Hysterectomy for endometrial cancer grossing
Jump to navigation
Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
The protocol is for grossing a hysterectomy for endometrial cancer.
Hysterectomies with endometrial hyperplasia are dealt with in the hysterectomy for hyperplasia protocol.
Introduction
This is a very common procedure as endometrial cancer.
Opening
Orientation of hysterectomies
- Less peritoneum on anterior (as the urinary bladder is there).
- Posterior peritoneal edge: pointy (upside down triangle).
- Anterior peritoneal edge: rounded/non-pointy.
- Posterior peritoneal edge: pointy (upside down triangle).
- Tubes on anterior-lateral aspect.[1]
- Round ligaments posterior to tubes.
Protocol
Specimen:
- Hysterectomy for endometrial cancer.
External measures:
- 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.
- Exocervix: ___cm.
- Cervical os: ___cm, round/slit-like, probe patent.
Appearance:
- Shape: [pear-shaped/distorted].
- Serosal surface: [smooth, shiny, powder-burn lesions].
- Serosa nodules/lesion/mass: [none, present ___cm in greatest dimension].
- Ectocervix: tan-white glistening.
- Left ovary: [unremarkable / atrophic / cortical cysts].
- Left fallopian tube: [unremarkable / paratubal cysts].
- Right ovary: [unremarkable / atrophic / cortical cysts].
- Right fallopian tube: [unremarkable / paratubal cysts].
Internal measures:
- Endometrial cavity: ____x____cm.
- Myometrial wall thickness (maximum): ____cm.
Tumour:
- Dimension: ___x___x___cm.
- Location: [fundus/body, involves anterior and/or posterior wall, lower uterine segment, cervix].
- Appearance: [ill-defined, soft, friable, polypoid-shape, tan-white].
- Maximum depth of invasion: ___cm.
- Myometrial thickness: ___cm.
- Grossly normal endometrium - maximum thickness: ___cm.
Other findings:
- Myometrial tumour(s):
- Location: intramural / subserosal.
- Appearance: white, firm, whorled.
- Size range: ___-___cm in greatest dimension.
- Other features:
- Hemorrhage: absent.
- Necrosis: absent.
Inking code:
- Green - anterior serosa.
- Black - posterior serosa.
Representative sections:
- Anterior cervix.
- Anterior lower uterine segment.
- Posterior cervix.
- Posterior lower uterine segment.
- Tumour and anterior endomyometrium with greatest depth of invasion, full thickness sections [submit two full thickness section of deepest invasion from each involved wall of the myometrium with inked serosa].
- Tumour and posterior endomyometrium with greatest depth of invasion, full thickness sections.
- Additional sections of the tumour [for a total of at least one section/cm of tumour].
- Section of firm whorled tan nodules in anterior/posterior myometrium.
- Any other lesions.
- Right ovary.
- Right fallopian tube [fimbria submitted entirely].
- Left ovary.
- Left fallopian tube [fimbria submitted entirely].
Protocol notes
In BRCA1 mutation or BRCA2 mutation carriers, the ovaries and tubes should be submitted in total.[2]
Alternate approaches
See also
Related protocols
References
External links
- ↑ Lester, Susan Carole (2010). Manual of Surgical Pathology (3rd ed.). Saunders. pp. 425. ISBN 978-0-323-06516-0.
- ↑ Downes, MR.; Allo, G.; McCluggage, WG.; Sy, K.; Ferguson, SE.; Aronson, M.; Pollett, A.; Gallinger, S. et al. (Aug 2014). "Review of findings in prophylactic gynaecological specimens in Lynch syndrome with literature review and recommendations for grossing.". Histopathology 65 (2): 228-39. doi:10.1111/his.12386. PMID 24495259.