Protocol for the Examination of Rhabdomyosarcoma Specimens



Protocol for the Examination of Rhabdomyosarcoma Specimens























































































































































































































































































































































Rhabdomyosarcoma and Related Neoplasms: Resection or Biopsy


Surgical Pathology Cancer Case Summary (Checklist)


Procedure



____Biopsy



____Excision, local



____Excision, radical



____Excision, compartmentectomy



Amputation (specify type):



Other (specify):



____Not specified


Specimen Laterality



____Right



____Left



____Midline



____Indeterminate



____Not specified


Tumor Site



____Bladder/prostate



____Cranial parameningeal



____Extremity



____Genitourinary (not bladder/prostate)



____Head and neck (excluding parameningeal)



____Orbit



____Other(s) (includes trunk, retroperitoneum, etc.)



(Specify) :



____Not specified


Tumor Size



Greatest dimension: cm



*Additional dimensions: x cm



____Cannot be determined


*Tumor Depth for Soft Tissue-based Tumors



*____Dermal



*____Subcutaneous



*____Subfascial



*____Intramuscular



*____Intraabdominal



*____Retroperitoneal



*____Intracranial



*____Organ based



* Other (specify):



*____Cannot be assessed


Histologic Type



____Embryonal, botryoid



____Embryonal, spindle cell



____Embryonal, not otherwise specified (NOS)



____Alveolar



____Mixed embryonal and alveolar rhabdomyosarcoma




(Specify percentage of each type) :



____Rhabdoid rhabdomyosarcoma



____Sclerosing rhabdomyosarcoma



____Undifferentiated sarcoma



____Ectomesenchymoma



____Other (specify):



____Rhabdomyosarcoma, subtype indeterminate


Anaplasia



____Not identified



____Focal (single or few scattered anaplastic cells)



____Diffuse (clusters or sheets of anaplastic cells)



____Indeterminate



____Cannot be assessed


Margins



____Cannot be assessed



____Sarcoma involvement of margins not identified




Distance of sarcoma from closest margin: mm OR cm




Specify margin:



____Indeterminate


Lymph Nodes



____No regional lymph nodes sampled



____Metastatic involvement of regional lymph nodes not identified



____Regional lymph node metastasis present




Specify: Number examined:






Number involved:


Distant Metastasis



____Not applicable



____Distant metastasis present





*Specify site(s), if known:


The Intergroup Rhabdomyosarcoma Study Postsurgical Clinical Grouping System


Note: Clinical information required to definitively assign stage group (e.g., gross residual disease or distant metastatic disease) may not be available to the pathologist. Alternatively, this protocol may not be applicable to some situations (e.g., group IIIA). If applicable, the appropriate stage group may be assigned by the pathologist.



____Not applicable



____Cannot be assessed



Group I



____A) Localized tumor, confined to site of origin, completely resected



____B) Localized tumor, infiltrating beyond site of origin, completely resected



Group II



____A) Localized tumor, gross total resection, but with microscopic residual disease



____B) Locally extensive tumor (spread to regional lymph nodes), completely resected



____C) Locally extensive tumor (spread to regional lymph nodes), gross total resection, but microscopic residual disease



Group III



____A) Localized or locally extensive tumor, gross residual disease after biopsy only



____B) Localized or locally extensive tumor, gross residual disease after major resection (> 50% debulking)



Group IV



____Any size tumor, ± regional lymph node involvement, with distant metastases, with respect to surgical approach to primary tumor


*Modified Site, Size, Metastasis Staging for Rhabdomyosarcoma (for relevant stage) (select all that apply)


Note: Clinical information required to definitively assign stage (e.g., nodal status or distant metastatic disease) may not be available to the pathologist.



*____Not applicable



*____Cannot be assessed



*____Stage I (requires all of the following to be true)




*____Tumor involves orbit, head and neck, or genitourinary site (excluding bladder, prostate, and cranial parameningeal)




*____Tumor metastatic to distant site not identified



*____Stage II (requires all of the following to be true)




*____Tumor does not involve orbit, nonparameningeal head and neck, or nonbladder/nonprostate genitourinary tract




*____Tumor size < 5 cm




*____Tumor involvement of lymph nodes not identified




*____Tumor metastatic to distant site not identified



*____Stage III (select one if applicable)




*____Tumor involves bladder or prostate and is metastatic to regional lymph nodes but distant metastases are not identified




*____Tumor involves site other than orbit, nonparameningeal head and neck, or nonbladder/nonprostate genitourinary tract and is > 5 cm, but distant metastases are not identified



*____Stage IV




*____Distant metastases present


* Additional Pathologic Findings



*Specify:________________


*Data elements with asterisks are not required. However, these elements may be clinically important but 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 Rhabdomyosarcoma.” Web posting date October 2009, www.cap.org.

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Protocol for the Examination of Rhabdomyosarcoma Specimens
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