Endocrine Pancreas Resection

Specimen:
   Head of pancreas
   Body of pancreas
   Tail of pancreas
   Duodenum
   Stomach
   Common bile duct
   Gallbladder
   Spleen
   Adjacent large vessels
   Portal vein
   Superior mesenteric vein
   Other large vessel (specify):
   Other (specify):
   Not specified
   Cannot be determined

Procedure Type:
Excisional biopsy (enucleation)
Pancreaticoduodenectomy (Whipple resection), partial pancreatectomy
Pancreaticoduodenectomy (Whipple resection), total pancreatectomy
Partial pancreatectomy, pancreatic body
Partial pancreatectomy, pancreatic tail
Other (specify):
Not specified

Tumor Site:
Pancreatic head
Uncinate process
Pancreatic body
Pancreatic tail
Other (specify):
Cannot be determined
Not specified

Tumor Size:
   Greatest dimension (cm): (specify size of largest tumor if multiple tumors are present)
   Additional dimensions: cm
   Cannot be determined (see Comment)

Tumor Focality:
Unifocal
Multifocal (specify number of tumors:): tumor foci
Cannot be determined
Not specified

Histologic Type:
Well-differentiated endocrine neoplasm
Poorly differentiated endocrine carcinoma
Small cell carcinoma
Large cell endocrine carcinoma
Other (specify):
Carcinoma, type cannot be determined

World Health Organization Classification:
Well-differentiated endocrine tumor, benign behavior
Well-differentiated endocrine tumor, uncertain behavior
Well-differentiated endocrine carcinoma
Poorly differentiated endocrine carcinoma

Functional Type:
Cannot be assessed
Pancreatic endocrine tumor, functional (correlation with clinical syndrome and elevated serum levels of hormone product)
Insulin-producing (insulinoma)
Glucagon-producing (glucagonoma)
Somatostatin-producing (somatostatinoma)
Gastrin-producing (gastrinoma)
Vasoactive intestinal polypeptide (VIP)-producing (VIP-oma)
Other (specify):
Pancreatic endocrine tumor, nonfunctional
Pancreatic endocrine tumor, functional status unknown

Mitotic Activity:
Not applicable
Less than 2 mitoses/10 high-power fields: mitoses/10 HPF
Greater than or equal to 2 mitoses/10 HPF to 10 mitoses/10 HPF: mitoses/10 HPF
Greater than 10 mitoses per 10 HPF: mitoses/10 HPF
Cannot be determined

Ki67 labeling index:
<2% Ki67-positive cells
3%-20% Ki67-positive cells
>20% Ki67-positive cells

Tumor Necrosis:
Not identified
Present
Not applicable
Cannot be determined

Microscopic Tumor Extension:
Cannot be determined
No evidence of primary tumor
Tumor is confined to pancreas
Tumor invades ampulla of Vater
Tumor invades common bile duct
Tumor invades duodenal wall
Tumor invades peripancreatic soft tissues
Tumor invades other adjacent organs or structures (specify):

Margins:
Cannot be assessed
Margins uninvolved by tumor. Distance to closest margin: mm at
Margin(s) involved by tumor:
    Uncinate process (retroperitoneal) margin (nonperitonealized surface of the uncinate process)
    Distal pancreatic margin
    Common bile duct margin
    Proximal pancreatic margin
    Other (specify):
Tumor involves posterior retroperitoneal surface of pancreas


Lymph-Vascular Invasion:
Not identified
Present
Indeterminate

Perineural Invasion:
Not identified
Present
Indeterminate

Pathologic Staging (pTNM)

m (multiple primary tumors)
r (recurrent)
y (post-treatment)

Primary Tumor (pT):
pTX: Cannot be assessed
pT0: No evidence of primary tumor
pT1: Tumor limited to the pancreas, 2 cm or less in greatest dimension
pT2: Tumor limited to the pancreas, more than 2 cm in greatest dimension
pT3: Tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery
pT4: Tumor involves the celiac axis or the superior mesenteric artery

Regional Lymph Nodes (pN):
pNX: Cannot be assessed
pN0: No regional lymph node metastasis ( 0 / )
pN1: Regional lymph node metastasis ( / )

Distant Metastasis (pM):
Not applicable
pM1: Distant metastasis at

Additional Pathologic Findings:
None identified
Chronic pancreatitis
Acute pancreatitis
Adenomatosis (multiple endocrine tumors, each less than 5 mm in greatest dimension)
Other (specify):

Ancillary Studies:

Disease History:
       von Hippel-Lindau disease
       Multiple endocrine neoplasia type 1
       Familial pancreatic cancer syndrome
       Hypoglycemic syndrome
       Necrolytic migratory erythema
       Watery diarrhea
       Hypergastrinemia
       Zollinger-Ellison syndrome
       Other (specify):
       Not specified

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