• • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CALIFORNIA TUMOR TISSUE REGISTRY

LOS ANGELES COUNTY - UNIVERSITY OF SOUTHERN CALIFORNIA

PROTOCOL

FOR

MONTHLY STUDY SLIDES

APRIL 1988

GENERAL PATHOLOGY

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CONTRIBUTOR : Marthe Smith, M. D. APRIL 1988 - CASE NO. 1 San Francisco, California

TISSUE FROM: Peritoneum ACCESSION NO: 20381

CLINICAL ABSTRACT:

Histor{: A 70-year-old woman was admitted for samll bowel obstruction of one weeks duration. One year before, submucosal nodularity was noted in the left rectal wall during cystostow~ for a bladder stone.

SURGERY : (October 6, 1973)

The mid-il eum was densely bound to the bladder and sacral pt·omontory by a hard tumor. The obstructed bowel was removed, but the remaining tumor was left in situ.

GROSS PATHOLOGY:

Submitted was a 74 em. segment of small bowel. It showed serosal redness with mul tiple adhesions . At t he point of obstruction was a 4 em. f i rm white ·tumor, attached to the mesentery. A second peritoneal plague was also present.

CONTRIBUTOR: Marthe Smith, M. D. APRIL 19B8 - CASE NO. 2 San Francisco , Cal ifornia

TISSUE FROM: Glans penis ACCESSION NO. 22467

CLINICAL ABSTRACT:

History: A 42-year-old Puerto Rican man underwent circumcision for phimos i s. Af ter circumcision, funga t ing lesion was noted, involvi ng 70% of the glans and a portion of the uret hra.

Radiograph: Chest x-ray, IVP, cystoscopy, and liver and bone scans were no rmal .

SURGERY: (October 13, 1976)

Local excision was performed.

GROSS PATHOLOGY:

Submitted was a fleshy mass of tissue measuring 4.7 x 3.5 x 1.2 em. The surface was lobulated and white. The cut surface showed a papillary, st r iated white tumor 0.6 em. thick, with underlying yel low t i ssue .

CONTRIBUTOR: Ernest E. Simard, M. D. APRIL 1988 - CASE NO. 3 Salinas, California

TISSUE FROM: Thyroid ACCESSION NQ. 9954

CLINICAL ABSTRACT:

Histor~: A 64-year-old man was admitted for thyroid enlargement of four months duration. He had a nodular goiter for 20 years, which had not changed in size. Six months before admission, he developed palpitations , followed by shortness of breath and a 26 pound weight loss.

Physical examination: The thyroid gland contained several smooth , soft masses measuring up to 6.5 em. in diameter. Cervical and supraclavicular adenopathy was present.

SURGERY: (March 1955)

The left lobe and 90~ of the right lobe of the thyroid were removed.

GROSS PATHOLOGY:

The resected thyroid lobes measured 4 x 3 x 3 em and 8 x 5 x 4 em. , and weighed 114 grams in aggregate . The external surfaces were nodular, granular and red- brown. The cut surface was light-colored, with cystic and necroti c regions. The tumor var ied in consistency and i ts margins were rather poorly demarcated. The capsule was d~finite ly involved.

CONTRIBUTOR: A. L. Dol linger, M. 0. APRIL 1988 - CASE NO. 4 Hanford, California

TISSUE FROM: Uterus ACCESSION NO. 21gog

CLINICAL ABSTRACT:

Histor.l: A 52-year-old gravida 1 para 0 woman presented with occasional incontinence and difficulty starting urine for three years.

Physical examination: ·Pelvic examination showed cystocele, rectocele, and slight enlargement of the uterus.

SURGERY: { June 30, 1976)

Vaginal hysterectomy was performed .

GROSS PATHOLOGY:

The uterus and cervix weighed 220 grams. It showed two bulging white intramural masses, measuring 3 em. and 4 em. in diameter, but was otherwise grossly unremarkable.

CONTRIBUTOR: Joelle M. Lambert, M. D. APRIL 1988 - CASE NO. 5 San Francisco, California

TISSUE FROM: Vulva ACCESSION NO. 25804

CLINICAL ABSTRACT:

History: A 64-year-old gravida 3 para 3 woman presented with a mass on the right labium majus, which had been present for two months. She had a total hysterectomy 19 years earlier for menorrhagia.

Physical examination: The right labium majus showed a 4 em. firm, smooth mass. The cervix, uterus, and adnexa were absent . No lymph adeno­pathy was present.

SURGERY: (December 4, 1985)

Excisional bfopsy of the mass was performed.

GROSS PATHOLOGY:

The mass measured 4 x 3 x 2.5 em. and appeared unencapsulated. The cut surface was moderately firm and tan to yellow, with a vague lacy pattern.

