Hysterectomy for endometrial cancer grossing

Gross image of endometrial adenocarcinoma.

The protocol is for grossing a hysterectomy for endometrial cancer.

Hysterectomies with endometrial hyperplasia are dealt with in the hysterectomy for hyperplasia protocol.

Introduction

This is a very common procedure as endometrial cancer.

Protocol

Specimen:

• Hysterectomy for endometrial cancer.

External measures:

• Uterus and cervix: ___x___x___cm
• Specimen mass: ____grams.
• Left ovary: ___x___x___cm.
• Left fallopian tube ___x___cm.
• Right ovary: ___x___x___cm.
• Right fallopian tube: ___x___cm.
• Exocervix: ___cm.
• Cervical os: ___cm, round/slit-like, probe patent.

Appearance:

• Shape: [pear-shaped/distorted].
• Serosal surface: [smooth, shiny, powder-burn lesions].
• Serosa nodules/lesion/mass: [none, present ___cm in greatest dimension].
• Ectocervix: tan-white glistening.
• Left ovary: [unremarkable / atrophic / cortical cysts].
• Left fallopian tube: [unremarkable / paratubal cysts].
• Right ovary: [unremarkable / atrophic / cortical cysts].
• Right fallopian tube: [unremarkable / paratubal cysts].

Internal measures:

• Endometrial cavity: ____x____cm.
• Myometrial wall thickness (maximum): ____cm.

Tumour:

• Dimension: ___x___x___cm.
• Location: [fundus/body, involves anterior and/or posterior wall, lower uterine segment, cervix].
• Appearance: [ill-defined, soft, friable, polypoid-shape, tan-white].
• Maximum depth of invasion: ___cm.
• Myometrial thickness: ___cm.
• Grossly normal endometrium - maximum thickness: ___cm.

Other findings:

• Myometrial tumour(s):
  • Location: intramural / subserosal.
  • Appearance: white, firm, whorled.
  • Size range: ___-___cm in greatest dimension.
  • Other features:
    • Hemorrhage: absent.
    • Necrosis: absent.

Inking code:

• Green - anterior serosa.
• Black - posterior serosa.

Representative sections:

• Anterior cervix.
• Anterior lower uterine segment.
• Posterior cervix.
• Posterior lower uterine segment.
• Tumour and anterior endomyometrium with greatest depth of invasion, full thickness sections [submit two full thickness section of deepest invasion from each involved wall of the myometrium with inked serosa].
• Tumour and posterior endomyometrium with greatest depth of invasion, full thickness sections.
• Additional sections of the tumour [for a total of at least one section/cm of tumour].
• Section of firm whorled tan nodules in anterior/posterior myometrium.
• Any other lesions.
• Right ovary.
• Right fallopian tube [fimbria submitted entirely].
• Left ovary.
• Left fallopian tube [fimbria submitted entirely].

See also

Related protocols

• Hysterectomy for endometrial hyperplasia.