Vulvectomy grossing

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Schematic showing what is removed in a vulvectomy.

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.

Protocol notes

Alternate approaches

See also

Related protocols

References

External links