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CALI FORNI A TUMOR TISSUE REGiSTRY

HUNTINGTON MENORIAL HOSPITAL

PROTOCOL

FOR

MONTHLY STUDY SLIDES

MAY 1991

UTERUS AND GENI TO-URINARY TUMORS

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CONTRIBUTOR: Gloria Yu, M. 0. W. J. Hedemeyer, M. 0. Martinez, Cal ifornia

TISSUE FROM: Urethra

CLINICAL ABSTRACT:

MAY 1991 - CASE NO. 1

ACCESSION NO. 26663

History: Thi s 58-year-old white male was first seen i n June 1986 for gradual increase in penile girth due to an enlarging mass. He had an aspiration of right inguinal node adenopathy and refused further workup. He was nonsymptomatic until about a week ago when he began to have dysuria and an incidence of hematuria. He was readmitted for the purpose of penectomy and perineal urethrostomy to be foll owed by lymph node staging at a later date.

Physi cal examinati on : The peni s was swollen and pai nful. There was a large mass in right groin.

SURGERY: (March 27, 1987)

A total penectomy and perineal urethrostomy was performed.

GROSS PATHOLOGY:

The resected peni s measured 10 .0 x 4.0 em. in greatest dimension. There was no abnormal ities visibl e . The urethra when opened revealed a f irm white nodul ated tissue throughout t he length of the penis except for 0.4 em. f rom the resected margin . The central portion had a strictured area. 11ultiple cross sections revealed infiltration of the corpora cavernosum and the glans peni s.

CONTRIBUTOR: Cynthia Pettross, M. 0. MAY 1991 - CASE NO. 2 Marysville , Cal ifornia

TISSUE FROM: Ureter ACCESSION NO. 26358

CLINI CAL ABSTRACT:

History: Thi s 28-year-old femal e presented a few weeks pri or to admission wi t h pain in her left groi n due to a hernia. At age 4 she had urinary retenti on for which she had an IVP which showed norma l ki dneys and col l ec ting system. There was urinary retention and she was treated with a "TUR".

Physical examination revealed a left groin herni a.

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Radiograph : An IVP was performed which showed decreased right renal f unction with hydroureter and obs truct ion i n the region of t he ureterovesicular valve with several calcifications in the renal pel vi s.

SURGERY: (Sept ember 6, 1988)

A 1 eft i nguina 1 herniorrhaphy was performed, fo 11 owed by a midl i ne exploratory lapar otomy which revealed a l emon-si zed , hard , f ixed mass in t he right pelvis which was firmly adhered to the surrounding s tructures . In a lengthy and difficult operative procedure , t he right external iliac vein was resected and t he tumor dissected from t he right iliac ar tery . The ureter was di vided above t he mass and t he enti re mass and di stal ureter as well as t he right ili ac vei n was removed . It was t hen possi ble after mobi l izing the right kidney to reimplant t he right ureter into the bladder.

GROSS PATHOLOGY:

The ri ght pelvi c mass measuring 5 x 3 x 3 em. was an irregu lar nodul ated dense f ibrous ti ssue ~lith areas of hemorrhagic alterati on with a large at tached vein . A tubular segment of ureter was encased in the mass, the l umen was dilated up to 0.4 em. and appeared i ntricately involved wi t h t he dense fib rous tissue .

The resected r ight ureter was 7. 5 x 0.7 em. in greatest diamet er . The multi ple sections appeared unremarkabl e.

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27CONTRIBUTOR: Patrick Fitzgibbons, M. D. MAY 1991 - CASE NO. 3 Pasadena, Cali fornia

TISSUE FROH: Urethra ACCESSION NO. 26954

CLINICAL ABSTRACT:

Histor y: This 72-year-old male was seen by his physician on January 18, 1991 with lump in his peni s, one month's durat ion. He is admitted to the hospital for surgical procedure following biopsy of urethra. Past history of TUR in 1989.

Physical examination revealed an external genital ia mid-urethral 1+ em. solid mass involving the corpus spongiosum and most likely inferi or portion of the corpora cavernosum. Prostate, grade I enlargement, benign in consistency.

A CT scan demonstrated a hazy soft tissue density medial to the left crus of the base of the penis.

SURGERY: (March 8, 1991)

A partial urethrectomy, penectomy and perineal urethrotomy were performed.

GROSS PATHOLOGY:

The specimen was an amputated penis, 9 em. in length, without abnor­malities. Upon opening the urethra, a 5 em. circumferential tumor was present along the distal half. Cut surfaces were pale white to light yel low and the tumor measured 10 mm. in thickness. There was a cl ear surgical margin, 2.5 em. in the fixed state.