CONTRIBUTOR: Henry Tesl uk, M. D. Mark A. Grathwohl, M.D. Sacramneto, California

TISSUE FROM: Ovary

CLINICAL ABSTRACT:

APRIL 1988 - CASE NO . 6

ACCESSION NO. 25938

Histor~: A 21-year-old gravida 3 ab 3 woman presented with abdominal bloating, r1ght lower quadrant abdominal pain, fever, and nausea for two weeks. She had a similar episode one month earlier, which subsided spontaneously. Since then, she·had a white vaginal discharge. She denied a history of pelvic inflammatory disease, foul-sme l ling discharge, and IUD us~.

Phys i ca 1 ex ami nat 1 on: Temperature was 102. f. The right 1 ower abdomen contained a tender, slightly irregular mass. There was tenderness on cervical motion, and the right adnexa was not palpable because of the mass.

Radiographs: Ultrasound showed a complex, predominantly solid mass occupying most of the pelvis. CT scan showed focal calcification and moderate ascites .

SURGERY: (February 6, 1987}

The patient underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and removal of the peritoneum of the pelvis.

Operative findings : A l arge mass of tumor was noted on the omentum, which was stuck to a large ovarian mass coming from the left ovary. This mass was fixed to the peritoneum overlying the sigmoid colon with a large clot where the tumor had bled. The tumor itself had a single twist in it which 1vas probably responsible for the infarction . Implants were noted on the appendix, omentun1 and parietal peritoneum overlying the liver . However, the liver itself felt to be clear. Peritoneal washings obtained were positive only for meso­thelial reaction. There were no tumor cells identified in the peritoneal fluid.

GROSS PATHOLOGY:

Submitted was a pink-tan, firm mass which measured 13 x 11 x 5 em. and weighed 455 grams . Sections showed fleshy, yellow-tan solid areas and cysts containing cheesy material and hai r.

CONTRIBUTOR: Tony Hui, M. D. APRIL 1988 - CASE NO. 7 Fayetteville, Arkansas

TISSUR FROM: Ovary ACCESSION NO. 25861

CLINICAL ABSTRACT:

History: A 13-year-old girl was admitted for severe abdominal pain for two days. This was prec·eeded by vague abdominal pain and frequent urination. Menarche occurred two years before; obstetric and gynecological history was unevent fu 1 .

Physical examinati on: A midline pelvic mass extended to the pelvic brim.

SURGERY: (August 21, 1986}

Abdominal hysterectomy, bi lateral salpingo-oophorectomy, omentectomY and tumor debulking were performed.

Operative f indings : There was a large midline mass which presented from the left ovary, showing a site of previous rupture on its left aspect. Blood clot was present in the abdominal cavity . There were several areas of peri­toneal studding which were mostly in the pelvis, tumor adherent to the rectum and sigmoid colon, and tumor involving the omentum. A large mass was seen to obstruct the left ureter.

GROSS PATHOLOGY:

The left ovary was replaced by a mass measuring 12 x 11 x 8 em. and weighing 553 grams. The cut surface was tan-yellow, lobulated and gritty. Focal hemorrhage was present.

CONTRIBUTOR: Arthur L. Koehler, M. 0. APRIL 1988 - CASE NO. 8 Pasadena, California

TISSUE FROM: Vagina ACCESSION NO. 25631

CLINICAL ABSTRACT:

History: This 61-year-old female was seen on October 23, 1985 with initial complaint of bl adder pressure , rectal bleeding and vaginal discharge. She was found to have a huge tumor completely filling the pelvis which was biopsied. She underwent exploratory laparotomy and a diverting sigmoid colostomy and there was no evidence of di ssemination of disease. She was then given radiation therapy with remarkable shrinkage of the tumor to the point where she had a 1 em. ulcer in the vagina and a 3 em. ulcer with some tunneling of the mucosa on the rectal side. The mass was freely movable and seemed to be readily operable.

SURGERY: (January 17, 1986)

A posterior pelvi c exenteration was performed. Operative finding was of a large mass in the rectovaginal septum.

GROSS PATHOLOGY:

The specimen consisted of a uterus with attached adnexa, posterior vaginal wall and rectum. A 6 em. mass was present in the posterior vaginal wall. The overlying vaginal mucosa was ulcerated over a 2 em. area. The mass was located 1 em. distal to the cervix and 4 em. proximal to the .labial margin. The cut surfaces were grey yellow and focally hemorrhagic .

CONTRIBUTOR: Gerrit D'Ablaing , M. D. los Angeles, California

TISSUE FROM: Ovary

CLINICAL ABSTRACT:

APRIL 1988 - CASE NO. 9

ACCESSION N0. ' 25996

History: This 69-year-old Hispanic woman presented because of an abdominal mass associated with an 8 months' history of progressi~te weakness, anorexia and a 34 pound weight loss. Her medical history was significant for hypertension for one year, which was somewhat resistant to medical therapy.

