Orient the specimen. Identify which parts are included: helix, antihelix, concha, tragus, lobule.
Measure the specimen (three dimensions) and any lesions (two dimensions if flat, three dimensions if raised).
Describe any lesions (color, shape, ulceration, borders). Note their location and measure their distances to the resection margins. Describe the uninvolved skin (color, texture, atrophy, erosion, flaking, plaque).
Ink the resection margins.
If the specimen is a wedge resection, slice off the resection margins at the two ends of the specimen, then serially section the remainder of the specimen, roughly parallel to the end margins.
If the specimen is a subtotal or total external ear, slice off the margin, then serially section the specimen perpendicular to the border of the helix. The approach may need to be modified for each individual case.
Describe the cut surface of the tumor and measure the depth of invasion. Re-measure the distances to the margins, if applicable. Determine whether cartilage is invaded.
Resection margins: entirely submit. Margins may be shaved off and submitted en face if they are > 5 mm from the tumor. If tumor is close to the margin, the margin should be inked, and specimen should sectioned perpendicularly to the margin so that the distance between the tumor and the margin can be assessed.
Tumor: Entirely submit if 5 blocks or less; otherwise, submit representatively, including uninvolved tissue and deepest point of invasion in some sections. If it is a pigmented lesion, submit the entire lesion (unless extremely large).
Uninvolved area: entirely submit if small, otherwise one to three sections. Additional sections if other lesions present.
Received without fixative/in formalin, labeled _____ and “_____”, is a wedge resection of/partial/total external ear (__ x __ x __ cm) consisting of helix/antihelix/concha/tragus/lobule. The specimen is oriented with a suture (= _____). There is a __ x __ x __ cm _____ (color, ulceration, shape, borders) mass located on the _____, __ cm from the _____ resection margin and __ cm from the _____ resection margin. It has a _____ cut surface and a thickness of __ cm. It does/does not invade the underlying cartilage. The uninvolved skin is _____ (color, texture, atrophy, erosion, flaking).
#__ = superior resection margin, en face; 1 piece.
#___ - #___ = tumor with the lateral margin; __ pieces in each.
#__ & #__ = tumor, from superior to inferior; __ pieces in each.
#__ = erythematous skin; __ pieces.
#__ = skin with erosion; __ pieces.
#__ = inferior resection margin, en face; __ pieces.