CONTRIBUTOR: Anthony Cunha, M. 0. MAY 1991 - CASE NO. 4 Grass Valley, California

TISSUE FROM: Kidney ACCESSION NO. 26059

CLINICAL ABSTRACT:

History: This 77-year-old female had a normal day before when she, following a breakfast of a bowl of rice, was struck with a sudden pain in her back. This had a rapid crescendo, she became weak, diaphorectic and rushed to the emergency room.

Physical examination: Her initial blood pressure was 112/60 and dropped to 50 mm. Hg. She was stabilized with Ringer's lactate. Her abdomen revealed a large mass in the right upper quadrant which was extremely tender, but non-pulsatile. Bowel sounds were noted. No abdominal scars were present.

laboratory reTort: Initial hemoglobin was 12.7 gms., hematocrit 37.1. Approximate y 1:45 hrs. later hemoglobin dropped to 9.8 and hematocrit to 28.5. Urine negative. Chemistry panel, including total protein, albumin, and cholesterol, was normal. The potassium 1~as 3.5 and uric acid 1.1.

Radiograph: After she was stabilized, a CT scan was performed and a large mass probably involving the right kidney, adrenal and liver was noted.

SURGERY: (August 11, 1987)

A right nephrectomy and adrenalectomy with mass was performed.

GROSS PATHOLOGY:

A right kidney with attached adipose tissue and Gerota's fascia ~1as received in which there was massive hemorrhage with clotted blood . This soft tissue mass weighed approximately 450 grams of which 1/3 was due to clotted blood . The kidney weighed 120 grams and measured 12.0 x 5.5 x 3.0 em. The upper 2/3 had a normal appearance. The dissection revealed the lower l/3 of the kidney was both anteriorly and posteriorly involved ~1ith a hemorrhagic f riable tumor that extended through the ruptured renal capsule. The multiple section made through this friable gray-tan to brown-tan tumor was fairly sharply circumscribed within the lower pole of the kidney. Its overal l dimensions were estimated at approximately 5.5 x 5.0 x 4.0 em.

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CONTRIBUTOR: Peter C. Dyke, M. D. MAY 1991 - CASE NO. 5 San Bernardino, Californi a

TISSUE FROM: Kidney ACCESSION NO. 23742

CLINICAL ABSTRACT:

History: This 46-year-old black female was admitted to the hospital on January 13, 1980, for continued management of the problem of a left renal mass and hydronephrosis.

She was previously hospital ized on December 15 , 1989 for acute left f lank pain and febri l e ill ness. Studies at that time revealed a non­visualizing left kidney. Several other studies revealed a poorly perfused left renal unit with hydronephrosis. There also was a suggestion of an underlying transitional cell carcinoma. Antibiotics were given with symptomatic improvement and discharged.

Past history included a 3 month hospitalization for treat ment of San Joaguin Valley Fever in 1970.

Laboratory report essentially normal except for an elevation of alpha II globulin.

SURGERY: (January 14, 1980)

A left radical en bloc nephrectomy with regional node di ssection was performed. The periaortic lymph node from the bifurcation upward to the level of the kidney ~tas removed.

GROSS PATHOLOGY:

The specimen consisted of a 994 gm. , 129 mm. greater diameter kidney with attached capacious perirenal fat, adrenal, myriads of metal cl ips, and pink-tan smooth gl i stening moderately frequently enlarged hilar lymph nodes. Ureter and vein were not identifi ed. A hilar, multibosselated, white swirl ed, focally frequently necroti c bulging mass, 128 mm. in greater diameter displaced wi thout manifestly invading the smooth gli stening unthickened overlying pelvis . Mucoid glistening pink-tan capsule lacked overt invasion or penetration .

CONTRIBUTOR: Weldon K. Bullock, M. D. John Craig , M. D. Pasadena, Cal i fornia

TI SSUE FROM: Kidney

CLINICAl ABSTRACT :

MAY 1991 - CASE NO. 6

ACCESS ION NO. 22258

History: Thi s 65-year-old Caucasian mal e was f i rst seen i n his physician's office on March 24, 1976 for painless gross hematuria.

Past history: He has had a history of decreasi ng urinary stream, nocturia and other symptoms of bl adder outl et obs truction. Diabet i c on Oiabinase 100 mg/day.

Physical examination essential ly noncont r i but ory except for a l arge, firm pros t ate which filled t he rectal ampulla .

Laboratory essent ial ly unremarkable except for hematuria .

Radiograph: IVP revealed a right kidney wi th a lower pole mass, approximately 4" in diameter.

SURGERY : (April 2, 1976)

A right nephrectomy was performed .

