Bone: Biopsy

Surgical Pathology Cancer Case Summary (Checklist)

Specimen

Specify bone involved (if known): ______________________________

____ Not specified

Procedure

____ Core needle biopsy

____ Curettage

____ Excisional biopsy

____ Other (specify): ______________________________

____ Not specified

Tumor Site (select all that apply)

____ Epiphysis or apophysis

____ Metaphysis

____ Diaphysis

____ Cortex

____ Medullary cavity

____ Surface

____ Tumor involves joint

____ Tumor extension into soft tissue

____ Cannot be determined

Tumor Size

Greatest dimension: __________ cm

^*Additional dimensions: __________ x __________ cm

____ Cannot be determined

Histologic Type (World Health Organization [WHO] classification of bone tumors)

Specify: ______________________________

____ Cannot be determined

^*Mitotic Rate

^*Specify: __________ /10 high-power fields (HPF)

(1 HPF x 400 = 0.1734 mm²; X40 objective; most proliferative area)

Necrosis

____ Not identified

____ Present

Extent: __________ %

____ Cannot be determined

Histologic Grade

Specify: __________

____ Cannot be determined

^*Lymph-Vascular Invasion

^*____ Not identified

^*____ Present

^*____ Indeterminate

^*Additional Pathologic Findings

^*Specify: ______________________________

Ancillary Studies (required only if applicable)

Immunohistochemistry

Specify: ______________________________

____ Not performed

Cytogenetics

Specify: ______________________________

____ Not performed

Molecular pathology

Specify: ______________________________

____ Not performed

Radiographic Findings (if available)

Specify: ______________________________

____ Not available

^* Data elements with asterisks are not required. These elements may be clinically important, but they are not yet validated or regularly used in patient management. Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens From Patients With Tumors of Bone.” Web posting date June 2012, www.cap.org.

Bone: Resection

Surgical Pathology Cancer Case Summary (Checklist)

Specimen

Specify bone involved (if known): ______________________________

____ Not specified

Procedure

____ Intralesional resection

____ Marginal resection

____ Segmental/wide resection

____ Radical resection

____ Other (specify): ______________________________

____ Not specified

Tumor Site (select all that apply)

____ Epiphysis or apophysis

____ Metaphysis

____ Diaphysis

____ Cortical

____ Medullary cavity

____ Surface

____ Tumor involves joint

____ Tumor extension into soft tissue

____ Cannot be determined

Tumor Size

Greatest dimension: __________ cm

^*Additional dimensions: __________ x __________ cm

____ Cannot be determined

____ Multifocal tumor/discontinuous tumor at primary site (skip metastasis)

Histologic Type (World Health Organization [WHO] classification of bone tumors)

Specify: ______________________________

____ Cannot be determined

^*Mitotic Rate

^*Specify: __________ /10 high-power fields

(1 HPF x 400 = 0.1734 mm²; X40 objective; most proliferative area)

Necrosis (macroscopic or microscopic)

____ Not identified

____ Present

Extent: __________ %

Histologic Grade

Specify: ______________________________

____ Not applicable

____ Cannot be determined

Margins

____ Cannot be assessed

____ Margins uninvolved by sarcoma

Distance of sarcoma from closest margin: __________ cm

Specify margin (if known): ______________________________

____ Margin(s) involved by sarcoma

Specify margin(s) if known: ______________________________

^*Lymph-Vascular Invasion

^*____ Not identified

^*____ Present

^*____ Indeterminate

Pathologic Staging (pTNM)

TNM descriptors (required only if applicable) (select all that apply)

____ m (multiple)

____ r (recurrent)

____ y (post-treatment)

Primary tumor (pT)

____ pTX: Primary tumor cannot be assessed

____ pT0: No evidence of primary tumor

____ pT1: Tumor ≤ 8 cm in greatest dimension

____ pT2: Tumor > 8 cm in greatest dimension

____ pT3: Discontinuous tumors in the primary bone site (not including skip metastasis)

Regional lymph nodes (pN)

____ pNX: Regional lymph nodes cannot be assessed

____ pN0: No regional lymph node metastasis

____ pN1: Regional lymph node metastasis

____ No nodes submitted or found

Number of lymph nodes examined

Specify: __________

Number cannot be determined (explain): ______________________________

Number of lymph nodes involved

Specify: __________

Number cannot be determined (explain): ______________________________

Distant metastasis (pM)

____ Not applicable

____ pM1a: Lung

____ pM1b: Metastasis involving distant sites other than lung (including skip metastases)

^*Specify site(s), if known: ______________________________

*Additional Pathologic Findings

Specify: ______________________________

Ancillary Studies (required only if applicable)

Immunohistochemistry

Specify: ______________________________

____ Not performed

Cytogenetics

Specify: ______________________________

____ Not performed

Molecular pathology

Specify: ______________________________

____ Not performed

Radiographic Findings (if available)

Specify: ______________________________

____ Not available

Preresection Treatment (select all that apply)

____ No therapy

____ Chemotherapy performed

____ Radiation therapy performed

____ Therapy performed, type not specified

____ Unknown

Treatment Effect (select all that apply)

____ Not identified

____ Present

^*Specify percentage of necrotic tumor: __________ %

____ Cannot be determined

^* Data elements with asterisks are not required. These elements may be clinically important, but they are not yet validated or regularly used in patient management. Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens From Patients With Tumors of Bone.” Web posting date June 2012, www.cap.org.