Difference between revisions of "Penectomy grossing"
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'''Penectomy''' | '''Penectomy grossing''' deals with the [[cut-up]] of [[penis|penile]] surgical specimens. It includes both total and partial penectomies. | ||
==Introduction== | ==Introduction== | ||
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*Dorsal aspect of penis = where the corpora cavernosa are; "anterior" when the penis is limp and hanging downward. | *Dorsal aspect of penis = where the corpora cavernosa are; "anterior" when the penis is limp and hanging downward. | ||
*Ventral aspect of penis = where the urethra/frenulum are; "posterior" when the penis is limp and hanging downward. | *Ventral aspect of penis = where the urethra/frenulum are; "posterior" when the penis is limp and hanging downward. | ||
<gallery> | |||
Image: Gray1158.png | Penis anatomy. (WC/Gray's Anatomy) | |||
Image: Gray1155.png | Penis anatomy - cross section. (WC/Gray's Anatomy) | |||
</gallery> | |||
==Opening== | |||
*+/-Insert probe into urethra from the proximal aspect (surgical margin). | |||
*No cutting necessary. ‡ | |||
*Place in [[formalin]]. | |||
Notes: | |||
*‡ Lester (2nd Ed.) suggests opening along the [[urethra]] on the ventral aspect prior to [[fixation]].<ref>{{Ref Lester|549-550}}</ref> | |||
==Protocol== | ==Protocol== | ||
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Representative sections: | Representative sections: | ||
*Resection margin on edge serially sectioned. | *Resection margin on edge serially sectioned. | ||
*Sagittal section of glans penis. | |||
*Parasagittal sections of glans penis (left, right). | |||
*Tumour - 1 section/cm. | |||
===Protocol notes=== | ===Protocol notes=== | ||
*Margin inked. | *Margin inked. | ||
*A slice is cut-off the penis at the site of the resection margin. This slice is then divided into left and right with a sagittal cut. Each portion (left and right) is sectioned with parasagittal cuts such that it is submitted as an on edge margin. | *A slice is cut-off the penis at the site of the resection margin. This slice is then divided into left and right with a sagittal cut. Each portion (left and right) is sectioned with parasagittal cuts such that it is submitted as an [[on edge margin]]. ‡ | ||
*The glans penis should be cut in the midline in the sagittal plane, and parasagittally.<ref name=pmid11474296>{{Cite journal | last1 = Cubilla | first1 = AL. | last2 = Piris | first2 = A. | last3 = Pfannl | first3 = R. | last4 = Rodriguez | first4 = I. | last5 = Agüero | first5 = F. | last6 = Young | first6 = RH. | title = Anatomic levels: important landmarks in penectomy specimens: a detailed anatomic and histologic study based on examination of 44 cases. | journal = Am J Surg Pathol | volume = 25 | issue = 8 | pages = 1091-4 | month = Aug | year = 2001 | doi = | PMID = 11474296 }}</ref> | *The glans penis should be cut in the midline in the sagittal plane, and parasagittally.<ref name=pmid11474296>{{Cite journal | last1 = Cubilla | first1 = AL. | last2 = Piris | first2 = A. | last3 = Pfannl | first3 = R. | last4 = Rodriguez | first4 = I. | last5 = Agüero | first5 = F. | last6 = Young | first6 = RH. | title = Anatomic levels: important landmarks in penectomy specimens: a detailed anatomic and histologic study based on examination of 44 cases. | journal = Am J Surg Pathol | volume = 25 | issue = 8 | pages = 1091-4 | month = Aug | year = 2001 | doi = | PMID = 11474296 }}</ref> | ||
===Alternate approaches=== | ===Alternate approaches=== | ||
*The [[CAP protocols|CAP protocol]] for Penis (Version 3.2.0.0) suggests taking the margin [[en face]].<ref>URL: [http://www.cap.org/web/home/resources/cancer-reporting-tools/cancer-protocol-templates http://www.cap.org/web/home/resources/cancer-reporting-tools/cancer-protocol-templates]. Accessed on: 2 March 2015.</ref> | *‡ The [[CAP protocols|CAP protocol]] for Penis (Version 3.2.0.0) suggests taking the margin [[en face]].<ref>URL: [http://www.cap.org/web/home/resources/cancer-reporting-tools/cancer-protocol-templates http://www.cap.org/web/home/resources/cancer-reporting-tools/cancer-protocol-templates]. Accessed on: 2 March 2015.</ref> | ||
==See also== | ==See also== | ||
===Related protocols=== | ===Related protocols=== | ||
*[[Orchiectomy grossing]]. | |||
*[[Prostatectomy grossing]]. | |||
==References== | ==References== | ||
Latest revision as of 18:04, 12 April 2016
Penectomy grossing deals with the cut-up of penile surgical specimens. It includes both total and partial penectomies.
Introduction
It is done for penile cancer.
Orientation/anatomy note
- Dorsal aspect of penis = where the corpora cavernosa are; "anterior" when the penis is limp and hanging downward.
- Ventral aspect of penis = where the urethra/frenulum are; "posterior" when the penis is limp and hanging downward.
Penis anatomy. (WC/Gray's Anatomy)
Penis anatomy - cross section. (WC/Gray's Anatomy)
Opening
- +/-Insert probe into urethra from the proximal aspect (surgical margin).
- No cutting necessary. ‡
- Place in formalin.
Notes:
Protocol
Dimensions, weight and inking:
- Type: [partial penectomy / penectomy].
- Size of specimen (length, left-right, dorsal-ventral): ___ x ___ x ___ cm.
- Foreskin size (length, thickness): ___ x ___ cm.
- Inking of margin: [colour].
Tumour:
- Dimensions (length, left-right, dorsal-ventral): ___ x ___ x ___ cm.
- Location: [glans / coronal sulcus].
- Colour: [tan / white].
- Growth pattern: [friable / fungating / papillary / verrucous / ulcerated].
- Consistency: [friable / soft / rubbery / hard ].
- Circumscription: [well demarcated / pushing border / infiltrative border].
- Hemorrhage: [present / absent].
- Necrosis: [present / absent].
- Margin: [nearest margin ___, distance ___ cm / positive margin, location ___].
- Extension into:
- Frenulum: [absent / suspicious / present].
- Glans penis: [absent / suspicious / present].
- Corpora cavernosa: [absent / suspicious / present].
- Corpora spongiosum: [absent / suspicious / present].
- Urethra: [absent / suspicious / present].
Representative sections:
- Resection margin on edge serially sectioned.
- Sagittal section of glans penis.
- Parasagittal sections of glans penis (left, right).
- Tumour - 1 section/cm.
Protocol notes
- Margin inked.
- A slice is cut-off the penis at the site of the resection margin. This slice is then divided into left and right with a sagittal cut. Each portion (left and right) is sectioned with parasagittal cuts such that it is submitted as an on edge margin. ‡
- The glans penis should be cut in the midline in the sagittal plane, and parasagittally.[2]
Alternate approaches
- ‡ The CAP protocol for Penis (Version 3.2.0.0) suggests taking the margin en face.[3]
See also
Related protocols
References
- ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 549-550. ISBN 978-0443066450.
- ↑ Cubilla, AL.; Piris, A.; Pfannl, R.; Rodriguez, I.; Agüero, F.; Young, RH. (Aug 2001). "Anatomic levels: important landmarks in penectomy specimens: a detailed anatomic and histologic study based on examination of 44 cases.". Am J Surg Pathol 25 (8): 1091-4. PMID 11474296.
- ↑ URL: http://www.cap.org/web/home/resources/cancer-reporting-tools/cancer-protocol-templates. Accessed on: 2 March 2015.