GROSS PATHOLOGY:

The kidney weighed 375 gm. and measured 15 x 6 x 6 em. A large bul ky tumor occupied approximately one half of the kidney. The surfaces made by cutting had a bulging, sol id , small cystic yel low-white , hemorrhagic and mucoid-yel low mul tilobate appearance. The renal vein was not involved . The remai ning uni nvol ved kidney appeared normal with easily recogni zed corticomedull ary j unct ions and t he cal iceal - pelvi s system was not dilated.

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CONTRIBUTOR: Elme~ Jordan , M. D. MAY 1991 - CASE NO . 7 Glendale, Cal ifornia

TISSUE FROM: Kidney ACCESSION NO. 25498

CLINICAL ABSTRACT :

History: This 73-year-old female was admitted t hrough the emergency room with complaint of intermittent left f lank pain, 8 days' duration. She was treated by the physi cian for poss i ble acute pyel onephr itis .

Physi ca 1 examination: She was in obvious pain and distress ~1i th extreme tenderness in t he left f lank . The rest of her examination was within normal l imi t s, including blood pressure, temperature, and pelvic examination .

Laboratory repor t: The WBC was .34,600; hemoglobin 12.1 gm; hema­tocrit 38.6. Urine: 2-5 rbc' s, 46 ~ibc' s/hpf. Sodi urn 140; potass i urn 4.1; creatinine 1.4.

Radi ograph: IVP revealed normal right upper urinary system. The l eft kidney was not visualized in the l ower 2/3 .

SURGERY :

A left nephrectomy was performed.

GROSS PATHOLOGY:

The specimen weighed 420 grams and when the fat was stripped a1~ay from the kidney, ~1hic h ~1as relatively easy except for an area near the hi lus where the fat was tenaciously adherent to a somewhat bossel ated pale grayish moderately firm turmor, 3 em. i n diameter. On cross sect ions of the kidney proper ~ih ich weighed 210 grams, there were nodular masses distorting the .cortical medullary markings over· about t~1o-t h irds of the kidney. This measured 6.5 x 6.0 em. The measured dimension of the kidney was 10 .4 em.

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CONTRIBUTOR: Kenneth Frankel, t~ . D. MAY 1991 - CASE NO. 8 Gl endora, California

TISSUE FR0f1: Uterus AC CESSION NO . 26558

CLINICAL ABSTRACT :

History: This 27-year-old fema le was admi tted to the hospital on June 30, 1989 with complaint of vaginal bleeding for three days.

Physical examination essentially normal except the pelvic examination revealed dark red clotted blood and bleeding exiting from the cervix.

SURGERY: (June 30, 1989)

A fractional di lation and curettage was performed.

GROSS PATHOLOGY:

The specimen consi sted of a 5.0 em. aggregate of pale pink granular fragment of tissue .

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CONTRIBUTOR : Mary Beth Shwayder, M. D. MAY 1991 - CASE NO. 9 Los Angeles, California

TISSUE FROfol: Uterus ACCESS ION NO. 26555

CLINICAL ABSTRACT:

History: This 75-year-old woman saw a urologist for i nconti nence and on examination was found to have an enl arged uterus. She had some questionabl e vaginal bleeding on October 25 , 1988 but had been off estrogen therapy. Pap smear showed a Class I II F suggestive of endometri al carcinoma .

Physical examination: A pelvic mass , approximately the size of a 3! months ' gestation, was noted.

SURGERY: (November 9, 1988)

Total abdomi nal hysterectomy, bilateral salpingo-oopharectomy, biopsies of cul-de-sac and right pelvic lymphadenectomy were performed.

GROSS PATHOLOGY:

The uterus weighed 482 grams and measured 15 x 10 x 8 em. The peritonealized surface was smooth. Sectioning revealed a large polypoid mass fi 11 i ng the uterine cavity attached to the anterior wa 11. The tumor measured 12 x 10 x 6.5 em. The surface and sections of the tumor showed a soft fleshy, tan, multil obular parenchyma. The tumor infiltrated the myometrium to within a few millimeters of the serosa. Some of the pelvic nodes appeared to contain metastatic neopl asm.

CONTRIBUTOR: Harry Pappas, M. 0. G. Varan, M. D. Northridge, California

TISSUE FROM: Kidney

CLINICAL ABSTRACT:

MAY 1991 - CASE NO. 10

ACCESSION NO. 22590

History : This 10-month-old infant was seen approximately one week ago because of difficulty with her bowel movements.

Physical examination revealed a somewhat movable , 5-6 em. mass which appeared to be continuous with the lower pole of the left kidney.

Radiograph: Intravenous pyel ogram showed a mass, approximately 7.5 em. in size, that was adjacenf to the left kidney and involved the lower pole of the kidney. A renal ultrasound scan showed evidence of a sol id tumor arising from the left kidney, approximately 4. 5 x 6.0 em.

