• Orient the specimen.  Even if there are no sutures/clips/ink marks, the specimen may be oriented by distinguishing the skin from the mucosal surface.
• Measure the specimen (left to right, superior to inferior, thickness) and lesions (two dimensions if flat, three dimensions if raised).
• Note the location (skin vs. mucosa) and describe the external features of any lesions (color, shape, borders).  Measure the distances to the margins.
• Blot dry and ink all surgical margins.
• Submerge the specimen in formalin for a few hours, unless frozen sections were requested.
• Make a slice through the middle of the specimen from the anterior (skin) aspect toward the posterior (internal) aspect, bisecting the tip.  Slice off the entire left and right resection margins, including the deep margin of the tip if possible.  Make additional parallel slices in the remaining tissue if large enough.
• Describe the cut surface of the lesion and measure the depth of invasion.

• Peripheral (left and right) resection margins:  entirely submit, en face.
• Remainder of tissue:  entirely submit.

Internal use only

Received without fixative/in formalin, labeled _____ and “_____”, is a wedge excision of the upper/lower lip (__ x __ cm surface, __ cm thickness).  It is oriented by a suture = _____.  There is a __ x __ cm, _____ (color, shape, borders) ulcer/nodule located on the skin/vermillion border/mucosa, __ cm from the nearest (_____) resection margin.  It has a depth of invasion of __ cm and a _____ (color, consistency) cut surface.  The uninvolved skin and mucosa are _____ (describe).  The soft tissue resection margins are _____ (describe).  The medial margin is inked blue and the lateral margin is inked black.  Entirely submitted as follows:

#__ = frozen section #__ remnant, medial margin, en face.

#__ = frozen section #__ remnant, lateral margin, en face.

#__ - #__ = remainder of specimen from medial to lateral.

#__ - #__ = remainder of specimen from medial to lateral; __ pieces in each.

__ blocks, __ H&E