Auto text: “Insert Vulva”
- Most vulvectomy specimens will be partial vulvectomies, very similar to large skin excisions.
- Orientation can be difficult and may require contacting the attending pathologist and/or the surgeon.
- Photograph intact specimen.
- Measure skin surface and depth of excision.
- Ink the deep and peripheral margins different colors. Example: deep-black, 12-6 o’clock-blue, 6-12 o’clock green.
- Take fresh measurements of any visible lesions, including size and distance to peripheral margins.
- Pin the specimen on wax and fix in formalin overnight.
- Describe the lesion (fungating, ulcerated, discolored).
- Serially section and determine the depth of invasion.
- Perpendicularly section the tips.
- Submit all small resections if they can be submitted in ~20 blocks or less.
- Submit sequentially and label which cassette involves the 3 and 9 o’clock margins.
- For larger resections(discuss with attending):
- 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.
- 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