SURGERY :

A left nephrectomy was performed .

GROSS PATHOLOGY:

The specimen consisted of the left kidney, including an extensi ve anterior wal l renal neoplasm. The kidney and renal mass totally weighed 212 grams . The kidney itsel f was well outl ined along the posterior aspect and measured 6 x 4 x 2 em. The huge anterior renal neoplasm measured 8 x 7 x 6.5 em. The renal capsular surface was smooth and grayish-white to tan in color and did not reveal evidence of neoplastic penetration of capsule . The capsule was stripped with minimal di fficu l ty revealing underlying lobular yellow-gray-white to tan colored neoplasm which assumed a characteristic brain-like cerebriform appearance . A complet e t hin

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layer of normal appearing gray-tan renal parenchyma surrounded the expanded portion . Sections made by cutting irregular foc i of yel l ow-tan and gray-white areas were prominent.

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CONTRIBUTOR: Jon F Gentry, M. D. MAY 1991 - CASE NO. 11 Upland, Cal ifornia

TISSUE FROM: Kidney ACCESSION NO. 26461

CLINICAL ABSTRACT:

History: This 57-year-old man developed "stomach flu" and vague right upper quadrant pain.

Physical examination was essentially unremarkable.

Radi ographs: Ultrasound showed a normal gallbladder and an incidental right renal mass. CAT scan and arteriography confirmed the presence of a hypervascular lesion in the lower pole of the right kidney.

SURGERY : (April 20, 1987)

A right nephrectomy was performed . '

GROSS PATHOLOGY:

The kidney weighed 488 grams and measured 12.5 x 6.5 x 5 em. A discrete, although non-circumscribed, solid, ovoid, firm, tan-brown tumor was identified in the inferior pole and measured 4.5 x 3 x 4 em. There were focal calcifications on sectioning .

CONTRIBUTOR: Philip Van Ha.le , H. D. Pasadena, Cal ifornia

TISSUE FROM: Urethra

CLINICAL ABSTRACT:

MAY 1991 - CASE NO. 12

ACCESSION NO. 26958

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History: This 88-year-old white male presented with urethral bleeding. A friable lesion was noted in the mid-pendulous urethra at the time of urethroscopy of February 19, 1gg1.

He underwent a total cystectomy and ureteroil eostomy for bladder carci noma , August 1g~5 .

Physical examination: The external genitalia showed a palpable 1 x 2 em. lesion in the mid-pendulous urethra equivocally adherent to Buck's fa sci a.

SURGERY: (March 6, 1991)

A urethrectomy was performed. A 1 x 2 em. tumor was present in the urethra at the penoscrotal junction . It was not invading Buck's fascia. The urethra was not opened, but no grossly palpable tumor was present, either distally or proximally.

GROSS PATHOLOGY:

The specimen labeled "urethra" consisted of an elongate segment of tubular tissue, 13 x 2 em. The di stal end was marked with a cl ip. The proximal end had attached fragments of muscular tissue. Within the midporti on of the specimen was a lobulated nodular area, 1.5 em. in diameter. Cross sections were embedded sectioning through the nodular area and proximal and distal surgical margins .

. CORRECTED COPY

STUDY GROUP CASES FOR

MAY 1991

CASE NO. 1 - ACCESSION NO. 26663

LOS ANGELES: Poorly differentiated transitional cel l carcinoma with squamous differentiation - 9

LONG BEACH: Squamous cel l carcinoma, poorly differenti ated- 8

SAN BERNARDI NO (INLAND): Transitional cell carcinoma of male urethra - 9

OAKLAND: Squamous cel l carcinoma- 11

SAN DIEGO: Trans i t ional cell carcinoma , high grade - 7; squamous cell carcinoma - 4

SACRAMENTO: Trans i tional cel l carcinoma - 8

HAWAII: Squamous cel l carcinoma- 1

GRASS VALLEY: Transitional cell carcinoma, moderate grade - 1

NORTH DAKOTA: Squamous cel l carcinoma- 1

FOLLOW-UP:

He expired on January 4, 1988.

DIAGNOSIS :

Transitiona l and squamous cel l carc inoma, urethra

REFERENCES:

HARTY J I and MOJSEJENKO I K: Transition a 1 Ce 11 Care i noma of the Anterior Urethra. J Surg Oncol 21 :121-124, 1982.

GRABSTALD H: Tumors of the Urethra i n Men and l·Jomen. Cancer 32( Supp 1 ement): 1236- 1255 , 1973.

KAMOSHIDA BS and TSUTSU~H Y: Extraprostatic Localization of Prostatic Acid Phosphatase and Prostatic-Speci f ic Antigen: Distribution in Cloacogenic Glandular Epithel ium and Sex- Dependent Expression in Human Anal Glands. Hum Pathol 21 :1108- 1111, 1990 (i ncludes urethral glands of males).

BOL DHAN JP and FARAH RN: Primary Urethra 1 Neap 1 asms . Review of 30 Cases. J Uro l 125:198-203 , 1981.

HUVOS AG and GRABSTALD H: Urethra l Meatal and Parameatal Tumors i n Young t~en : A Cl inicopathol ogic and El ectron t1icroscopic Study . J Ural 110:688, 1973 .

CASE NO. 2 - ACCESSION NO. 26358 MAY 1991

LOS ANGELES : Pelvic fibromatosis - 9

LONG BEACH : Periureteral fibromatosis - 7; leiomyoma - 1

SAN BERNARDINO (INLAND): Intra-abdominal desmoid (or fibromatosis)- 9

OAKLAND: Fi bromatos i s, NOS - 11; low grade fibrosarcoma- 1

SAN DIEGO: Fibromatosis - 16

SACRAMENTO: Fibromatosis - 8

HAWAII: Periureteral fibros i s -·1

GRASS VALLEY: Leiomyoma - 1

NORTH DAKOTA: Leiomyoma - 1

AFJ P REPORT:

Probable fibromatosis, r ight ureter

SPECIAL STAINS (by contributor):

The trichrome stain was predominantly green. The vascular 1~a l l 1~e re prominently red as well as the ureteral smooth muscle wall. The reticulum stain was negative. The elastic stain showed scattered coarse elastic bands within the tumor and vasculature .

FOLLOW-UP:

She was readmi tted for a large ventral herniorrhaphy on March 11, 1991 . She tolerated the procedure well. IVP showed no significant changes from her previous I VP. She s t i 11 has mild hydronephrosis and edema of 1 eg. She i s stabl e at the present time without evidence of disease.

DIAGNOSIS:

Fibromatosis, ureter

REFERENCES:

KIN DONG-HEUP , GOLDSMITH HS, GRACE SH, and HUVOS AG: Intraabdominal Desmoid Tumor . Cancer 27:1041 -1045, 1971.

HAYRY P and SCHEIN!N TM: The Desmoid (Reitamo) Syndrome: Etiology , Manifestations, Pathogenesis, and Treatment. Curr Prob Surg 25:225-320, 1988.

SCOUGALL P, STAHELI LT, CHEW DE et al: Desmoid Tumors in Childhood . Ortho Rev 16:41-48, 1987.

CASE NO. 2 - ACCESSION NO . 26358 MAY 1991

REFERENCES (Continued)

GANSAR FG, MARKOWITZ IP, and CERISE EJ: Thirty Years of Experience with Desmoid Tumors at Charity Hospital. Am Surg 53:318-319, 1987.

EASTER OW and HALASZ NA: Recent Trends in the Management of Desmoid Tumors . Summary of 19 Cases and Review of the Literature. Ann Surg 210:765-769, 1989.

POSNER MC, SHIU MH, NEWSOME JL et al: The Desmoid Tumor . Not a Benign Disease. Arch Surg 124:191-196, 1989 .

REITAMO JJ, SCHEININ TM, and HAYRY P: The Desmoid Syndrome . New Aspects in the Cause, Pathogenesis and Treatment of t he Desmo id Tumor. Am J Surg 151: 230-237, 1986.

CASE NO. 3 - ACCESSION NO. 26954 MAY 1991

LOS ANGELES: Poorly differentiated squamous cell carcinoma - 9

LONG BEACH: Squamous cell carcinoma - B

SAN BERNARDINO (INLAND) : Poorly differentiated transit ional cell carcinoma of male urethra - 9

OAKLAND: Transitional cel l carcinoma, high grade- 12

SAN DIEGO: Transitional cel l carcinoma - 14; squamous cell carcinoma - 2

SACRAMENTO: Squamous cel l carcinoma - B

HAWAI I: Transitional cell carcinoma with focal squamous differentiation- 1

GRASS VALLEY: Transitional cell carcinoma, high grade - 1

NORTH DAKOTA: Squamous cell carcinoma - 1

FOLLOW-UP:

He was seen in June 1g91 wi thout evidence of recurrence.

DIAGNOSIS:

Poorly differentiated transitional cel l carci noma, urethra xf:Poorly di fferent iated squamous cell carcinoma

REFERENCES:

MANDLER Jl and POAL TL: Primary Carcinoma of the Male Urethra. J Urol 96 :67-72, 1966 .

