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