Skin tumour specimen shrinkage with excision and formalin fixation—how much and why: a prospective study and discussion of the literature

Abstract

Background: Surgical skin specimens are known to undergo significant shrinkage when excised and processed. The degree of shrinkage is important for medical care, research and third-party assessment. Studies to date have shown variable degrees of shrinkage. Most have included multiple and sometimes unspecified variables-different surgeons, varied sites, ill-defined excision patterns and/or multiple pathologies. This study tries to exclude many of these variables to try to ascertain a more accurate predictor of shrinkage with a single surgeon, lower limb only site using a controlled excision pattern and restricted pathology cohort. Method: 100 previously untreated malignant BCC's and SCC's on the lower limb were excised and measurements made of the resulting wound and the specimen removed. Measurements were subsequently made after pathologic processing and statistically compared. Results: With excision of lower limb skin tumours the surgical defect enlarges significantly (15%) and the specimen shrinks significantly (20%) in both length (12%) and width (9%). The specimen shrinks a further 11%-again shrinking in length (8%) and width (2.6%) with formalin processing. The pathology specimen is 28.6% smaller than the specimen marked for excision. Anatomical site contributes to the degree of shrinkage. The pathologic specimen is only 75% of the suture repaired wound length. Conclusions: Skin specimens shrink significantly both with excision and processing. Most shrinkage (70%) takes place with excision while the remaining 30% with processing. The shrinkage takes place disproportionately in the normal tissue component of the specimen. Age, anatomical location, and pathology appear to play a part.

Precise Measurement of the Thickness of Vaginal Intraepithelial Neoplasia

“…Anatomical site contributes to the degree of shrinkage. For lower limb skin tumors, it was showed that the pathology specimen is 28.6% smaller than the specimen marked for excision 15 . Excision and FFPE treatment can make the skin tumors shrink to various extents depending on the original liquid content in the sample 15 .…”

“…For lower limb skin tumors, it was showed that the pathology specimen is 28.6% smaller than the specimen marked for excision 15 . Excision and FFPE treatment can make the skin tumors shrink to various extents depending on the original liquid content in the sample 15 . However, temporal artery biopsies contract upon surgical excision but do not shrink further during formalin fixation 16 .…”

“…15 Excision and FFPE treatment can make the skin tumors shrink to various extents depending on the original liquid content in the sample. 15 However, temporal artery biopsies contract upon surgical excision but do not shrink further during formalin fixation. 16 However, the squamous cells construct a firm layer on the mucosa without blood vessels than the soft tissue beneath them.…”

Modified Histopathological Protocol for Poly-ɛ-Caprolactone Scaffolds Preserving Their Trabecular, Honeycomb-like Structure

“…Compared with the standard protocol, it also enabled the assessment of almost 10x more soft tissues on the scaffold cross-section. Moreover, the percentage of soft tissues (STPs) was only 1.5% lower than in the corresponding µCT cross-sections analyzed before the histopathological procedure, which may have resulted from the process of tissue shrinking during formalin fixation [ 33 , 34 ].…”

Effects of formalin fixation on polarimetric properties of brain tissue: fresh or fixed?

“…The FF is also reported to cause physiological shrinkage in tissues from a number of organs. 53 – 58 During diagnostics such changes are of significant importance, especially when reporting tumor size. Furthermore, it would be absolutely relevant to determine the extent of shrinkage in brain tissue, as well as to explore the potential consequences on the developed algorithms.…”