CASE NO. 4 - ACCESSION NO. 26059

LOS ANGELES: Angiomyolipoma- 9

LONG BEACH: Angiomyolipoma - 8

SAN BERNARDI NO (INLAND): Angiomyolipoma - 9

OAKLAND: Angiomyolipoma - 12

SAN DIEGO: Angiomyolipoma- 16

SACRAMENTO: Angiomyolipoma - 8

HAWAII: Angiomyol ipoma- 1

GRASS VALLEY: Angiomyolipoma - 1

NORTH DAKOTA: Renal cell carcinoma - 1

FOLLOW-UP:

Patient lost to follow-up.

DIAGNOSIS:

Angi omyo 1 i poma, kidney

REFERENCES:

MAY 1991

FARROW GM, HARRISON EG, UTZ DC et al: Renal Angiomyolipoma. A Clinicopathologic Study of 32 Cases. Cancer 22:564-570 , 1968.

BUSCH F, BARK CJ , and CLYDE HR: Benign Renal Angiomyolipoma with Regiona l Node Involvement. J Urol 116:715-717, 1976.

WALKER DE, BARRY JM, and HODGES CV: Angiomyolipoma. Diagnosis and Treatment . J Urol 116:712-14, 1976.

CASE NO. 5 - ACCESSION NO. 23742 MAY 1991

LOS ANGELES : Leiomyosarcoma - 9

LONG BEACH: leiomyosarcoma - 7; sarcomatoid renal cell carcinoma - 1

SAN BERNARDINO (INLAND): Low-grade leiomyosarcoma of kidney- 9

OAKLAND: Smooth muscle tumor of uncertain malignant potential - 12

SAN DIEGO: Nalignant spindle cell tumor favoring leiomyosarcoma - 16

SACRAMENTO: Leiomyoma - 8

HAWAII: Leiomyosarcoma - 1

GRASS VALLEY: Low grade leiomyosarcoma - 1

NORTH DAKOTA: Leiomyosarcoma - 1

FOLLOW-UP:

She expired on April 22 , 1985 . Autopsy cause of death was sarcoidosi s .

DIAGNOSIS:

Leiomyosarcoma, renal pel vis

REFERENCES:

TOL!A BM, HADJU SI, and WHITMORE WF Jr: Leiomyosarcoma Renal Pelvis . J Urol 109:974-976, 1970.

CHATELANAT F: Sarcomatous Tumors of the Kidney. In Progress in Surgical Pathology . Fenoglio CM, Wol fe N (eds). New York, Mason Vol. Ill, pp. 181-194, 1981.

BAZAZ-l•1AL!K G and GUPLA ON: Leiomyosarcoma of the Kidney. Report of a Case and Revie1~ of the Literature. J Urol 95:754- 758, 1966.

CASE NO. 6 - ACCESSION NO. 22258 MAY 1991

LOS ANGELES : Renal cel l carcinoma - 9

LONG BEACH: Renal cell carci noma - 8

SAN BERNARDINO (INLAND): Renal cell carcinoma- 9

OAKLAND: Renal cel l carci noma, primarily clear cell type - 12

SAN DIEGO: Renal cell carcinoma - 16

SACRAMENTO: Renal tubular adenocarcinoma - 8

HAWAII: Clear cell carcinoma, Grade III - 1

GRASS VALLEY: Renal cell carcinoma - 1

NORTH DAKOTA: Renal cel l carci noma - 1

FOLLOW-UP:

Patient expired April 15 , 1980.

DIAGNOSIS :

Renal cell carcinoma, kidney

REFERENCES :

McCLEHNAN BL : Oncologic Imagi ng. Staging and Follow-Up of Renal and Adrenal Carcinoma . Cancer 67 :1199-1208, 1991.

BASI L B, DOSORETZ DE, and PROUT GR Jr : Val ida tion of the Tumor , Nodes, and Metastasis Cl assi f ication of Renal Cell Carcinoma. J Urol 134:450-454, 1985.

FEIN AB, LEE JKT, BALFE OM et al: Diagnosis and Staging of Renal Cell Carcinomas: A Comparison of MR Imaging and CT . AJR 148:749-753, 1987.

FUHR~~N SA , LASKY LC, and LIMAS C: Prognostic Significance of Morphologic Parameters in Renal Cel l Carcinoma . Am J Surg Pathol 6:655-663, 1gs2 .

CASE NO . 7 - ACCESSION NO. 25498

LOS ANGELES : Sarcomatoid renal cell carcinoma - 9

LONG BEACH : Hodgkin ' s lymphoma - 5; carcinoma - 3

SAN BERNARD INO ( IN LAND): Xanthogranulomatous pyel onephriti s - 9

MAY 1991

OAKLAND: Renal cel l carcinoma, sarcomatoid vari ant with pyelonephri tis - 12

SAN DIEGO : Xanthogranulomatous pyelonephritis with acute interstitial nephritis - 12; renal cell carcinoma - 3; Hodgkin's disease - 1

SACRAMENTO: Renal tubular adenocarci noma - 8

HAWAII: Sarcomat oi d renal cel l adenocarci noma - 1

GRASS VALLEY : Sarcomatoid renal cell ca rcinoma - 1

NORTH DAKOTA : Transitional cell carcinoma - 1

FOLLOW-UP:

She expired at home on October 18, 1985.