Physical examination: Blood pressure was 170/78 supine, 160/78 standing. A large, firm, nontender mass was palpable extending from the pelvis to umbilicus. No bruits were audible. Palpation of the mass produced no change in blood pressure.

Pelvic ultrasound revealed a 16.6 x 19.3 x 12.0 em. midline mass. CT scan of abdomen: Lagre mass consistent with fibroid vs malignancy.

laboratory data: Revealed a plasma renin activity of 81.9 ng/ml/h (nml 0.3-0.9 on normal salt intake). Plasma aldosterone 57 .5 ng/dl (normal 3.4-9.4).

SURGERY:

The patient underwent and exploratomy celiotomY which demonstrated a solid, lobulated mass completely replaced the left ovary and extended to involve the utero-ovarian ligament and adhere to the transverse colon.

GROSS PATHOLOGY:

A 2,778 gram, 19x 17 x 16 em. multilobulated mass with a smooth, glistening grey-yellow external surface and slimy, nodular, grey white to yellow cut surfaces. With focal hemorrhage and cyst formation was received.

CONTRIBUTOR: Antoinette Mahoney, M. 0. APRIL 1988 - CASE NO. 10 Anaheim, California

TISSUE FROM: Ovary ACCESSION NO . 25992

CLINICAL ABSTRACT:

History: This 33-year-old woman presented with acute onset ·of abdominal pai n i n October 1986. Laparoscopy was performed and revealed serous ascitic fluid and a small cystic mass in the left ovary. Surgi cal excisi on of t he ovarian cyst was deferred because of concern about possible peritonitis.

SURGERY: (April 20, 1987)

Six months later, an exploratory laparotomy with left salpingo-oophorectomy was per fomed.

Findings at surgery : 100 cc . of straw-colored ascites . A 6 em. mobile simple appearing left ovarian tumor.

GROSS PATHOLOGY:

The left ovary was replaced ·by an 8.0 x 6.0 x 5.0 em. sol id mass . The cut surfaces were mottled and tan-brown. An attached segment of fallopian tube was unremarkable .

CONTRIBUTOR: M. J. H. Juttner, M. 0. APRIL 19B8 - CASE NO. 11 Ingl ewood, California

TISSUE FROM: Ovary ACCESSION 'NO. 25496

CLINICAL ABSTRACT:

History: This 22-year-old woman presented with a 6 month history of hirsutism, amenorrhea and weight gain. She noted deepening her voice and clitoral enlargement for 1-2 months.

SURGERY: (July 8, 1985)

A right salpingo-oopherectomy was performed.

GROSS PATHOLOGY:

The right ovary weighed 75 grams and measured 6 x 5 x 6 em. The cortical surface was smooth and grey. On section a dicrete, 4.5 x 3.5 x 5 em. bright yellow nodule with a tan periphery was noted. The attached fallopian tube was unremarkable.

CONTRIBUTOR: Dennis Kasimian, M. D. APRIL 19B8 - CASE NO. 12 Van Nuys, California

TISSUR FROM: Ovary ACCESSION NO. 25928

CLINICAL ABSTRACT:

Hi story: Thi s 26-.year-old woman presented with acute right lower quadrant pain.

Radiographs: Ultrasound revealed a mass in the area of the right tube and ovary.

SURGERY : (Januaray 11, 1987)

An exploratory laparotomy with right salpingo-oophorectomy was performed.

Surgical findings: The right tube and ovary was completely bound down on the right side and fixed in the cul-de-sac.

GROSS PATHOLOGY:

The ovary measure 6.0 x 5.0 x 3.0 em. The external surface was slightly nodular and gray tan to tan brown. The cut surface was partially solid and partially cystic with cysts up to 3.0 ems. in diameter filled with cloudy tan brown mucoid fluid. Within the cysts there were isolated papillary excrescences up to 1.3 ems. in diameter. The solid regions were soft and pink tan.

STUDY GROUP CASES FOR

APRIL 1988

CASE NO. 1 - ACCESSION NO. 20381

LOS ANGELES: Mesothelioma - 6 MARTINEZ: Mesothelioma, malignant - 8 FRESNO: Malignant mesothelioma - 9; large cell malignant tumor (sarcoma vs. carcinoma) - 1 NORTH DAKOTA: Mesothelioma - 1 VENTURA: Angiosarcoma - 3 LONG BEACH: Malignant mesothelioma - 7; malignant tumor, NOS - 1 SAN FRANCISCO: Lymphangiosarcoma, involving small bowel - 2 SEATTLE: Mesothelioma - 8 SAN BERNARDINO (INLAND): Malignant mesothelioma, peritoneum- 11 OAKLAND: Mesothelioma, ileum- 9 BAKERSFIELD: Mesothelioma , peritoneum - 2; angiosarcoma - 1; liposarcoma - 1; sarcoma, NOS - 1 OHIO: Mesothelioma- 4

FOLLOW-UP:

Two months later, she was admitted with stool draining from her Foley catheter. She died shortly afterward. Autopsy showed a g em. pelvic mass of dense white fibrous tissue, which was focally cystic and attached to most of the pelvic organs.

