Melanoma (SSKME)

- For specimens with melanoma of cutaneous surfaces only

Specimen and Surgical Procedure

Site, laterality, procedure.......................................................

Tumor

Tumor size (required only if tumor is grossly identified)......................

Histologic type..............................................................................

Depth/thickness (in mm)................................ __mm/at least __mm/cannot be determined

Anatomic level..............................................................................

Growth phase........................................................... radial/vertical/cannot be determined

Ulceration.................................................................................. present/Not identified/ cannot be determined

Mitotic rate.................... none identified/ specify # per mm2/cannot be determined

Regression...................................................................................Not identified/ Present/Cannot be determined

Lymphovascular invasion.............................................................. present/not identified/ cannot be determined

Neurotropism........................................................................present/ not identified/ cannot be determined

Tumor infiltrating lymphocytes........................................................not identified/present, non-brisk/present, brisk/cannot be determined

Macroscopic satellite nodule:present/not identified/cannot be determined

Microsatellite(s): not identified/present/cannot be determined

Associated nevus...........................................................................

Final Margins

Peripheral Margins

Uninvolved by invasive melanoma (Report distance from invasive melanoma to nearest peripheral margin… in mm, specify location)         

Involved by invasive melanoma (specify location)

Uninvolved by melanoma in situ (Report distance from melanoma in situ to nearest peripheral margin in mm, Specify location)

Involved by melanoma in situ (specify location)

Cannot be assessed

Deep Margin

Uninvolved by invasive melanoma (report distance of invasive melanoma from deep margin in mm)

Involved by invasive melanoma

Cannot be assessed

Lymph Nodes (section required ONLY if LNs present in the specimen)

                                                               SLN          Non-SLN        Total

# examined

# with gross metastasis

# with microscopic metastasis                                                        ____

Size of largest sentinel node metastasis (in mm)

Size of  other non SLN metastasis (in mm, only if larger than SLN)

Matted nodes.............................................................................. present/not identified

Extranodal extension ………….(not identified/present/cannot be determined)

Pathologic stage (AJCC 8th edition)..................................... pT__N__M_

Skin

Staging

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