DIAGNOSI S:

Sarcomatoid renal cel l carci noma, ki dney

REFERENCES:

FARROW GM, HARRISON EG Jr, UTZ DC, and REMURE WH : Sarcomas and Sarcomatoid and Mixed Nalignant Tumors of the Kidney in Adults. Part III. Cancer 22:556-563, 1968.

TOMERA KV, FARROW GM, and LIEBER MM : Sarcomatoid Renal Cell Carcinomas . J Urol 130:657-659 , 1983.

TANNENBAUI-1 M: Ultrastructura 1 Patho 1 ogy of Human Rena 1 Ce 11 Tumors . Pathol Ann 6:249-277, 1971.

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CASE NO. 8 - ACCESSION NO. 26558

LOS ANGELES: Hydatidiform mole, complete - 9

LONG BEACH: Hydatidiform mole - 8

SAN BERNARDINO (INLAND): Parti al hydatidi form mol e - 9

OAKLAND: Hydatidiform mole, complete - 12

MAY 1991

SAN DIEGO: Gestational trophoblastic disease, favor complete mole - 16

SACRAMENTO: Partial mole - 8

HAWAII: Partial mol e - 1

GRASS VALLEY: Hydatidiform mole - 1

NORTH DAKOTA: Hydatidiform mole - 1

FOLLOW-UP:

She is lost to follow-up.

DIAGNOSIS:

Hydatidiform mol e, complete , uterus

REFERENCES:

MAZUR MT and KURMAN RJ: Gestational Trophoblastic Disease. In Blaustein's Pathology of the Female Genital Tract, Jrd ed, RJ Kurman (Ed), Heidelberg, New York, Springer-Verlag, 835-875, 1987 .

MORROW CP: Postmolar Trophoblasti c Disease: Diagnosis, Management, and Prognos is. Clin Obstet Gynecol 27:211-220, 1984 .

CURRY SL, HAMMOND CB, TYREY L et al: Hydatidiform 11ol e: Diagnosis, Management, and Long-Term Follow-Up of 347 Patients . Obstet Gynecol 45:1-8, 1975 .

MORROW CP , KLETZKY OA, DISAIA PJ et al: Clinical and laboratory Correlates of Molar Pregnancy and Trophoblastic Disease. Am J Obstet Gynecol 128:424-430, 1977.

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" .

CASE NO. 9 - ACCESSION NO. 26555 MAY 1991

LOS ANGELES: Mixed mullerian tumor - 9

LONG BEACH: Mal ignant mi xed Mullerian tumor ~lith het erol ogous elements (rhabdomyosarcoma) - 8

SAN BERNARDINO (INLAND): Ma 1 i gnant mixed mu 11 erian tumor, hetero 1 ogous type -9

OAKLAND: Malignant mixed mullerian tumor, heterologous - 12

SAN DIEGO: Carcinosarcoma (mal ignant mixed mullerian tumor) - 16

SACRAMENTO: Mixed mesodermal tumor (malignant mixed mullerian tumor) - 8

HAI~AII: f•1ixed mul leri an tumor with heterologous component - 1

GRASS VALLEY: Epithelioid leiomyosarcoma, high grade - 1

NORTH DAKOTA: Malignant Mullerian tumor with heterologous elements- 1

FOLLOW-UP:

In November 1988 she recei ved 2 cycl es of chemotherapy and radiation. A year l ater she had a small bowel obstruction due to· adhesions. She was discharged to a rest home in Orange County.

DIAGNOSIS:

Mal ignant mixed Mullerian tumor , uterus

REFERENCES:

EVAN G, MARSI VEL JC, DEHNER LP, and ~liCK I~P: Tumors: An Immunohistochem1cal St udy of 47 Cases, and Cl inical Correlation. Hum Pat hol 22:213-233,

Mal ignant Mi xed Mull erian with Histogenic Considerations 1991.

KEMPSON RL and BEAl W: Uterine Sarcomas. Classifi cation, Diagnosis, and Prognosis . Human Pathol 1:331-349, 1970.

SILVERBERG SG, NAJOR FJ, BLESSING JA et al: Carcinosarcoma [r~alignant ~lixed Mesodermal Tumor] of the Uterus . A Gynecologic Oncology Group Patholog ic Study of 203 Cases . Int J Gynecol Pathol 9:1-19, 1990.

. ' ..

