Radical cystectomy grossing

This article deals with radical cystectomy grossing, also radical cystectomy cut-up.

A cystectomy is removal of the urinary bladder; however, it may refer to the removal of a cyst, e.g. ovarian cystectomy.

Introduction

It is done for bladder cancer (urothelial carcinoma).

In men, the urinary bladder is usually removed along with the prostate gland (see cystoprostatectomy).

Protocol

Specimen:

• Type: cystectomy [with vagina / uterus / uterine tubes / ovaries].
• Specimen weight: ___ grams.
• Specimen dimensions (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.

Tumour:

• Size of tumour (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
• Location of tumour: [dome, left, right, anterior, posterior, trigone].
• Nearest margin: [soft tissue margin / urethral / ureteric ].
• Distance to nearest margin: ___.
• Configuration: [ulcerated / exophytic].
• Appearance: [tan/brown / white], [firm / friable].
• Extension into perivescicular adipose tissue: [not identified, present].

Representative sections:

• Urethral resection margin on edge.
• Ureteral surgical (or specimen) margins (left and right).
• Bladder tumour - 1 section/cm.
• Section with deepest invasion.
• One section if fat invasion obvious, three sections if it is suspicious.
• Suspicious granular areas.
• Left bladder wall at site of ureteric oriface.
• Right bladder wall at site of ureteric oriface.
• Anterior bladder wall.
• Posterior bladder wall.
• Dome of bladder.
• Trigone of bladder.

Sections of additional structures (if applicable):

• Ovaries.
• Uterine tubes - esp. fibriated ends.
• Vagina - esp. in relation to tumour.
• Uterus:
  • Cervix.
  • Corpus - anterior & posterior walls.

See also

Related protocols

• Partial cystectomy.
• Cystoprostatectomy.

External links

• Radical cystectomy with ileal conduit (osu.edu).