FILE DIAGNOSIS:

Mesothelioma, peritoneum

REFERENCES:

Winslow, D. J., Taylor , H. B.: Malignant Peritoneal Mesotheliomas . Cancer 13:127, 1960.

Cantin , Rejean , Al-Jabi , Maha, McCaughey, W. T. Elliott: Desmoplastic Diffuse Mesothelioma. Am J. Surg. Path. 6:215-222, April 1982.

Moertel , C. G.: Peritoneal Mesothelioma . . Gastroendtero 63:346-350, 1972.

Antman, K. H.: Clinical Presentation and Natural History of Benign and Malignant Mesothelioma. Semin. Oncol. 8:313-320, 1981.

CASE NO . 2 - ACCESSION NO. 22467 APRIL 1988

LOS ANGELES: Squamous cell carcinoma, low grade- 1; verrucous carcinoma of Ackerman (gi~nt condyloma of 8uschke & Lowenstein) - 5

MARTINEZ: Squamous cell carcinoma , verrucous - 7

FRESNO: Verrucous carcinoma - 10 NORTH DAKOTA: Verrucous carcinoma - 1

VENTURA: Squamous cell carcinoma - 1; verrucous carcinoma - 2 LONG BEACH: Verrucous carcinoma - 8 SAN FRANCISCO: Giant condyloma, glans penis - 2 SEATTLE: Verrucous squamous cell carcinoma- 8

SAN BERNARDINO (INLAND): Verrucous carcinoma, penis - 11 OAKLAND: Verrucous carcinoma, glans penis - 7; squamous carcinoma - 2 BAKERSFIELD: Verrucous carcinoma , glans penis - 5 OHIO: Verrucous carcinoma - 4

FOLLOW-UP :

On October 13, 1976 the patient had a partial penectorny with removal of some residual tumor with associated carcinoma insitu, however the patient was then lost to follow-up.

FILE DIAGNOSIS!

Verrucous carcinoma of Ackerman, glans penis

REFERENCES:

Mckee, P. H., Lowe, D. and Haigh , R. J.: Penile Verrucous Carcinoma. Histopathology 7:897-906, 1983.

Kraus, F. T., Perez-Mesa, C.: Verrucous Carcinoma. Cancer 19:26-38, 1966.

Dawson, D. F. , Duck Worth, J. K., Bernhardt, H. and Young, J. M.: Giant Condyloma and Verrucous Carcinoma of the Genital Area. Arch. Pathol. 79:225, 1965.

Balaz, M. Buschke-Lowenstein Tumor: A Histologic and Ultrastructural Study of Six Cases. Virch. Archiv. A 410(2):83-92, 1986.

CASE NO. 3 - ACCESSION NO. 9954 APRIL 1988

LOS ANGELES: Hur thle cell carcinoma - 6 MARTINEZ: ' Follicular carcinoma, oxyphil cell type- 9 FRESNO: Hurthle cell carcinoma with anaplastic component - 9; metastat ic carcinoma, undetermined primary - 1 NORTH DAKOTA: Hurthle cell carcinoma - 1 VENTURA: Hurthle cell carcinoma - 3 LONG BEACH: Large cell anaplastic carcinoma arising in a pre-existing Hurthle cell tumor- 7; spindle cell (pseudosarcomatous) carci noma - 1 SAN FRANCISCO: Giant cell carcinoma, thyroid - 2 SEATTLE: Hurthle cel l carcinoma, thyroid - 8 SAN BERNARDINO (INLAND): Oxyphilic follicular carcinoma, thyroid- 9; giant cell carcinoma - 2 OAKLAND: Anaplastic carcinoma, thyroid - 5; Hurthle cell carcinoma - 4 8AKERSFILEO: Hurthle cell carcinoma, thyroid- 5 OHIO: Malignant Hurthle cell tumor- 4

FOLLOW-UP:

Eighteen mqnths after surgery, the patient returned with a mass in the left neck and lung metastases. He expired shortly .afterward.

FI LE DIAGNOSIS:

Hurthle cell carcinoma, thyroid

REFERENCES:

Frazell, E. L., Duffy, 8. J.: Hurthle Cell Cancer of the Thyroid: A review of 40 Cases . Cancer 4:952, 1951.

