NEPHRECTOMY FOR UROTHELIAL CARCINOMA
Tumors of this nature proliferate within the ureter, pelvis and calyces. It is not uncommon for the tumor to invade into the parenchyma. For these specific tumors, use the grossing protocol “Nephrectomy for Malignant Neoplasm”. The first step should always be to shave the surgical margin and submit en face. If the tumor has ureter extension, ink the entire adventitial surface and open longitudinally. Submit one section per cm of tumor, including greatest depth of invasion (i.e. limited to urothelium, invades through adventitia, etc.). Systematically submit sections of uninvolved/involved ureter, including distal, mid, proximal and ureter/pelvic junction. This is done to determine if any in-situ disease is present. Remember to keep the sectioned ureter in order, wrapped in a labeled paper towel if more sections from a specific area are required at a later time. Urothelial tumors of the renal pelvis and ureter are often very soft and friable. Please take care to ensure that when grossing it in you rinse your knife blade frequently to avoid carry-over of tumor into underlying tissue.