Wilm's tumor

Wilms and Other Pediatric Renal Tumor click to access explanations in the original CAP template

This is additional protocol for biopsy specimen.

OPTIONAL: Expert Consultation before completion of the reporting.

Gross descriptions:

- Procedure:
- Specimen weight (g):
- Specimen laterality:
- Tumor focality:
- Tumor size:
- Tumor size:	- Greatest dimensions of additional tumor nodules: Tumor #2 (cm): Tumor #3 (cm): Other (specify):

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Histologic type:
+ Nephrogenic rests:
- Tumor Disruption (pre-op or intra-op):
- Renal Sinus Involved by Viable Tumor:
- Renal Vein Involvement by Viable Tumor:
- Extension Beyond Renal Capsule:
- Direct Extension into Adjacent Organs:
+ Lymphovascular invasion:
+ Perineural invasion:
+ Post therapy histologic classification:

Surgical margins:

Specifically, comments on Vascular, Ureteral and Soft tissue margins.

Regional lymph nodes:

- Number of regional lymph nodes examined:
- Number of lymph nodes involved (specify locations):
- Extranodal extension:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:

Distant Metastasis: Not applicable Not identified Lymph node(s) outside of the abdomino-pelvic region (specify): Lung (specify): Liver (specify): Other (specify): Cannot be determined:

Children’s Oncology Group Staging System (2005):

- Not applicable Nephrogenic rests only

- Local Stage I: Tumor limited to kidney and completely resected No penetration of renal capsule No tumor involvement of extrarenal or renal sinus lymph-vascular spaces identifie No tumor metastasis to lymph nodes

- Local Stage II: Tumor extends beyond kidney but is completely resected Tumor extends through the renal capsule Tumor involvement of extrarenal or renal sinus lymph-vascular spaces present Tumor involves renal vein, but has not been transected and is not attached to vein wall at resection margin Tumor more than minimally involves the renal sinus soft tissue

- Local Stage III: Residual tumor is suspected Tumor present at margin(s) of resection Tumor rupture identified Tumor spill before or during surgery identified Piecemeal excision of tumor (removal of tumor in more than 1 piece) Metastatic tumor in regional lymph nodes identified History of renal tumor biopsy before definitive surgery

- Stage IV: Metastatic disease Hematogenous metastases or lymph node metastases outside the abdomino-pelvic region

- Stage V: Bilateral renal involvement at diagnosis Right kidney stage: Left kidney stage:

+ Additional pathologic findings: