Myomectomy

Auto text: “Insert Myomectomy”

Triage

  • Myomectomies are excisons of leiomyomas (fibroids) without removal of the uterus. These specimens may come intact or fragmented.
  • The “MyoSure” procedure is transvaginal removal of leiomyomas through a hysteroscope.  These specimens always come in small white fragments.
  • These specimens can be grossed same-day.

Gross

  • MyoSure Procedure:
    • Weigh and measure in aggregate.
    • Specimens weighing less than or equal to 5 gm: Submit entirely (should fit in approximately 5-6 cassettes).
    • Specimens weighing more than 5 gm: Submit 5 grams (in approximately 5-6 cassettes), and an additional cassette per each additional 10 grams.
    • Please make sure cassettes have only 1 “H&E Initial” stain – 2 levels are NOT needed.
  • Intact Myomectomy:
    • Weigh the specimen in aggregate and give a measurement range for the nodules.
    • Serially section and look for areas of necrosis (opaque yellow-white), hemorrhage, or softening.
    • For normal-appearing whorled nodules (firm, white-tan, well-circumscribed):
      • If largest is < 10 cm, submit up to 5 representative sections (can be included in the full-thickness sections of the endomyometrium).
      • If largest is > 10 cm, submit 3 sections of the largest nodule and 3 representative sections of smaller nodules.
    • For atypical-appearing whorled nodules (hemorrhage, necrosis, softening, discoloration, infiltration) submit 1 section per cm of the atypical nodule, up to 10 sections. We can always go back if more sections are needed.

Updated 1-8-19 NAC.

Print Friendly, PDF & Email