Rosen, I . B. et al.: Hurthle Cell Tumor Behavior. A Dilemma andRe­solution. Surg. 98:777-783, 1985.

Gosain, A. K. et al .: Hurthle Cell Neoplasms: Malignant Potential . Arch. Surg. 119(5):515-519, May 1984.

Gonzales-camporo, Ricardo, et al. : Hurthle Cell and Mitochondrion-Rich Cell Tumors. A Clinicopathologic Study. Cancer 57:1154-1163, 1986.

CASE NO. 4 - ACCESSION NO. 21909 APRIL 1988

LOS ANGELES: Plexiform tumorlet - 6

MARTINEZ: Leiomyoma and epithelioid leiomyoma with plexiform tumorlet- 7; uterine sex-cord-like tumor - 2

FRESNO: Stromal nodule - 1; stromal myoma with sex cord elements - 8; epithelial leiomyoma - 1

NORTH DAKOTA: Leiomyoma - 1

VENTURA: Uterine sex-cord-like tumor - 3

LONG BEACH: Plexiform l eiomyoma- 2; spindle cell epithel ioid leiomyoma- 5; stromal myoma with organoid cell ar rangement resembling sex cord • 1

SAN FRANCISCO: Epithelioid lei omyosarcoma, uterus - 2

SEATTLE: Uterine tumor with sex cord-like differentiation (plexiform tumor) - 8

SAN BERNARDINO {INLAND): Endometrial stromal nodule- 6; leiomyoma (plexiform tumorlet type) - J; leiomyoma - 1

OAKLAND: Endometrial stromal nodule, uterus - 9

BAKERSFIELD: Leiomyoma, rare variant with sex cord-l ike changes- 5

OHIO: Benign stroma nodule and leiomyoma - 4

CONSULTATION:

Henry J. Norr i s, M. D., AFIP: Leiomyoma, uterus Plexiform epithel ioid leiomroma

FOLLOW-UP:

The patient expired in 1984.

FILE DIAGNOSIS:

Plexiform tumorlet, uterus

REFERENCES:

Kaminski, P. F., Tavassoli , F. A.: Plexiform Tumorlet: A Clinical and Pathologic Study of 15 cases with Ultrastructural Observations. Int. J, Gynecol. Pathol. 3:124, 1984.

Kurman, Robert J. and Norris, Henry J.: Mesenchymal Tumors of the Uterus . VI. Epithelioid Smooth Muscle Tumors Including keio~oblastoma and Clear Cell Leiomyoma. A Clinical and Pathologic Analysis of 26 Cases. Cancer 37:1853-1865, 1976.

CASE NO. 5 - ACCESSION NO. 25804

LOS ANGELES: Granular cell tumor- 6 MARTINEZ: Granular cell tumor- 9

APRIL 1988

FRESNO: Granular cell tumor - 1; malignant granular cell tumor- 9 NORTH DAKOTA: Granul ar cell tumor - 1

VENTURA: Granular cell myoblastorna - 3

LONG BEACH: Malignant granular cell tumor- 8

SAN FRANCISCO: Granular cell rnyoblastoma - 1; apocrine (sebaceous) adeno­carcinoma, vulva - 1 SEATTLE: Granular cell tumor - 8

SAN BERNARDINO (INLAND): Malignant granular cell tumor - 7; skin adnexal carcinoma - 3; poorly differentiated squamous cell carcinoma - 1 OAKLAND: Granular cell tumor- possibly malignant, right labium majora - g

BAKERSFIELD: Granular cell tumor, right labia majora - 4; leiomyosarcoma - 1

OHIO: Granular cell tumor- 3

CONSULTATION:

Hector Battifora, M. D., City of Hope National Medical Center: Soft tissue, vul va - Granular cell leiomyosarcoma. SPECIAL STAHIS:

Keratin: Negative S-100: Negative Collagen Type IV: Negative Muscle specific action: Positive

FOLLOW-UP:

The patient underwent radical v.ul vectomy and bilateral groin di~section three months later. There was residual tumor in the vulva, but no tumor in lymph nodes.

FILE DIA-GNOSIS:

Granular cell tumor, vulva X-file: Smooth muscle tumor, NOS

REFERENCE:

Nance, K., Reddick, R. L.: Epithelioid Leiomyosarcoma of Small Intestine with Oncocytic Changes. Arch. Pathol. Lab. Med. 111:1181-1182, 1987.

