- For resection specimens with soft tissue tumors of intermediate (locally aggressive) and intermediate (rarely metastasizing) potential and malignant soft tissue tumors.
Specimen and Surgical Procedure
Specimen, procedure.....................................................................
Tumor
Tumor site...................................................................................
Tumor size...................................................................................
Histologic type (WHO classification).................................................
Mitotic rate................................................................................... __/10 hpf
Necrosis (macroscopic or microscopic)...................... present (extent: __%)/absent
Histologic grade (FNCLCC)..............................................................
Treatment Effect
Preresection treatment............................... none/chemo/RT/therapy NOS/unknown
Treatment effect ……………………….................... present/absent/cannot be determined
Final Margins
Nearest margin............................................................................
Distance from specified margin to tumor.........................................
List any other close (<2 cm) margins..............................................
Anterior resection margin.......................................................... positive/negative
Posterior resection margin......................................................... positive/negative
Superior resection margin.......................................................... positive/negative
Inferior resection margin........................................................... positive/negative
Medial resection margin............................................................. positive/negative
Lateral resection margin............................................................ positive/negative
Other margin(s) (if applicable; please specify).............................. positive/negative
Lymph Nodes
Regional lymph nodes involved........................................ __
Regional lymph nodes examined....................................... __
Ancillary Studies (required if applicable)
Immunohistochemistry.................................................. performed/not performed If performed, specify results...............................................
Cytogenetics (CTG-__-_____)............................ performed/pending/not performed If performed, specify results...............................................
Molecular pathology (MOL-__-_____).................. performed/pending/not performed If performed, specify results...............................................
Pathologic stage (AJCC 8th ed.).................................................. pT__N__M__