Vulvectomy grossing

The protocol is for vulvectomy grossing.

Introduction

This procedure is done for vulvar cancer (vulvar squamous cell carcinoma or malignant melanoma).

Protocol

• Specimen: vulvectomy.
• Overall dimesions: ___x ___x ___ cm.
• Right labium majus: ___x ___x ___cm.
• Left labium majus: ___x ___x ___ cm.
• Right labium minus: ___x ___x ___ cm.
• Left labium minus: ___x ___x ___ cm.
• Clitoris: ___x ___x ___ cm.
• Urethral orifice: ___x ___cm.
• Urethra: ___cm in length, ___cm in diameter.
• Vagina ___cm in length, ___cm in diameter.
• Perineal skin: ___x___cm.
• Anus: ___x___ cm.
• Anal canal: ___ cm in length, ____cm in diameter.
• Rectum ___cm in length, ___cm in diameter.
• Urinary bladder: ___x ___x ___ cm.
• Pelvic bone: ___x ___x ___ cm.
• Underlying soft tissue: ___x ___x ___ cm, and fascia ___x ___x ___ cm.

Tumour:

• Focality: unifocal / multifocal.
• Size: ___ x ___ cm, maximum depth: ___cm.
• Location (center of lesion): ___.
• Lesion extent: right labium majus, left labium majus, right labium minus, left labium minus, clitoris, soft tissue/fascia, urethral orifice, lower 1/3 of urethra, vagina, anal canal, rectum, pelvic bone.
• Ulceration: absent / present.
• Exophytic component: [absent / present].
• Colour and consistency: white-tan, soft.
• Borders: pushing / infiltrative, ill-defined.

Margins:

• Skin margins (clitoris or stitch = 12 o'clock):
  • 12 o’clock: ___ cm.
  • 3 o’clock: ___ cm.
  • 6 o’clock: ___ cm.
  • 9 o’clock: ___ cm.
• Deep margin: ___ cm.

The surfaces of both labia majora have multiple well circumscribed, raised/patchy white plaques that range from ____ to _____ cm in largest dimension. [Describe any other findings]. _________ possible lymph nodes are found in the attached fibroadipose tissue that ranges from _______ to _________cm in greatest dimension. ____lymph node(s) is/are grossly suspicious ( ___x ___x ___ cm) for involvement by tumour.

INK CODE:

• Blue:12-to 3-to 6 o’clock half;
• Orange: 6-to-9-to12 o’clock half;
• Black: urethral margin;
• Yellow: vaginal margin.

SECTION CODE:

• Block __, 12 o’clock tip, en face, ink-side up.
• Block __, 6 o’clock tip, en face, ink-side up.
• Block __, 3 o’clock margin, en face, ink-side up [submit perpendicular section if tumour <=1cm from margin].
• Block __, 9 o’clock margin, en face, ink-side up [submit perpendicular section if tumour <=1cm from margin].
• Block __ tumour deepest invasion [submit three section with the greatest invasion, include soft tissue and fascia].
• Block __, urethral margin, en face.
• Block __, vaginal margin, en, face.
• Block __, tumour, clitoris.
• Block __, tumour, right labium minus.
• Block __, tumour, left labium minus.
• Block __, tumour and right labium majus.
• Block __, tumour, and left labium majus.
• Block __, tumour and urethra.
• Block __, tumour and vagina.
• Block __, tumour with any other involved structure [perineum, anus, anal canal, rectum, bone, other structures].
• Block __, Lymph nodes.