___ Inguinal-femoral nodes

___ Pelvic nodes

OTHER ORGANS OR TISSUES

___ None

___ Urethra

___ Vagina

___ Anus

___ Bladder

___ Rectum

___ Other


TUMOR SITE (check all that apply)

___ Unknown

___ Right vulva

        ___ Labia major

        ___ Labia minor

___ Left vulva

        ___ Labia major

        ___ Labia minor

___ Clitoris

TUMOR SIZE: ___ x ___ x ___ cm

COMMENT

___________________________________________

___________________________________________

___________________________________________

___________________________________________

 

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Squamous cell carcinoma

        ___ Vulvar intraepithelial neoplasia 3 (VIN3: severe dysplasia/carcinoma in situ)

        ___ Keratinizing

        ___ Non keratinizing

        ___ Basaloid

        ___ Verrucous

        ___ Warty (condylomatous)

        ___ Other (specify): ______________________

___ Adenocarcinoma

        ___ Paget’s disease

        ___ Bartholin’s gland carcinoma

        (specify type:________________________)

        ___ Carcinoma resembling breast carcinoma

        ___ Eccrine carcinoma

        ___ Other (specify): ______________________

___ Malignant melanoma

        ___ Superficial spreading

        ___ Nodular

        ___ Acrolentiginous

        ___ 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) (carcinomas only)

___ TX:    Cannot be assessed

___ T0:     No evidence of primary tumor

___ Tis:    Carcinoma in situ

___ T1:     Tumor confined to vulva or vulva and perineum ≤ 2cm in greatest dimension

                  ___ T1a:   with stromal invasion ≤ 1mm

                  ___ T1b:   with stromal invasion > 1mm

___ T2:     Tumor confined to vulva or vulva and perineum > 2 cm in greatest dimension

___ T3:     Tumor invades any of the following: lower urethra, vagina, anus

___ T4:     Tumor invades any of the following: bladder mucosa, rectal mucosa, upper urethral mucosa; or is fixed to pubic bone

EXTENT OF INVASION (malignant melanoma only)

Clark Level

___ I:      In situ

___ II:     Invades superficial papillary dermis

___ III:    Fills and expands papillary dermis

___ IV:   Invades reticular dermis

___ V:    Invades fat or deeper tissues

Breslow Measurement

___ Invasion < 0.75 mm from deep border of granular layer

___ Invasion 0.76 to 1.5 mm from deep border of granular layer

___ Invasion > 1.5 mm from deep border of granular layer

TUMOR BORDER (all tumors)

___ Pushing

___ Infiltrating

BLOOD/LYMPHATIC VESSEL INVASION (all tumors)

___ Absent

___ Present

___ Indeterminate


MARGINS (all tumors)

___ Uninvolved by tumor

        Distance of tumor from closest margin: ___ cm

        (specify margin: _________________________)

___ Involved by tumor (specify margin:_________)

REGIONAL LYMPH NODES (all tumors)

___ NX:    Cannot be assessed

___ N0:    No regional lymph node metastasis

                  Number examined: ___

___ N1:    Unilateral lymph node metastasis

                  Number examined: ___

                  Number involved: ___

___ N2:    Bilateral regional lymph node metastasis

                  Number examined: ___

                  Number involved: ___

DISTANT METASTASIS (all tumors)

___ MX:   Cannot be assessed

___ M0:    No distant metastasis

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

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Dysplasia

___ Condyloma accuminatum

___ Other (specify: ____________________)

COMMENT

___________________________________________

___________________________________________

___________________________________________

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