CASE NO. 6 - ACCESSION NO. 25938 APRIL 1988

LOS ANGELES: Poorly differentiated malignant neoplasm with pigment arising in association with a teratoma - 5; malignant teratoma - 1

MARTINEZ: Teratocarci noma - 9

FRESNO: Small cel l carcinoma, ovary - 4; malignant teratoma - 3; mali~nant granulosa cell tumor - 9

NORTH DAKOTA: Histiocytic lymphoma - 1

VENTURA: Undifferentiated carcinoma - 3 LONG BEACH: Undifferentiated malignant neopl asm- 7; germ cell tumor- 1

SAN FRANCISCO: Poorly differentiated adenocarcinoma (teratocarcinoma} on basis of history & gross - 2

SEATTLE: Teratocarcinoma - 8

SAN BERNARDINO (INLAND}: Teratoma with malignant neoplasm, NOS- 8; malignant teratoma - 2; teratoma with embryonal carcinoma - 1

OAKLAND: Teratocarcinoma, l eft ovary - 8; rhabdomyosarcoma arising in a teratoma - 1 BAKERSFIELD: Malignant teratoma- 2; undifferentiated tumor- 2; leiomyosarcoma - 1

OHIO: Malignant granulosa cell tumor- 2; embryonal carcinoma arising in teratoma - 2

FOLLOW-UP:

One month after surgery, the patient had ileus with abdominal carcinomatosis. She was given chemotherapy with VP-16, bleomycin and cisplatinum.

SPECIAL STAINS:

Perl stain positive for iron. Fontana stain negative.

FILE DIAGNOSIS:

Immature teratoma with poorly differentiated malignant neoplasm, NOS , ovary.

REFERENCES:

Thurlbeck, William M. & Scully, Robert E.: Solid Teratoma of the Ovary. A Clinicopathological Analysis of 9 Cases. Cancer 13{4}:804-811, July-August 1969.

Norris, Henry J., Zi rki n, Howard J. and Benson, William L.: Immarture (Malignant} Teratoma of the Ovary. A Clinical and Pathologic Study of 58 Cases. cancer 37:2359-2372 , May 1976 .

Curry, S. L., Smith, J. P. and Gallager, H. S.: Malignant Teratoma of the Ovary: Prognostic Factors and' Treatment. Am. J. Obstet. ~necol. 131:845, 1978.

CASE NO. 7 - ACCESSION NO. 25861 APRIL 1988

LOS ANGELES: Dysgerminoma with yolk sac carcinoma - 6

MARTINEZ: Yolk-sac tumor (endodermal sinus tumor) with areas of dysgerminoma- 9

FRESNO: Endodermal sinus tumor - 5; mal ignant mixed germ cell tumor - 3; poly­embryoma- 1; embryonal carcinoma - 1 NORTH DAKOTA: Malignant germ cell tumor showing sarcoma with just germinoma and yolk sac tumor - 1 VENTURA: Endodermal sinus tumor - 3 LONG BEACH: Mixed germ cel l t umor (dysgerminoma and endodermal sinus tumor yol k sac tumor) - 8 · SAN FRANCISCO: Endodermal sinus tumor (yolk sac tumor), ovary with dysgerminoma - 2

SEATTLE: Yolk sac tumor - 8 SAN BERNARDINO (INLAND): Endoderma 1 s'inus tumor with dysgerminoma - 11

OAKLAND: Mixed germ cel l tumor - endodermal sinus t umor and dysgerminoma, left ovary - 9 BAKERSFIELD: Yolk sac tumor, left ovary - 5

OHIO: Yolk sac tumor- 4

FOLLOW- UP :

Second look laporatomy in April 1987 showed endodermal sinus tumor implants in the pelvis. The patient continued on therapy as of March 1988.

SPECIAL STAIN:

AFP: Negative

FILE DIAGNOSIS:

Yolk sac tumor in a dysgerminoma , ovary

REFERENCES :

Hunt ington, P.. W., J r ., Bul lock, W. K.: Yolk Sac Tumors of t he. Ovary. Cancer 25:1357 (Case 5 in this article is a mixed dysgerminoma - endodermal sinus tumor as was presented at Scully's Conference on February 26, 1966, as Case 208).

Jimerson, G. K., Woodruff, J.D.: Ovarian Extraembryonal Teratoma: Endo­dermal Sinus Tumor Mixed with Other Germ Cell Tumors. Am. J. Obstet . Gynecol. 127:302-309, Jan-April/1977 .

Clement Philip B., Young, Robert H. & Scully, Robert E.: Extraovarian Pelvic Yolk Sac Tumors . Cancer 62:620-626, August 1, 1988.

