Michael at 03:13, 11 October 2016

2016-10-11T03:13:42Z

← Older revision		Revision as of 03:13, 11 October 2016
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	*Right fallopian tube: [unremarkable/benign paratubal cyst/none].		*Right fallopian tube: [unremarkable/benign paratubal cyst/none].

	Ink code:		[[Ink]] code:
	*Orange - anterior.		*Orange - anterior.
	*Blue - posterior.		*Blue - posterior.

Michael: /* Staging */

2014-09-23T05:55:43Z

Staging

New page

This protocol is for grossing a '''[[radical hysterectomy]] for cervical cancer'''.

The cervical cancers done for this type of surgery are advanced. Smaller cancers are dealt with by [[cervical conization]].

==Introduction==
Three types of surgeries for cervical cancers:
#Simple: only uterus is removed with the cervix
#Extended type II: resects medial portion of the parametria (cardinal ligament), uterosacral ligaments and superior part of the vagina, pelvic lymph nodes (the iliacs, and obturator).
#Extended type III: Resects majority of the parametria and uterosacral ligament and superior part of vagina. Pelvic lymphadenopathy is routinely performed.

==Protocol==
Specimen type:
*Radical hysterectomy.

Dimensions - exterior:
*Uterus and cervix: ___x___x___ cm.
*Specimen mass: ___ grams.
*Left ovary: ___x___x___ cm.
*Left fallopian tube: ___x___ cm.
*Right ovary: ___x___x___ cm.
*Right fallopian tube: ____x___ cm.
*Vaginal cuff/vaginal - (axial) length: ___ cm, wall thickness: ___cm.
*Left parametrial soft tissue: ___x___x___cm.
*Right parametrial soft tissue: ___x___x___cm.

Serosal surface of the uterus:
*Appearance: smooth shiny.
*Presence of lesion/mass: [none / present, ____cm in greatest dimension].

Dimensions - internal:
*Endometrial cavity: ___x___ cm.
*Maximal myometrial wall thickness: ____ cm.
*Endometrial thickness: ___ cm.
*Endocervical canal - length ___ cm, diameter ___ cm.

Tumour:
*Appearance: [white-tan / firm / ill-defined / hemorrhagic / ulcerated].
*Dimensions: ___x___x___ cm.
*Location of tumour/tumour center: ___.
*Extent (involvement):
**Ectocervix: [yes/no/suspicious].
**Endocervix: [yes/no/suspicious].
**Cervical stroma: [yes/no/suspicious]
**Parametrial soft tissue: [yes/no/suspicious]
**Vaginal cuff: [yes/no/suspicious].
**Upper vagina: [yes/no/suspicious/not applicable].
**Lower vagina: [yes/no/suspicious/not applicable].
**Endometrium: [yes/no/suspicious]
**Myometrium: [yes/no/suspicious]
*Margins:
**Closest vaginal cuff margin ___cm.
**Right parametrial margin ____cm.
**Left parametrial margin ___ cm.

Appearance and additional findings:
*Myometrium: [unremarkable/white whorled well-circumscribed lesion without hemorrhage & necrosis measuring __x___x___ cm].
*Left ovary: [atrophic/functional cyst/none].
*Left fallopian tube: [unremarkable/benign paratubal cyst/none].
*Right ovary: [atrophic/functional cyst/none].
*Right fallopian tube: [unremarkable/benign paratubal cyst/none].

Ink code:
*Orange - anterior.
*Blue - posterior.
*Black - vaginal/vaginal cuff margin.

Section code:
*Right parametrial margin in total.
*Left parametrial margin in total.
*Vaginal margin en face, four quadrant in four cassettes (12 to 3 in one cassette, 3 to 6 in one cassette, 6 to 9 in one cassette, 9 to 12 in one cassette.
*Tumour and adjacent tissue, full thickness of cervical wall (1 block per cm of tumour).
*Cervix and lower uterine segment.
*Anterior endomyometrium.
*Posterior endomyometrium.
*Right adnexa.
*Left adnexa.

===Protocol notes===
====Procedural notes====
#Cervix is ampuated after painting.
#Cervix is opened at 3 o'clock.
#Block diagram for cervix is sketched on requisition.

====Special situations====
If no tumour present:
*Submit entire cervix as a cone specimen radially from 12 o'clock - see [[cervical cone]].

If tumour involves the vagina/vaginal cuff:
*Submit a section to document this.
===Alternate approaches===

==See also==
*[[Gynecologic pathology]].

===Related protocols===
*[[Cervical cone]].

==References==

==External links==

[[Category:Gynecologic pathology]]
[[Category:Gross pathology]]

Radical hysterectomy for cervical cancer grossing - Revision history

Michael at 03:13, 11 October 2016

Michael: /* Staging */