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Proforma for Histopathology Reporting Uterine Malignant and Potentially Malignant Mesenchymal Tumours Histopathology Reporting Guide Family/Last name Date of birth DD – MM – YYYY Given name(s) Patient identifiers Date of request Accession/Laboratory number DD – MM – YYYY Elements in black text are CORE. Elements in grey text are NON-CORE. SCOPE OF THIS DATASET indicates multi-select values indicates single select values CLINICAL INFORMATION (select all that apply) (Note 1) ACCOMPANYING SPECIMENS (select all that apply) (Note 4) Information not provided None submitted History of previous cancer, specify Peritoneal biopsies, specify site(s) Ovaries Left Right Not specified History of previous gynecologic biopsy/surgical excision, Fallopian tubes specify Left Right Not specified Omentum Lymph nodes, specify site(s) Other, specify Other, specify OPERATIVE PROCEDURE (select all that apply) (Note 2) TUMOUR SITE (select all that apply) (Note 5) Not specified Hysterectomy Indeterminate Simple total Cervix Simple supracervical/subtotal Lower uterine segment Radical Corpus Type not specified Other, specify Myomectomy Lymph nodes, specify site(s) Other, specify MAXIMUM TUMOUR DIMENSION (Note 6) mm Cannot be assessed, specify SPECIMEN INTEGRITY (Note 3) Intact Non-intact Morcellated/fragmented BLOCK IDENTIFICATION KEY (Note 7) Opened (List overleaf or separately with an indication of the nature and origin of all tissue blocks) DRAFT Version 1.0 Published XXXX 2021 ISBN: XXXX Page 1 of 4 © 2021 International Collaboration on Cancer Reporting Limited (ICCR). Uterine Malignant and Potentially Malignant Mesenchymal Tumours b HISTOLOGICAL TUMOUR TYPE (Note 8) Vagina (Value list based on the World Health Organization Cannot be assessed Classification of Female Genital Tumours (2020)) Not involved Leiomyosarcoma Involved Low grade endometrial stromal sarcoma Fallopian tubeb High grade endometrial stromal sarcoma Undifferentiated uterine sarcoma Cannot be assessed Mullerian adenosarcoma without sarcomatous overgrowth Not involved Mullerian adenosarcoma with sarcomatous overgrowth Involved Uterine tumour resembling ovarian sex cord tumour Left Right Indeterminate Perivascular epithelioid cell tumour b Ovary Inflammatory myofibroblastic tumour Cannot be assessed NTRK-rearranged sarcoma Not involved SMARC-deficient uterine sarcoma Involved Rhabdomyosarcoma (RMS) (embryonal and pleomorphic) Left Right Indeterminate Alveolar soft part sarcoma Smooth muscle tumour of uncertain malignant potential b If received. (STUMP) Other, specify LYMPHOVASCULAR INVASION (Note 11) Not identified Present Indeterminate a MITOTIC COUNT (Note 9) MARGIN STATUS (Note 12) 2 /mm Distal/cervical or vaginal Cannot be assessed Cannot be assessed Not involved Distance of tumour from closest a Core for leiomyosarcoma, smooth muscle tumour of uncertain cervical or vaginal margin mm malignant potential, PEComa; non-core for all other entities but including mitotic count is strongly recommended. Specify closest margin, if possible EXTENT OF INVASION (Note 10) Myometrial or cervical stromal invasion Involved (Applicable to adenosarcoma only) Specify margin, if possible Cannot be assessed Cervical Not identified Vaginal ≤50% Other, specify >50% Uterine serosa involvement Cannot be assessed Parametrial Not involved Cannot be assessed Distance of tumour to uterine serosa mm Not involved Involved Involved Parametrial involvement Not submitted Cannot be assessed Not involved Involved Left Right Indeterminate b Omentum Cannot be assessed Not involved Involved DRAFT Version 1.0 Published XXXX 2021 ISBN: XXXX Page 2 of 4 © 2021 International Collaboration on Cancer Reporting Limited (ICCR). Uterine Malignant and Potentially Malignant Mesenchymal Tumours c LYMPH NODE STATUS (select all that apply) (Note 13) Representative blocks for ancillary studies, specify those blocks best representing tumour and/or normal tissue Pelvic nodes for further study Cannot be assessed No nodes submitted or found Number of nodes examined PROVISIONAL PATHOLOGICAL STAGING (Note 16) Number of positive nodes d FIGO (2015 edition) Size of maximum tumour deposit mm Leiomyosarcomas and endometrial stromal sarcomas I Tumour limited to uterus Para-aortic nodes IA Less than 5 cm Cannot be assessed IB More than 5 cm No nodes submitted or found II Tumour extends beyond the uterus, within the Number of nodes examined pelvis IIA Adnexal involvement Number of positive nodes IIB Involvement of other pelvic tissues III Tumour invades abdominal tissues (not just protruding into the abdomen) mm Size of maximum tumour deposit IIIA One site IIIB More than one site Other lymph nodes removed, specify site(s) IIIC Metastasis to pelvic and/or para-aortic lymph nodes IV Tumour invades bladder and/or rectum and/or distant metastasis