Difference between revisions of "Orchiectomy grossing"
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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]]. | ||
===Alternate approaches=== | ===Alternate approaches=== | ||
Revision as of 20:52, 26 April 2016
Orchiectomy specimen showing testis replaced by tumour (proven to be seminoma). (WC/Ed Uthman)
This article deals with orchiectomy grossing.
Introduction
Orchiectomies are typically done for testicular tumours.
They may be done for chronic pain[1] or to control prostate cancer.
Specimen opening
- Orient the specimen.
- Follow cord to hilum of testis and epididymis.
- Bisect the testis with one cut toward the hilum.
- Do not cut through.
- 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.
Protocol
Dimensions and weight:
- Laterality: [ left / right ].
- Weight: ___ grams.
- Testis: ___ x ___ x ___ cm.
- Epididymis: ___ x ___ x ___ cm.
- Spermatic cord - length: __ cm, diameter: ___ cm.
- Inking: [colour].
Tumour:
- Size: ___ x ___ x ___ cm.
- Colour: [ tan / white / variable ].
- Firmness: [ firm / soft ].
- Morphology: [solid / cystic / solid and cystic - with ___ % cystic].
- Circumscription: [circumscribed / infiltrative border ].
- Hemorrhage: [ absent / present ].
- Necrosis: [ absent / present ].
- Extension into tunica albuginea: [ not identified / indeterminate / present ].
- Extension into the epididymis: [ not identified / indeterminate / present ].
Other - after sectioning:
- Testicular parenchyma: [ brown-tan, unremarkable / ___ ].
- Spermatic cord: [ unremarkable / ___ ].
Representative sections are submitted as follow:
- Spermatic cord resection margin, en face.
- Spermatic cord mid-section, cross section.
- Spermatic cord close to testis.
- Tumour in relation to epididymis.
- Tumour and rete testis.
- Tumour with testicular coverings.
- Additional tumour sections.
- Testis distant from the tumour.
Protocol notes
- The tumour should be submitted in total if this can be done in less than 10 cassettes.
- Lester's book (2nd Ed.) recommends 1 cassette per cm of maximal tumour dimension.[2]
Staging
Main article: Testicular cancer staging
Based on AJCC 7th Edition:[3][4]
- pT1 - confined to the testis or epididymis, no lymphovascular invasion.
- pT2 - into tunica vaginalis or lymphovascular invasion.
- pT3 - into spermatic cord.
- pT4 - into the scrotum.
Alternate approaches
See also
Related protocols
References
- ↑ Rönkä, K.; Vironen, J.; Kokki, H.; Liukkonen, T.; Paajanen, H. (Feb 2015). "Role of orchiectomy in severe testicular pain after inguinal hernia surgery: audit of the Finnish Patient Insurance Centre.". Hernia 19 (1): 53-9. doi:10.1007/s10029-013-1150-3. PMID 23929499.
- ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 409. ISBN 978-0443066450.
- ↑ URL: https://en.wikibooks.org/wiki/Radiation_Oncology/Testis/Staging. Accessed on: 15 December 2014.
- ↑ URL: http://www.cancer.org/cancer/testicularcancer/detailedguide/testicular-cancer-staging. Accessed on: 15 December 2014.