Auto text: “Insert Ovary and Tube Tumor” or “Insert Ovaries and Tubes Prophylactic”
- Weigh and measure.
- Document if ovary was received intact vs. disrupted/previously opened.
- Measure length and diameter of fallopian tube (if attached)
- Ink the outer surface of the ovary (cauterized areas may help to identify external surface).
- Open cystic structures over sink and note whether cyst is unilocular or multilocular. Describe contents (serous/mucoid, clear, blood, hair, and the amount of fluid).
- Describe internal lining surface (smooth, plaque-like thickenings, papillary excrescences, etc.).
- Note average thickness of cyst wall or variations of thickness.
- If for prophylactic salpingo-oophorectomy, submit the ENTIRE specimen per SEE-FIM protocol as follows:
- Ovary serially sectioned.
- Body of tube transversely sectioned.
- Fimbriated end of tube radially sectioned (Place NO MORE than 2-3 sections in a cassette to ensure proper orientation).
- All of associated soft tissue.
- If a prophylactic uterus was resected with adnexa, please refer to Uterus, BRCA or Uterus, Lynch guidelines.
- Simple serous/physiological cyst: If ovarian parenchyma is recognized in the wall, two sections will confirm the diagnosis (i.e. one of cyst wall and one of wall with ovarian stroma).
- Dermoid cyst (teratoma): Areas of thickening in the wall may contain tissues of various germ-cell layers and immature elements. Submit 1 section per cm including sampling the thickened / solid areas thoroughly. The calcified areas do not need to be submitted unless grossly are abnormal.
- Endometriotic cyst: Submit 2-3 sections of cyst wall, as well as 1 of normal ovary (if present). Submit all solid areas since tumors may arise in endometriotic cysts.
- Mucinous tumors: Even if grossly benign, submit 1 section per cm (2-3 per cassette).
- For all cysts with thin-walled areas, submit thin walls as a “membrane-roll” rather than strips on edge, which are difficult to embed on edge.
Updated 6-22-2020 SRR