Cannot be assessed IVA Tumour invades bladder and/or rectum No nodes submitted or found IVB Distant metastasis Number of nodes examined Adenosarcomas Number of positive nodes I Tumour limited to uterus IA Tumour limited to endometrium/endocervix with Size of maximum tumour deposit mm no myometrial invasion IB Less than or equal to half myometrial invasion c If resected. IC More than half myometrial invasion II Tumour extends to the pelvis COEXISTENT PATHOLOGY (Note 14) IIA Adnexal involvement None identified IIB Tumour extends to extrauterine pelvic tissue Present, specify III Tumour invades abdominal tissues (not just protruding into the abdomen) IIIA One site IIIB More than one site IIIC Metastasis to pelvic and/or para-aortic lymph nodes IV Tumour invades bladder and/or rectum and/or ANCILLARY STUDIES (Note 15) distant metastasis Not performed IVA Tumour invades bladder and/or rectum Performed (select all that apply) IVB Distant metastasis Immunohistochemistry, specify test(s) and result(s) d Reprinted from Int J Gynaecol Obstet., Volume 131(Suppl 2), Prat J, Mbatani N, Uterine sarcomas, pages S105-10, 2015, with permission from Wiley. Molecular findings, specify test(s) and result(s) Other, specify test(s) and result(s) DRAFT Version 1.0 Published XXXX 2021 ISBN: XXXX Page 3 of 4 © 2021 International Collaboration on Cancer Reporting Limited (ICCR). Uterine Malignant and Potentially Malignant Mesenchymal Tumours e TNM staging (UICC TNM 8th edition 2016) TNM Descriptors (only if applicable) (select all that apply) m - multiple primary tumours r - recurrent y - post-therapy Primary tumour (pT) LEIOMYOSARCOMAS AND ENDOMETRIAL STROMAL SARCOMAS T1 Tumour limited to the uterus T1a Tumour 5 cm or less in greatest dimension T1b Tumour more than 5 cm T2 Tumour extends beyond the uterus, within the pelvis T2a Tumour involves adnexa T2b Tumour involves other pelvis tissues T3 Tumour infiltrates abdominal tissues T3a One site T3b More than one site N1 Metastasis to regional lymph nodes T4 Tumour invades bladder or rectum M1 Distant metastasis ADENOSARCOMA T1 Tumour limited to the uterus T1a Tumour limited to the endometrium/endocervix T1b Tumour invades to less than half of the myometrium T1c Tumour invades more than half of the myometrium T2 Tumour extends beyond the uterus, within the pelvis T2a Tumour involves adnexa T2b Tumour involves other pelvis tissues T3 Tumour involves abdominal tissues T3a One site T3b More than one site N1 Metastasis to regional lymph nodes T4 Tumour invades bladder or rectum M1 Distant metastasis Regional lymph nodes (pN) NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1 Regional lymph node metastasis Distant metastasis (pM) f M0 No distant metastasis M1 Distant metastasis (excluding adnexa, pelvic and abdominal tissues) e Reproduced with permission. Source: UICC TNM Classification of Malignant Tumours, 8th Edition, eds by James D. Brierley, Mary K. Gospodarowicz, Christian Wittekind. 2016, Publisher Wiley (incorporating any errata published up until 6th October 2020). f No pathological stage use clinical stage cM0. DRAFT Version 1.0 Published XXXX 2021 ISBN: XXXX Page 4 of 4 © 2021 International Collaboration on Cancer Reporting Limited (ICCR). Scope The dataset has been developed for the pathology reporting of resection specimens of the uterus for sarcomas and mesenchymal tumours with potentially malignant behaviour; this dataset is applicable to tumours of the uterine corpus and the uterine cervix. Carcinomas, other non-mesenchymal malignancies and metastatic neoplasms are excluded from this dataset. Carcinosarcoma is also excluded as it is considered to represent a malignant epithelial tumour with divergent mesenchymal differentiation based on clinicopathologic, immunohistochemical and molecular analysis; as such, this entity is included in the International Collaboration on Cancer Reporting (ICCR) Endometrial cancer dataset. Back Note 1 – Clinical information (Non-core) Adequate clinical history is essential for accurate diagnoses and appropriate clinical care. The frequency of the lack of clinical information negatively impacting the final diagnostic pathology report has been estimated at approximately 1%; in these instances, additional clinical information resulted in a change in diagnosis.1 A history of prior malignancy, radiation or hormonal therapy (which increases risk for sarcomas) and any prior excision is considered relevant. Back Note 2 – Operative procedure (Core) While a diagnosis of a uterine sarcoma or tumour of uncertain malignant potential may occur with limited sampling of disease (endometrial biopsy, curetting or core biopsy), a significant subset are clinically unsuspected and first diagnosed upon pathologic examination of a myomectomy or hysterectomy specimen.
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