Adrenal 


 Cancer Case summary 

) Adrenal 

Adrenal Gland Tumours AJCC 6th Edition; CAP 2005
  Revised 2006-08-11 Cancer Case Summary
The protocol is for Adrenal Cortical Carcinoma in the official CAP publication, but may be used for Pheochromocytoma locally.
Diagnosis Example: Adrenal Gland, Right (Adrenalectomy) - Pheochromocytoma, See Case Summary
Microscopic:    
# Report Header Dictation Options Note
Surgical Pathology Cancer Case Summary  
1 Specimen Type Subtotal  / Total Adrenalectomy State all tissues received
2 Laterality Right / Left  
3 Tumour Size, Weight __ x ___ x ___ cm  
4 Tumour Weight __ g  
5 Histologic Type Cortical Tumors: Adenoma; Ca; Myelolipoma  
    Medullary Tumors#: Pheo; Neuroblastoma;Ganglioneuroblastoma;Ganglioneuroma
    # Not covered in official protocol.  
6 Descriptive features eg, nuclear atypia , mitotic rate, necrosis  
7 Venous (Large Vessel) Invasion Absent / Indeterminate V0
    Present: Intramural or Extramural V1
    Gross Venous inv. V2
8 Lymphatic (Small Vessel) Invasion Absent / Indeterminate L0
    Present: Intramural or Extramural L1
9 Margins Negative for tumour  
    Margins Involved (specify)  
10 Lymph Nodes # Positive / __ Total #  
    Largest involved LN __ cm  
11 Other Findings NA or specify Tumour necrosis, etc
12 Other Tissues / Organs NA or specify  
13 Correlation With Biopsy Or Cytology NA, Agrees, Disagrees Explain discrepancy if any
14 Correlation with Operative Consult (FS) NA, Agrees, Disagrees Explain discrepancy if any
15 Internal Consultation Pathologist name / NA  
16 Comments    
    Note: No pathologic criteria for differentiation of benign from malignant pheochromocytomas have been defined. Metastatic disease is considered the only irrefutable proof of malignancy. Adrenal cortical tumors are not usually graded on histologic grounds. Severe nuclear atypia, high mitotic count, vascular invasion, tumor necrosis, and other microscopic features may, in combination, support a diagnosis of adrenal cortical carcinoma over adenoma and should be recorded, but no precise clustering of histologic features is considered diagnostic of malignancy.
17 pTNM  AJCC 6th Ed Applicable only to Cortical Carcinomas See note re r, y, (m)
  Tumour Tx Cannot Be Assessed
    T0 No Evidence Of Tumour
    T1 Tumor 5 cm or less, no invasion
    T2 Tumor greater than 5 cm, no invasion
    T3 Tumor of any size, locally invasive but not involving adjacent organs
    T4 Tumor of any size with invasion of adjacent organs
  Lymph Nodes Nx LN cannot be assessed
    N0 No LN Mets
    N1 Regional LN Mets
  Metastases Mx Distant Mets Cannot Be Assessed
    M0 No Distant Met
    M1 Distant Mets
  Residual Tumour RX Residual tumour cannot be assessed
    R0 No residual tumour
    R1 Microscopic residual tumour
    R2 Gross residual tumour
  Venous/Lymphatic Inv. V,L See Note re Venous Lymphative Inv.