Self Instructional Manual for Cancer Registrars - SEER - National ...

EXAMPLE
G4 (continued)
left radical neck dissection which bordered upon the anterior aspect of the vertebral column.
A fragment of tissue is excised from this area and submitted for sectioning labeled "VM."
After having been photographed in several positions, the specimen is blocked further. A
section is taken through the main tumor mass and submitted for sectioning labeled _I'
POST." Attention is directed to the left radical neck dissection proper. This part of the
specimen is divided into the appropriate five levels. Each level is examined for lymph nodes
which are dissected free and submitted in their entirety for sectioning. The remainder of
the specimen is saved.
Part #3 of the specimen, labeled "anterior margin of inferior mandible" consists of an
irregular fragment of fibrous connective and skeletal muscular tissues and measures
approximately 1.0 x 0.5 x 0.2 cm. The specimen is submitted in its entirety for sectioning
on three levels.
MICROSCOPIC
DESCRIPTION:
Microscopic examination of frozen section control #1 confirms the original frozen section
diagnosis of "ganglion."
Microscopic examination of frozen section control #2 confirms the original frozen section
diagnosis of "no tumor seen."
Microscopic examination of frozen section control #3 confirms the original frozen section
diagnosis of "no tumor seen."
Microscopic examination of part #2 of the specimen reveals foei of moderately well
differentiated squamous cell carcinoma in the floor of the left side of the mouth. The
residual tumor is surrounded by large amounts of dense fibrous connective tissue.
Microscopic examination of the section labeled CM which represents the carotid margin
reveals squamous cell carcinoma extending to within 0.1 cm of the surgical margin.
Microscopic examination of section labeled VM representing the vertebral margin fails to
reveal evidence of tumor in this location. Microscopic examination of the tissue in level I
reveals section of fibrotic and atrophic submaxillary salivary gland. There is also one lymph
node in level I which is negative for metastatic tumor. Microscopic examination of the
tissue in level II reveals sections of 11 lymph nodes none of which contains metastatic
tumor. However, the extranodal fibrous connective tissue in level III contains numerous
loci of squamous cell carcinoma. Microscopic examination of the tissue in level IV reveals
sections of 6 lymh nodes, none of which contains metastatic tumor. Microscopic
examination of the tissue in level V reveals 1 lymph node which is negative for metastatic
tumor.
Name Phineas Feltbad Reg. No. 000040
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