Auto text: “Insert Ovary and Tube Tumor”

Triage

1. 1. Weigh and measure prior to opening.
   2. Document if a.) ovary was received intact vs. disrupted/previously opened, and b.) ovary has surface lesions or implants.
   3. Measure length and diameter of fallopian tube (if attached), and document a.) whether the serosa is intact or disrupted, and b.) the presence/absence of serosal implants.

1. Ink the outer  surface of the ovary.
2. Open cystic structures over sink and note whether cyst is unilocular or multilocular.
3. Describe contents (serous/mucoid, clear or blood, hair) and the amount of fluid.
4. Describe internal lining surface (smooth, plaque-like thickenings, papillary excrescences, etc.).
5. State whether any portion of normal ovary is recognized.
6. Note average thickness of cyst wall or variations of thickness.
7. Describe (and subsequently section) any areas of solid tissue or raised foci within cystic tumors.

Gross

1. Document involvement of ovarian surface, fallopian tube, and/or uterine serosa.
2. Cysts with papillary excrescences: Submit excrescences in entirety if focal. Otherwise, submit 1 section per cm (2-3 per cassette).
3. Mucinous tumors: Submit 1 section per cm (2-3 per cassette).
4. If patient is status post neoadjuvant chemotherapy and no gross tumor remains, submit ovaries and fallopian tubes in their entirety.
5. If high-grade serous carcinoma, completely submit the fallopian tube per SEE-FIM protocol (adnexal soft tissue need not to be submitted). For all other histotypes, submit the fimbriae entirely and representative sections of the remainder of the tube.
6. If the appendix is removed:
   • Mucinous tumor: submit entirely.
   • All other tumors: submit representative sections (including tip, margin, and 1-2 sections of nodule/metastases if present).
7. If bowel is removed:
   • Tumor far from margin: submit proximal and distal margins EN FACE.
   • Tumor close to margin: ink margin and submit perpendicular section of tumor to margin.
   • Submit 2 sections of bowel wall with tumor to include areas with closest involvement to bowel mucosa.
   • Palpate the fat, and if any lymph nodes are easily identifiable, submit entirely. An extensive lymph node dissection is NOT needed!

Updated 6-22-2020 SRR