Response Options to “Histologic Type”

___ Hydatidiform mole, invasive

___ Choriocarcinoma

___ Placental site trophoblastic tumor

___ Epithelioid trophoblastic tumor

___ Malignant trophoblastic tumor, type cannot be determined

___ Other histologic type not listed (specify): ____________________________

Response Options to “Other Tissue/Organ Involvement” (select all that apply)

Note: Any organ not selected is either not involved or was not submitted.

___ Not applicable

___ Not identified

___ Right ovary

___ Left ovary

___ Ovary (side not specified)

___ Right fallopian tube

___ Left fallopian tube

___ Fallopian tube (side not specified)

___ Vagina

___ Right broad ligament

___ Left broad ligament

___ Broad ligament (side not specified)

___ Other organs/tissue (specify): ________________

___ Cannot be determined (explain): _________________________

Gynecologic

Staging

Click here to leave feedback