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Uterus

Miscellaneous tumors

Grossing hysterectomy specimens


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 4 September 2011, last major update September 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Procedure (tumor)
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● Measure, weigh, describe, photograph
● Open along lateral sides
● Ink serosa adjacent to tumor, vaginal margin of resection
● Section from endocervical canal to superior aspect
● If cervical tumor present/suspected, amputate cervix and process as cone biopsy

Sections to obtain
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No significant gross pathology
● Anterior and posterior cervix (important for identifying carcinoma in situ, J Clin Pathol 2002;55:629)
● Anterior and posterior endomyometrium
● Lower uterine segment
● Each ovary (cortex, hilar region) and fallopian tube
● Any gross lesions, including leiomyomas

Suspected tumor:
● Above plus:
● With tumor, full thickness endomyometrium and serosa to assess depth of invasion
● 1 section per 1 cm of tumor, minimum 3 sections
● All grossly different appearing regions of tumor
● High endocervical canal or lower isthmus
● Ink and obtain margins of resection, including vaginal mucosa

● Notes: in laparoscopic hysterectomies, pathologists may create artifactual vascular invasion by mechanically transporting tumor into vascular spaces during the grossing process (Am J Surg Pathol 2009;33:298)
● May be difficult to identify specific cervical anatomic regions in morcellated specimens (Indian J Pathol Microbiol 2010;53:634)

Gross images / diagrams
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IARC: various images for grossing protocol


Morcellated specimen: endometrium identified as a slit like space

End of Uterus > Miscellaneous tumors > Grossing hysterectomy specimens


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