Vulva CA

Primary carcinoma of the vulva click to access explanations in the original CAP template

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Histologic type (WHO 5e):
- Histologic grade:
- Depth of invasion:
+ Tumor border:
- Other tissue/ organ involvement:	Not applicable Not identified Vagina, lower one-third Vagina, upper two-thirds Urethra, lower one-third Urethra, upper two-third Anus Bladder mucosa Rectal mucosa Pelvic bone Other organs/tissue (specify): Cannot be determined (explain):
- Lymphatic and / or Vascular Invasion:
+ Perineural invasion:
+ p16 IHC:
+ p53 IHC:

HPV-ISH is not available, PCR-sequencing type test can be ordered.

Surgical margins for invasive tumor:

- Peripheral margins:
- Deep margins:

Surgical margins for Squamous Precursor Lesion(s):

- Peripheral margins:
- Deep margins:

Surgical margins for HSIL:

- Peripheral margins:
- Deep margins:

Surgical margins for dVIN:

- Peripheral margins:
- Deep margins:

Surgical margins for VAM / HPVi (p53wt) vaVIN:

- Peripheral margins:
- Deep margins:

Surgical margins for Paget Disease:

- Peripheral margins:
- Deep margins:

Regional lymph nodes:

- Number of regional lymph nodes examined:
- Number of sentinel lymph nodes examined:
- Number of lymph nodes with metastasis > or = 5 mm:
- Number of lymph nodes with metastasis < 5 mm (exclude ITC):
- Number of lymph nodes with isolated tumor cells (< or = 0.2 mm):
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Additional lymph node findings:	Extranodal extension Fixed/ulcerated nodes Other (specify): Cannot be determined

Distant Metastasis: Not applicable Not identified Pelvic lymph node(s): Internal iliac / hypogastric lymph node(s): External iliac lymph node(s): Common iliac lymph node(s): Presacral lymph node(s): Lung (specify): Liver (specify): Bone (specify): Other (specify): Cannot be determined:

FIGO stage (2021 Cancer Report):

I: Tumor confined to the vulva IA: Tumor size less than or equal to 2 cm and stromal invasion less than or equal to 1 mm
IB: Tumor size greater than 2 cm or stromal invasion greater than 1 mm

II: Tumor of any size with extension to lower one-third of the urethra, lower one-third of the vagina, or lower one-third of the anus with negative nodes

III: Tumor of any size with extension to upper part of adjacent perineal structures, or with any number of non-fixed, non-ulcerated lymph node(s)
IIIA: Tumor of any size with disease extension to upper two-thirds of the urethra, upper two-thirds of the vagina, bladder mucosa, rectal mucosa, or regional lymph node metastases less than or equal to 5 mm#
IIIB: Regional lymph node metastases greater than 5 mm
IIIC: Regional lymph node metastases with extracapsular spread

IV: Tumor of any size fixed to bone, or fixed, ulcerated lymph node metastases, or distant metastases
IVA: Disease fixed to pelvic
IVB: Distant metastases

+ Additional pathologic findings:

Low grade squamous intraepithelial lesion / vulvar intraepithelial neoplasia, grade 1 (VIN 1) High grade squamous intraepithelial lesion / vulvar intraepithelial neoplasia, grade 2 (VIN 2) High grade squamous intraepithelial lesion / vulvar intraepithelial neoplasia, grade 3 (VIN 3) Differentiated vulvar intraepithelial neoplasia (dVIN) Vulvar aberrant maturation / HPV-independent, p53-wild-type verruciform acanthotic vulvar intraepithelial neoplasia Condyloma acuminatum Lichen sclerosus

- Other (specify):

- Additional notes: