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Procedure

Local excision Wide excision Partial vulvectomy Total vulvectomy Radical vulvectomy Other Not specified

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Tumor Site (select all that apply)

Right vulva Left vulva Clitoris Other Not specified

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Tumor Size (cm)

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Tumor Focality

Unifocal Multifocal Cannot be determined Not specified

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Histologic Type

Squamous cell carcinoma, keratinizing Squamous cell carcinoma, nonkeratinizing Squamous cell carcinoma, basaloid Squamous cell carcinoma, verrucous Squamous cell carcinoma, warty Squamous cell carcinoma, papillary Adenocarcinoma, NOS Adenocarcinoma, mammary gland type Adenocarcinoma, skene gland type Adenocarcinoma, sweat gland type Adenocarcinoma, intestinal type Adenocarcinoma, with associated Paget disease Adenosquamous carcinoma Transitional cell carcinoma Adenoid cystic carcinoma Adenoid basal carcinoma Small cell neuroendocrine carcinoma Large cell neuroendocrine carcinoma Undifferentiated carcinoma Other histologic type not listed Carcinoma, type cannot be determined

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Histologic Grade

G1: Well differentiated G2: Moderately differentiated G3: Poorly differentiated G4: Undifferentiated Other GX: Cannot be assessed Not applicable

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Depth of Invasion (mm)

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+ Tumor Border

Pushing Infiltrating

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Margins - Peripheral (select all that apply)

Cannot be assessed Uninvolved by invasive carcinoma Involved by invasive carcinoma Uninvolved by intraepithelial neoplasia Involved by high-grade squamous intraepithelial lesion (VIN 2-3) Involved by vulvar intraepithelial neoplasia, differentiated (simplex) type (dVIN) Involved by Paget disease

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Margins - Deep (select all that apply)

Cannot be assessed Uninvolved by invasive carcinoma Involved by invasive carcinoma Uninvolved by intraepithelial neoplasia Involved by high-grade squamous intraepithelial lesion (VIN 2-3) Involved by vulvar intraepithelial neoplasia, differentiated (simplex) type (dVIN) Involved by Paget disease

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Lymphovascular Invasion

Not identified Present Cannot be determined

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Regional Lymph Nodes

Check here if any lymph nodes submitted?

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Pathologic Staging (pTNM) TNM vs FIGO designation

TNM Descriptors (select all that apply)

Not applicable m r y

pT

pTX: Primary tumor cannot be assessed pT0: No evidence of primary tumor pT1a: Lesions 2 cm or less, confined to the vulva and/or perineum, and with stromal invasion of 1.0 mm or less pT1b: Lesions more than 2 cm, or any size with stromal invasion more than 1.0 mm, confined to the vulva and/or perineum pT2: Tumor of any size with extension to adjacent perineal structures (lower/distal third of the urethra, lower/distal third of the vagina, anal involvement) pT3: Tumor of any size with extension to any of the following: upper/proximal two-thirds of the urethra, upper/proximal two-thirds of the vagina, bladder mucosa, or rectal mucosa, or fixed to pelvic bone

pN

pNX: Regional lymph nodes cannot be assessed pN0: No regional lymph node metastasis pN0(i+): Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm pN1a: One or two lymph node metastasis each less than 5 mm# pN1b: One lymph node metastasis ≥ 5 mm pN2a: Three or more lymph node metastases each less than 5 mm# pN2b: Two or more lymph node metastases ≥ 5 mm pN2c: Lymph node(s) with extranodal extension pN3: Fixed or ulcerated regional lymph node metastasis

pM

pMX: Not applicable pM1: Distant metastasis (including pelvic lymph node metastasis)

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+ FIGO Stage

I: Tumor confined to the vulva IA: Lesions ≤2 cm in size, confined to the vulva or perineum and with stromal invasion ≤1.0 mm, no nodal metastasis# IB: Lesions >2 cm in size or with stromal invasion >1.0 mm, confined to the vulva and/or perineum, with negative nodes II: Tumor of any size with extension to adjacent perineal structures (lower third of urethra, lower third of vagina, anus) with negative nodes III: Tumor of any size with or without extension to adjacent perineal structures (lower third of urethra, lower third of vagina, anus) with positive inguinofemoral nodes IIIA: With 1 lymph node metastasis (≥5 mm) IIIA: With 1 to 2 lymph node metastasis(es) (<5 mm) IIIB: With 2 or more lymph node metastases (≥5 mm) IIIB: With 3 or more lymph node metastases (<5 mm) IIIC: With positive nodes with extracapsular spread IV: Tumor invades other regional (upper two-thirds urethra, upper two-thirds vagina), or distant structures IVA: Tumor invades any of the following: upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone, or fixed or ulcerated inguinofemoral lymph nodes IVB: Any distant metastasis including pelvic lymph nodes

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+ Additional Pathologic Findings

Condyloma accuminatum High grade squamous intraepithelial lesion (VIN 2-3) Low grade squamous intraepithelial lesion (VIN 1) Vulvar intraepithelial neoplasia, differentiated (simplex) type (dVIN) Lichen sclerosus Other