Auto text: “Insert Uterus Endometrial Cancer”
- Weigh specimen and measure:
- 3 dimensions of uterus (C-C, Fundus-LUS, A-P).
- 3 dimensions of cervix (face and length).
- Shape, diameter of os.
- Bilateral ovaries (3D) and fallopian tubes (2D), if present.
- Identify anterior and posterior sides and note quality of serosa. (The peritoneal reflection extends further inferiorly on the posterior side; the tube is anterior to the ovary).
- Ink outer surface: anterior blue and posterior black.
- Bisect uterus through 3:00 and 9:00 positions.
- Measure endocervical canal and endometrial cavity in 2 dimensions, and thickness of endometrium and myometrium.
- Measure lesion and note location. * Specifically, note if lesion involves endocervical canal.*
- Slice endomyometrium transversely at 1 cm intervals.
- Fix in formalin.
- Take 2 longitudinal sections through ecto/endocervix (1 anterior and 1 posterior).
- Take 2 longitudinal sections through upper endocervix/lower uterine segment (1 anterior and 1 posterior), immediately adjacent to sections taken from cervix:
- Measure deepest area of tumor invasion and thickness of wall.
- Submit tumor as below:
- If tumor < 3 cm, submit entirely.
- If tumor > 3 cm, submit 1 per cm.
- Include 2 full-thickness sections (1 anterior and 1 posterior).
- Remaining sections can be superficial to include tumor and inner myometrium (submit sections from LUS to fundus to maintain orientation).
- If possible, include 1 section with interface between tumor and normal.
- Submit any additional pathology (leiomyomas, polyps in their entirety, etc).
- Submit 1 section of uninvolved endometrium.
- Inspect serosa for implants and submit sections if you see any.
- For serous carcinomas, submit the entire ovary and fallopian tube:
- Ovary serially sectioned perpendicular to long axis.
- SEE-FIM protocol for fallopian tube:
- Amputate the distal 2 cm (fimbriae) and section parallel to the long axis.
- Section the remainder of tube transversely in 2-3 mm intervals.
- For all other types, submit adnexa as follows:
- 2 representative sections of each ovary.
- Entire fimbriae (longitudinally bisected, 1-2 cassettes maximum) and 2 representative cross-sections on each side.
- Submit entirely per SEE-FIM protocol if patient has a history of breast cancer.
Lymph Nodes (Sentinel and Non-Sentinel)
- For lymph nodes < 2 mm, submit intact.
- For lymph nodes > 2 mm, serially section perpendicular to the long axis in 2 mm intervals.
- If no gross tumor, submit entirely.
- If grossly positive, submit 1-2 representative sections showing the greatest tumor dimension and extranodal fat.
Updated 6-6-2022 SRR