CASE NO. 8 - ACCESSION NO. 25631 APRIL 1988

LOS ANGELES: Adenocarcinoma with radiation effect, possibly arising from vaginal adenosls - 6

MARTINEZ: Adenocarcinoma of Mullerian duct origin - 9

FRESNO: Poorly differentiated adenocarcinoma - 5; papillary adenocarcinoma - 5

NORTH DAKOTA: Adenocarcinoma of the endocervix - 1

VENTURA: Adenocarcinoma - 2; adenocarcinoma (?mesonephric origin) - 1

LONG BEACH: Adenocarcinoma (papillary) - 8

SAN FRANCISCO: Adenocarcinoma, poo~ly differentiated, in rectovaginal septum - 2

SEATTLE: Adenocarcinoma (papillary serous) - 8

SAN BERNARDINO (INLAND): Adenocarcinoma metastatic to vagina - 6; adenocarcinoma primary in vagina - 5

OAKLAND: Adenocarcinoma, vagina - 7; cloacogenic adenocarcinoma - 1; endo­metrioid carcinoma - 1

BAKERSFIELD: Papillary adenocarcinoma, metastatic, vagina - 5

OHIO: Metastatic adenocarcinoma - 4

FOLLOW-UP:

The patient expired on August 18, 1987 with cardiac arrest, renal failure, and adenocarcinoma of the retrovaginal space.

SPECIAL STAIN:

PAS digested: Negative

FI LE DIAGNOSIS:

Adenocarcinoma, vagnia

REFERENCES:

Kaiser, I . H.: Primary Carcinoma of Vagina, Cancer 5:1146-1160, 1952.

Granai, C. 0., Walters, M.D., Safaii, H. et al.: Malignant Transp formation of Vaginal Endometriosis Obstet. Gynecol. 64:592,1984.

CASE NO. 9 - ACCESSION NO. 25996 APRIL 1988

LOS ANGELES: Poorly differentiated malignant stromal tumor, renin producing - 6

MARTINEZ: Leiomyosarcoma - 9

FRESNO: Malignant fibrous histiocytoma- 3; stromal sarcoma- 4; leiomyosarcoma - 3 NORTH DAKOTA: Leiomyosarcoma - 1

-VENTURA: Leiomyosarcoma - 1; fibrosarcoma - 1; sarcoma, NOS - 1

LONG BEACH: Leiomyosarcoma - 6; malignant fibrous histiocytoma- 2

SAN FRANCISCO: Malignant stromal cell tumor, ovary - 2

SEATTLE: leiomyosarcoma - 8

SAN BERNARDINO {INLAND): Ovarian leiomyosarcoma - 8; ovarian sarcoma, NOS- 3

OAKLAND: Leiomyosarcoma, left ovary - 9

BAKERSFIELD: Leiomyosarcoma, left ovary - 3; malignant fibrous histiocytoma - 1; stromal sarcoma - 1

OHIO: Malignant spindle cell tumor - 2; malignant thecoma- 1; bizarre leiomyoma, symplastic - 2

FOLLOW-UP:

Post-operative plasma renin levels returned to normal and the patients hypertension resolved without further therapy.

FILE DIAGNOSIS:

Poorly differentiated malignant stromal tumor , renin producing, ovary.

REFERENCES:

Tetu, Bernard & Lebel , Marcel: Renin~Producing Ovarian Tumor. A Case Report with Immuno-histochemical & Electron M1crosco~ic Study. Am. J. Surg. Path. 12(8):634-640, 1988.

Korzets, Asher et al.: Resistant Hypertension Associated with a Renin­Producing Ovarian_Sertoli Cell Tumor. Am. J. Clin. Path. 85:242-247, February 1986.

CASE NO. 10 - ACCESSION NO. 25992 APRIL 1988

LOS ANGELES: Lipid cell tumor, ovary- 6

MARTINEZ: Hilus cell tumor - 5; sertoli cell tumor-stromal cel l tumor - 2; lipid cell tumor - 2

FRESNO: Lipid cell tumor - 4; l eydig cell tumor- 4; carcinoid - 2

NORTH DAKOTA: Lipid cell tumor - 1

VENTURA: Metastatic renal cell carcinoma - 2; lipid cell tumor - 1

LONG BEACH: Lipoid tumor, ovary- 8 ·

SAN FRANCISCO: Lipid cel l (hilar cell) tumor, ovary - 2

SEATTLE: Lipid cell tumor - 8

SAN BERNARDINO (INLAND): Lipid cell tumor (steroid cell tumor) - 9; sertoli­leydig cell tumor - 2

OAKLAND: Lipid cell tumor, left ovary- 6; adrenal rest tumor - 3

BAKERSFIELD: Lipid cell tumor, left ovary - 5

OHIO: Carcinoid - 2; lipi d cell tumor - 2; gonado cel l tumor (sertoli cell tuiiiOr) - 1

FOLLOW-UP:

Not availabl e.

FILE DIAGNOSIS:

Lipid cell tumor, ovary

REFERENCE:

Muechler, Eberhard K., Gillette, Mary Beth, Cary, Donna, Ryan , Charlotte K., 9i Sant' Agnese, P. Ant hony, Ma rkham, Raymond E. and Jacobs , Laurence S.: Ovarian Lipoid Cell Tumor. Steroid Hormones and Ultrastructure. Diag. Gyn. and Obst. 4, No. 4:309-315 , Winter 1982.

