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<p>Tumor site: Cecum and terminal ileum</p><p>Histologic type: Adenocarcinoma</p><p>Histologic grade: Moderately differentiated (Grade 2)</p><p>Tumor size: 3 × 2.5 × 2 cm</p><p>Depth of invasion: Tumor extends through the muscularis propria into the pericolic fat</p><p>Tumor budding: Intermediate</p><p>Lymphovascular invasion: Present</p><p>Perineural invasion: Not identified</p><p>Appendix: Uninvolved by tumor</p><p>Surgical Margins</p><ul><li>Proximal margin (terminal ileum): Negative for tumor</li><li>Distal margin (ascending colon): Negative for tumor</li><li>Radial/circumferential margin: Negative for tumor</li></ul><p>Regional Lymph Nodes</p><ul><li>Metastatic carcinoma identified in 1 of 11 lymph nodes (1/11 positive)</li><li>Extranodal extension: Present</li><li>Largest lymph node measures 0.8 cm</li></ul><p>Pathologic Staging (AJCC TNM)</p><ul><li>Primary tumor: pT3</li></ul><p>Tumor invades through the muscularis propria into surrounding fat</p><ul><li>Regional lymph nodes: pN1a</li></ul><p>Metastasis in 1 regional lymph node</p><ul><li>Distant metastasis: pMx</li></ul><p>Cannot be assessed from the surgical specimen</p>
<p class="ql-align-justify">History of intestinal obstruction was found to have a tumor mass, for which a hemicolectomy was done.</p>
<p class="ql-align-justify">Right hemicolectomy: The terminal ileum measured 6 x 2.3 cm, with an attached appendix measuring 5 x 1 cm. The cecum and ascending colon measured 25 x 2.5 cm. The attached mesenteric fat and omentum measured 22 x 13 cm. Opening revealed a solid, firm mass measuring 3 x 2.5 x 2 cm. The mass was located 5.5 cm away from the proximal margin and 22 cm away from the distal margin. Dissection of the mesenteric fat revealed 11 lymph nodes, with the largest measuring 0.8 cm.</p>
<p><strong><em><u>Right hemicolectomy:</u></em></strong></p><ul><li><strong>Adenocarcinoma, Grade 2 (moderately differentiated), involving the cecum and terminal ileum</strong></li></ul>
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