Squamous Cell Carcinoma of the Skin

Biopsy, Excision, Reexcision, Lymphadenectomy

Procedure

____ Biopsy, punch

____ Biopsy, shave

____ Biopsy, other (specify): ______________________________

____ Excision, ellipse

____ Excision, wide

____ Excision, other (specify): ______________________________

____ Reexcision, ellipse

____ Reexcision, wide

____ Reexcision, other (specify): ______________________________

____ Lymphadenectomy, sentinel node(s)

____ Lymphadenectomy, regional nodes (specify): ______________________________

____ Other (specify): ______________________________

____ Not specified

Tumor Site

Specify, if known: ______________________________

____ Not specified

Tumor Size

Greatest dimension: __________ cm

*Additional dimensions: __________ x __________ cm

____ Cannot be determined

Histologic Type (select all that apply)

____ Squamous cell carcinoma (SCC)

*____ Acantholytic SCC

*____ Spindle cell (sarcomatoid) SCC

*____ Verrucous SCC

*____ Pseudovascular SCC

*____ Adenosquamous carcinoma

*____ Squamous cell carcinoma, type not otherwise specified

*____ Other (specify): ______________________________

Histologic Grade

____ GX: Cannot be assessed

____ G1: Well differentiated

____ G2: Moderately differentiated

____ G3: Poorly differentiated

____ G4: Undifferentiated

Maximum Tumor Thickness

____ Not applicable

Thickness: __________ mm

Thickness: At least __________ mm

Margins (select all that apply)

Peripheral margins

____ Cannot be assessed

____ Uninvolved by invasive carcinoma

*Distance of invasive carcinoma from closest peripheral margin: __________ mm

*Specify location(s), if possible: ______________________________

____ Involved by invasive carcinoma

Specify location(s), if possible: ______________________________

____ Uninvolved by carcinoma in situ

*Distance of carcinoma in situ from closest peripheral margin: __________ mm

*Specify location(s), if possible: ______________________________

____ Involved by carcinoma in situ

Specify location(s), if possible: ______________________________

Deep margin

____ Cannot be assessed

____ Uninvolved by invasive carcinoma

*Distance of invasive carcinoma from margin: __________ mm

*Specify location(s), if possible: ______________________________

____ Involved by invasive carcinoma

Specify location(s), if possible: ______________________________

Lymph-Vascular Invasion

____ Not identified

____ Present

____ Indeterminate

Perineural Invasion

____ Not identified

____ Present

____ Indeterminate

Lymph Nodes

____ No nodes submitted or found

Number of lymph nodes examined

Specify: __________

____ Number cannot be determined (explain): ______________________________

Number of lymph nodes involved by metastatic carcinoma

Specify: __________

____ Number cannot be determined (explain): ______________________________

*Extranodal extension

*____ Present

*____ Not identified

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

____ pTis: Carcinoma in situ

____ pT1: Tumor ≤ 2 cm in greatest dimension with < 2 high-risk features

____ pT2: Tumor > 2 cm in greatest dimension ± 1 additional high-risk feature, or any size with ≥ 2 high-risk features

____ pT3: Tumor with invasion of maxilla, mandible, orbit, or temporal bone

____ pT4: Tumor with direct or perineural invasion of skull base or axial skeleton

Regional lymph nodes (pN)

____ pNX: Regional lymph nodes cannot be assessed

____ pN0: No regional lymph node metastasis

____ pN1: Metastasis in a single ipsilateral lymph node ≤ 3 cm in greatest dimension ____ pN2: Metastasis in a single ipsilateral lymph node, > 3 cm but ≤ 6 cm in greatest dimension, or multiple ipsilateral lymph nodes, none > 6 cm in greatest dimension, or in bilateral or contralateral lymph nodes, none > 6 cm in greatest dimension

____ pN2a: Metastasis in a single ipsilateral lymph node, > 3 cm but ≤ 6 cm in greatest dimension

____ pN2b: Metastasis in multiple ipsilateral lymph nodes, none > 6 cm in greatest dimension

____ pN2c: Metastasis in bilateral or contralateral lymph nodes, none > 6 cm in greatest dimension

____ pN3: Metastasis in a lymph node, > 6 cm in greatest dimension

Distant metastasis (pM)

____ Not applicable

____ pM1: Distant metastasis

*Specify site(s), if known: ______________________________

*Additional Pathologic Findings

*Specify: ______________________________

Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens from Patients with Squamous Cell Carcinoma of the Skin.” Web posting date: February 2011, www.cap.org. Protocol applies to invasive squamous cell carcinomas of the skin. Squamous cell carcinomas of the eyelid, vulva, and penis are not included. Note: Use of checklist is optional for tumors < 2 cm. *Data elements with asterisks are not required. These elements may be clinically important but are not yet validated or regularly used in patient management.