Based on AJCC 7Th Ed. and WHO 2014

Ovarian Cancer Checklist

(Based on AJCC 7th ed. and WHO 2014)

A. Pathological Diagnosis:

Ovary, right or left or bilateral, salpingo-oophorectomy:

Fallopian tube, right or left or bilateral, salpingo-oophorectomy:

Adnexa, right or left or bilateral, salpingo-oophorectomy:

Uterus, corpus, total hysterectomy:

Uterus, cervix, total hysterectomy:

Lymph node, , biopsy:

Omentum, omentectomy:

Appendix, appendectomy:

Others

B. Gross Examination:

The specimen is received in parts.

Part (A) consists of a uterus and (right left bilateral) adnexa, measuring: right ovary: x x cm; left ovary: x x cm: right tube: cm; left tube: cm; and uterus: x x cm. Tumor is identified in the right left bilateral ovary.

Tumor size:

Tumor appearance: cystic solid partly cystic and partly solid hemorrhagic necrotic mucoid

Specimen integrity: Ovarian capsule intact or ruptured

The adnexa soft tissue is

Part (B) consists of groups of lymph nodes

Part (C) consists of

Representative parts are taken and embedded in blocks and labeled as: cervix: , corpus: , right tube: , right ovary: , left tube: , left ovary: cm, lymph node: , ….

C. Micro Examination:

Histologic type: serous carcinoma (mucinous endometrioid clear cell Brenner seromucinous others)

Histologic grade: grade 1 2 3(high grade low grade (for serous carcinoma))

Contralateral ovary involvement: present absent

Tumor side ovarian surface involvement: present absent

Contralateral ovary surface involvement: present absent

Right tube involvement: present (in lumen &/or parenchyma) absent

Left tube involvement: present (in lumen &/or parenchyma) absent

In situ adenocarcinoma (not) identified in right &/or left fallopian tube

Right adnexa soft tissue involvement: present absent

Left adnexa soft tissue involvement: present absent

Pelvic soft tissue involvement: present absent (describe the sites of involvement)

Uterine serosa involvement: present absent

Omentum involvement: present absent (describe invasive or noninvasive implants in borderline tumor)

Lymph nodes:

Positive for metastasis: describe location (No. of positive node/total No. of nodes)(metastasis >1cm in greatest dimention)

Negative for metastasis: describe location (0/total No. of nodes)

Cervix involvement: present absent

Endometrium involvement: present absent

Myometrium involvement: presentabsent

Appendix involvement: present absent

Other organs or specimens: present absent

(specify the other specimens received such as colon, etc….)

註1: Ovary endometrioid adenocarcinoma grading system: the same as those of endometrium

註 2: 卵巢癌標本通常十分複雜, 請參酌自己的標本來使用Checklist