Difference between revisions of "Orchiectomy grossing"

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[[Image:Seminoma_of_the_Testis.jpg|thumb|150px|Orchiectomy specimen showing testis replaced by tumour (proven to be [[seminoma]]). (WC/Ed Uthman)]]
[[Image:Seminoma_of_the_Testis.jpg|thumb|150px|Orchiectomy specimen showing testis replaced by tumour (proven to be [[seminoma]]). (WC/Ed Uthman)]]  
This article deals with '''orchiectomy grossing'''.  
This article deals with '''orchiectomy grossing'''.  


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Orchiectomies are typically done for [[testicular tumours]].
Orchiectomies are typically done for [[testicular tumours]].


They may be done for chronic pain or to control [[prostate cancer]].
They may be done for chronic pain<ref name=pmid23929499>{{Cite journal  | last1 = Rönkä | first1 = K. | last2 = Vironen | first2 = J. | last3 = Kokki | first3 = H. | last4 = Liukkonen | first4 = T. | last5 = Paajanen | first5 = H. | title = Role of orchiectomy in severe testicular pain after inguinal hernia surgery: audit of the Finnish Patient Insurance Centre. | journal = Hernia | volume = 19 | issue = 1 | pages = 53-9 | month = Feb | year = 2015 | doi = 10.1007/s10029-013-1150-3 | PMID = 23929499 }}</ref> or to control [[prostate cancer]].


==Specimen opening==
==Specimen opening==
*Orient the specimen - follow cord to hilum and [[epididymis]].
*Orient the specimen.
*Bisect the testis with one cut toward the epididymis.
**Follow cord to hilum of testis and [[epididymis]].
*Bisect the testis with one cut toward the hilum.
**Do not cut through.
**Do not cut through.
**If tumour is a large do additional cuts parallel to the first cut.
**If tumour is a large do additional cuts parallel to the first cut to ensure proper [[fixation]].
*Place specimen(s) in [[formalin]].
 
Note:
*Cutting easier if blade wet before cutting.
*[[Marking ink|Inking]] the cord at the margin and mid section of the cord in different colours allows one to reconstruct the location if one has to go back to the gross.


==Protocol==
==Protocol==
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====Staging====
====Staging====
{{Main|Testicular cancer staging}}
Based on AJCC 7th Edition:<ref>URL: [https://en.wikibooks.org/wiki/Radiation_Oncology/Testis/Staging https://en.wikibooks.org/wiki/Radiation_Oncology/Testis/Staging]. Accessed on: 15 December 2014.</ref><ref name=cancer_org>URL: [http://www.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-staging http://www.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-staging]. Accessed on: 15 December 2014.</ref>
Based on AJCC 7th Edition:<ref>URL: [https://en.wikibooks.org/wiki/Radiation_Oncology/Testis/Staging https://en.wikibooks.org/wiki/Radiation_Oncology/Testis/Staging]. Accessed on: 15 December 2014.</ref><ref name=cancer_org>URL: [http://www.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-staging http://www.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-staging]. Accessed on: 15 December 2014.</ref>
*pT1 - confined to the testis or epididymis, no [[lymphovascular invasion]].
*pT1 - confined to the testis or epididymis, no [[lymphovascular invasion]].
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*pT3 - into [[spermatic cord]].
*pT3 - into [[spermatic cord]].
*pT4 - into the [[scrotum]].
*pT4 - into the [[scrotum]].
Notes:
*Invasion into the [[epididymis]] and/or tunica albuginea does not change the [[cancer staging|stage]].<ref name=cancer_org/>
*[[Rete testis]] involvement and testicular hilum involvement may be seen or suspected at the time of [[cut-up]]. Both of these are poor prognosticators;<ref>{{Cite journal  | last1 = Yilmaz | first1 = A. | last2 = Cheng | first2 = T. | last3 = Zhang | first3 = J. | last4 = Trpkov | first4 = K. | title = Testicular hilum and vascular invasion predict advanced clinical stage in nonseminomatous germ cell tumors. | journal = Mod Pathol | volume = 26 | issue = 4 | pages = 579-86 | month = Apr | year = 2013 | doi = 10.1038/modpathol.2012.189 | PMID = 23238629 }}</ref> however, they to do not affect the (AJCC 7th Ed.) stage.


===Alternate approaches===
===Alternate approaches===


==See also==
==See also==
*[[Testicular cancer staging]].
===Related protocols===
===Related protocols===
==References==
==References==
{{Reflist|1}}
{{Reflist|1}}
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