In a thyroidectomy with more than one nodule, each discrete lesion should be measured, located and sampled, with the cassette key recording which block came from which focus. Small subcapsular or contralateral foci are easily under-sampled when attention goes to the largest nodule.
In the report, give each carcinoma focus its own line — site, size, histotype and invasion — so that staging and molecular testing can be tied to the right tumour.
- Measure and locate every discrete nodule at grossing
- Keep a cassette key that links each block to its focus
- Give each carcinoma focus its own line in the report
- Stage on the most aggressive focus as well as the largest
Why it matters
A report that merges foci can attach the wrong molecular result to the wrong tumour.
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