Part 1 is labeled "tissue right deep neck". It consists of a 0.8 x 0.5 x 0.3 cm irregular segment of rubbery, pink and fibrotic, soft tissue, with focal cautery artifact. The specimen is entirely frozen. The remainder of the frozen tissue is totally submitted labeled 1AFS.
INTRAOPERATIVE CONSULTATION: TISSUE FROM RIGHT DEEP NECK (Frozen section) - BENIGN.
Part 2 is labeled "lymph node right posterior triangle". It consists of a 1.0 x 0.6 x 0.3 cm irregular portion of pink to tan and focally cauterized soft tissue. The specimen is entirely frozen. The remainder of the frozen tissue is totally submitted labeled 2AFS.
INTRAOPERATIVE CONSULTATION: LYMPH NODE FROM RIGHT POSTERIOR TRIANGLE (Frozen section) - BENIGN.
Part 3 is received fresh labeled "right neck mass and hemimandibulectomy". The specimen consists of a 12.0 x 9.0 x 7.5 cm segment of mandibular facial skin and soft tissue attached to a resected right hemimandible that extends from the anterior of the canine tooth to the superior ramus. The coronoid and condylar process of the mandible are not included in this resection. The mandibular segment has three teeth, one canine and two premolars. Distal to the premolars there are no teeth. On the facial skin of the specimen, a cotton drape is affixed with metal staples. On removal of the cotton drape, an eruptive tumor is evident in the region of the mandibular angle. The tumor measures 4.5 x 4.3 x 3.5 cm and has a central brown- tan nodular appearance. The tumor projects about 3.0 cm above the surface of the skin and shows dependent wrinkling with hair at the inferior surface. The surgical margins from the skin to mandible are inked black. At the lingula of the mandible, the surgical margins of the lingual musculature are inked black. The gingival mucosal margin is inked black. Serially sectioning the tumor reveals a focus of liquified necrosis in the posterior and deep aspect of the tumor. Sections distal to the main tumor mass reveal a new tumor focus that is 1.4 cm in greatest dimension and grossly separated from the large tumor mass. Digital and photographic images of the tumor are captured. Representative sections are submitted as follows: 3A - Three sections of inferior margin 3B - Two sections of inferior anterior margin 3C - Anterior skin margin 3D and 3E - A deep section from surface skin to deep periosteum is taken and divided into two cassettes; the skin surface is 3D, the periosteal surface is in 3E. An additional deep surface is taken in cassette 3F. 3G - New tumor focus at the posterior angle of the mandible 3H - Two sections through the distal aspect of the specimen 3I - Lingual gingival margins distal to the premolars 3J - One section of gingival mucosa at the level of the canine 3K - Distal gingival margins along mandibular ramus 3L - Lingual surfaces of muscle showing relationship of tumor tracking beneath mandible 3M - Anterior bony resection margin 3N - Posterior bony resection margin