Taylor, Herbert B. and Norris, Henry J.: Lipid Cel l Tumors of the ~vary . Cancer 20: 1953-1962; November 1967 .

Teilum, Gunnar: Special Tumors of Ovary and Testis and Related Gonadal Lesion . J. B. Lippincott Company, 1972.

AFIP Fascicle, Tumors of the Ovary & Maldeveloped Gonads pps 215-220.

CASE NO. 11 - ACCESSION NO. 25496 . LOS ANGELES: Wel l di fferentiated sertoli cell tumor- 6

MARTI NEZ: Sertoli cell tumor (tubular androblastoma) - 9

FRESNO: Sertoli-Leydi9 cell tumor - 10

NORTH DAKOTA: Sertoli cell tumor- 1

VENTURA: Sertoli cell tumor- 3

APRIL 1988

LONG BEACH : Gonadal stromal ·tumor (Sertoli -Leydig cell tumor) - 8

SAN FRANCISCO: Sertoli cell tumor (tubular androblastoma) , ovary - 2

SEATTLE: Sertoli cell tumor - 8

SAN BERNARDINO (INLAND): Sertoli cell tumor- 11

OAKLAND: Well differentiated Sertoli-Leydig cell tumor, right ovary - 9

BAKERSFIELD: Sertoli cell tumor, right ovary - 5

OHIO: Sertoli cell tumor- 5

FOLLOW-UP:

The patient gave birth to a baby approximately 1 year after removal of the tumor.

FILE DIAGNOSIS:

Sertoli cell tumor, ovary

REFERENCES:

Young, R. H., Scully, R. E.: Ovarian Sertoli-Leydig Cell Tumors. A Clinicopathological Analysis of 207 Cases. Am. J. Surg. Pathol. 9:543-569, 1985. .

Young and Scully: Ovarian Sertoli Cell Tumors: A Report of 10 Cases. In~ernational J . Gynecol. Path. 2:349-363 , 1984.

Teilum, G. Classification of Testicular and Ovarian Androb1astoma, and Sertoli Cell Tumors; a Survey of Comparative Studies with Consideration of Histogenesis, Endocrinology, i!nd Embryological Theories. Cancer 11:769-782, 1958.

Warner, N. E. et al. : Comparative Pathology of Experimental and Spontaneous Androblastomas and Gynoblastomas ot the Gonads. Am. J. Obstet. Gynec. 7g:971-988, 1960.

6St CASE NO. 12 - ACCESSION NO. 25928 APRIL 1988

LOS ANGELES: Muci nous tumor of low malignant potential - 6

MARTINEZ: Mucinous papillary cystadenocarcinoma of low mal ignant potential - 6; mucinous cystadenoma - 2

FRESNO: Muci nous t umor borderline mal ignancy - 8; mucinous cystadenoma - 2

NORTH DAKOTA: Mucinous cystadenoma - 1

VENTURA: Mucinous cystadenoma of borderline malignancy - 2; mixed papillary serous and mucinous cystadenoma of borderline malignancy - 1

LONG BEACH: Mucinous cystadenocarcinoma of low malignant potenti al - 7; mucinous cystadenofibroma - 1

SAN FRANCISCO: Mucinous cystadenoma, borderl ine malignancy, ovary - 2

SEATTLE: Borderline mucinous tumor, ovary- 8

SAN BERNARDINO (INLAND) : Mucinous cystadenoma of borderline malignancy - 10; well differentiated mucinous cystadenocarcinoma - 1

OAKLAND: Mucinous cystadenoma, ovary- boderline , 6; malignant , 2; benign, 1

BAKERSFIELD: Muci nous carcinoma, ovary OHIO: Papillary cystadenoma - 3; serous cystadenomacarcinoma , borderline rna li gnancy - 2

FOLLOW-UP:

The patient i s doing well as of November 1987 without evidence of recurrence.

FILE DIAGNOSIS:

Mucinous tumor of low malignant potential, ovary X-file: Borderline mucinous t umor.

REFERENCES:

Sumithran, E., Sus il, B. J. and Looi, L.: The Prognostic Significance of Grading in Borderline Mucinous Tumors of the Ovary. Human Pathology 19: 15-18.

Chaitin, B. A., Gershenson, D. A. and Evans, H. L. : Mucinous Tumors of the Ovary. A Clinicopathologic Study of 70 Cases . Cancer 55 :1g58-1962. 1985.

Hart, W. R. and Norris, H. J.: Borderl ine and Malignant Mucinous Tumors of the Ovary. Cancer 31:1031-1045, 1973