CASE NO. 10 - ACCESSION NO. 22590

LOS ANGELES: Nephroblastoma - 10

LONG BEACH: Hilms' tumor - 8

SAN BERNARDI NO (INLAND): Wilms' tumor - 9

OAKLAND: Wilms ' tumor- 12

SAN DIEGO: Wilms ' tumor (favorable histology) - 16

SACRAMENTO : Wilms ' tumor- 8

HAWAII: Nephroblastoma, high grade - 1

GRASS VALLEY: Nephroblastoma - 1

NORTH DAKOTA: Wilms' tumor - 1

FOLLOW-UP:

MAY 1991

She moved out of state about f ive years ago and apparentl y is alive.

DIAGNOSIS:

Wilms' tumor, kidney

REFERENCES:

D'ANGIO GJ , BECKWITH JB, BRESLOW NE et al: Wilm's Tumor Tumors: An Update. Cancer 45(Supplement):1791-1798, 1980.

BRESL0\1 NE and BECKW ITH JB: Epidermeological Feat ures of Wilm's Tumor: Results of the National Wilm's Tumor Study . JNCI 68:429-436, 1982.

D'ANGIO GJ, EVANS AE, BRESLOW NE et al: The Treatment of Wi lm's Tumor: Results of the Second National Wilm's Tumor Study. Cancer 47:2302-2311, 1981.

EVANS AE , NORKOOL P, EVANS I et al : Late Effects of Treatment for Wilm's Tumor . A Report from the National Wi lm's Tumor Study Group. Cancer 67:331-336 , 1991 .

' '; t ..

CASE NO. 11 - ACCESSION NO. 26461 HAY 1991

LOS ANGELES: Oncocytoma - 9

LONG BEACH: Renal oncocytoma - 8

SAN BERNARDINO (INLAND): Oncocytoma of kidney - 9

OAKLAND: Renal cell carcinoma, granular cell type - 8; oncocytoma - 4

SAN DIEGO: Oncocytoma - 16

SACRAMENTO : Oncocytoma - 8

HAWAII : Oncocytoma - 1

GRASS VALLEY: Oncocytoma - 1

NORTH DAKOTA: Oncocytoma - 1

AFI P REPORT:

Granular cell adenoma, oncocytic type

FOLLOW-UP:

The patient is well with no evidence of disease as of February 1991.

D.IAGNOSIS:

Oncocytoma, kidney

REFERENCES:

CHOI H, URIAS AA, McHARRUS JT et al: Rena.l Oncocytoma. A Clinicopathologic Stu,dy. Canaer 51 :1887-1896, 1983.

MORALES A, WASON A, and BRYNlAK S: Renal Oncocytoma: Clinical, Radiological and Histological Features. J Urol 123 :261-264, 1980.

CHAUOBERG AP, SATCHIDAUANO SK, GAETA JF et al: Light and Ultrastructrual Studies of Renal Oncocytic Adenoma. Urology XIV(4)4:392-400, 1979.

' ..

CASE NO. 12 - ACCESSION NO. 26958

LOS ANGELES: Poorly differenti ated transitional cell carcinoma - 9

LONG BEACH: High grade transit ional cell carcinoma - 9

MAY 1991

SAN BERNARDINO (INLAND): Poorly differentiated carcinoma of mal e urethra, ? metastatic from bladder - 9

OAKLAND: Transitional cell carcinoma, high grade - 12

SAN DIEGO: Transi t ional cell carcinoma - 12; squamous cel l carcinoma - 3; poorly differentiated epithel ia l neoplasm, fav?r squamous - 1

SACRAMENTO: Poorly differentiated transitional carcinoma - 8

HAWAII : Transitional cell carcinoma, poorly differentiated- 1

GRASS VALLEY: Carcinoma of prostatic ducts - 1

NORTH DAKOTA : Transitional cell carcinoma - 1

FOLLOW-U P:

He was last seen a week ago with urinary tract infect ion and had no evidence of recurrence.

DIAGNOSIS:

Poorly differentiated transitional cell carcinoma, urethra

REFERENCES:

HARTY JI and HOJSEJENKO lK: Transitional Cell Carcinoma of t he Anterior Urethera . J Surg Oncol 21;121-124, 1982.

GRABSTALD H: Tumors of t he Urethera in ~1en and Homen. Cancer 32{Supplement): 1236-1255, 1973.

KAMOSHIDA BS and TSUTSUMI Y: Extraprostatic locali zation of Prostatic Acid Phosphatase and Prostatic-Specific Antigen: Distr ibution in Cloacogenic Glandular Epithelium and Sex-Dependent Expression in Human Anal Glands. Hum Pathol 21:1108-1111, 1990 (i ncludes urethral glands of mal es) .