Cardiac Tumors: Surgical Pathology Dissection

Cardiac Tumors

Resections of cardiac tumors are not common surgical pathology specimens. Despite their in-frequency, these specimens are easily tackled using the standard approach to tumor dissection.Describe the number and sizes of the tissue pieces received and the presence of epicardium, endocardium, or muscle. Document the size of any masses. The color and texture of the mass are also important to note, as they may indicate the predominant presence of fibrous tissue, myxoid stroma, adipose tissue, or muscle. Intra-cavitary masses can be pedunculated or sessile and should be described accordingly. The resec-tion margin(s) should be inked and sampled, and the status of these margins should be docu-mented in your final report, as it is useful infor-mation for the surgeon. As with any tumor, adequate sampling requires representative sec-tions of areas that may show distinct gross fea-tures, such as fibrosis, necrosis, hemorrhage, or a recognizable normal structure (e.g., valve, tra-beculae). If the mass is large, one cassette for every centimeter of maximal diameter of the tumor should be adequate. A piece of the tumor may be frozen and stored for special studies, and submission of fresh tissue may be indicated if cytogenetic or flow cytometric analysis is to be performed. Sampling the tumor for these analy-ses should avoid areas of frank necrosis. If the tumor is heavily calcified, it should be handled similar to a bone specimen for the slicing, sam-pling, and decalcifying procedures.