Auto text: “Insert Vulva”

Triage

1. Most vulvectomy specimens will be partial vulvectomies, very similar to large skin excisions.
2. Orientation can be difficult and may require contacting the attending pathologist and/or the surgeon.
3. Photograph intact specimen.
4. Measure skin surface and depth of excision.
5. Ink the deep and peripheral margins different colors. Example: deep-black, 12-6 o’clock-blue, 6-12 o’clock green.
6. Photograph intact inked specimen.
7. Take fresh measurements of any visible lesions, including size and distance to peripheral margins.
8. Pin the specimen on wax and fix in formalin overnight.

Gross

1. Describe the lesion (fungating, ulcerated, discolored).
2. Serially section and determine the depth of invasion.
3. Perpendicularly section the tips.
4. Submit all small resections if they can be submitted in ~20 blocks or less.
   1. • Submit sequentially and label which cassette involves the 3 and 9 o’clock margins.
5. For larger resections(discuss with attending):
   1. • Tumor: Submit 1 per cm including deepest invasion and perpendicular sections to closest margins.
      • Margins: If tumor is grossly >1 cm from the margins, a representative perpendicular section at 12, 3, 3 and 9 o’clock will suffice.
        1. Submit representative perpendicular sections of any margins designated by surgeon (urethral, clitoral, etc).
      • Submit any prior biopsy sites, scar tissue, discoloration, etc.

Updated 6-8-2022 SRR