CALIFORNIA TUMOR TISSUE REGISTRY

October, 2007 Study Cases, Subscription B

Soft Tissue Tumors

California Tumor Tissue Registry c/o: Department ofPathology a nd Human Anatomy

Loma Linda University School of Medicine 11021 Campus Avenue, A.H 335 Loma Linda, California 92350

(909) 558-4788 FAX: (909) 558· 0 188

E-mail: cm(t!)link!jne,eom Web site & Case of tbe Month: www.cltr.org

Target audience: Practicing pathologists and pathology residents.

Goal: To acquaint the panicipant with the histologic features of a variety ofbcnign and

malignant neoplasms and )umor-like conditions.

Obleetives: The panicipont will be able to recognize morphologic features of a variety of benign

and malignant oeoplasons and tumor-like conditions and relate those processes to penincnt references in the medical literature.

Educational methods and media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses t1·om participating pathologists. Listing of selected references from the medical literature.

Principal faculty: Donald R. Chase, MD

CME Credit: Lama Linda University School of Medicine designates this continuing medical

education activit)' for up to 2 hours of Category I of the Physician's Recognition Award of the American Medical Association.

CME credit is offered for the stlbscription year on ly.

Accreditation: Lorna Linda Universiry School of Medicine is accredited by the Accreditation

Council ror Continuing Medical Education (ACCME) to sponsor continuing medical education ror physicians.

Study Cases, October, 2007; Subscription B 2

Contributor: J ozef Kollin , M.D. Case No. 1 - October, 2007 8 L11kewood, CA

Tissue from: Abdominal wall Accession #3034 7

Clinical Abstract: A 20-year-old woman presented with a six-month history of progressive abdominal pain and an

abdominal mass that was initially felt to be a hernia. CT of the abdomen showed an abdominal wall mass.

Gross Pathology: The 800 gram specimen included a 12.0 x I 0.0 x 10.0 em fairly well-circumscribed mass with

attached portions of skin and soft tissue. ·The cut surface was tan rubbery-firm, moist, and glistening, generally homogeneous with focal hemorrhagic spots.

Contribu tor: Kenneth Frankel, M.D. Case No. 2 - October, 2007 B Covina, CA

Tissue from: Righ t leg Accession #30223

Clinical Abstract: A 44-year-old noted a mass in the right leg.

Gross Pathology: The specimen consisted of a 2.5 em polypoid-shaped piece of skin. The parenchyma was

composed of finn, yellow-tan homogeneous tissue.

Special Studies: Positive: CD68. Negative: S-1 00 protein, Pancytokeratin, HMB-45.

Study Cases, October, 2007; Subscription 13 3

Contributor : Douglas Eglen, M.D. Case No. 3 - October, 2007 B Kokomo, IN

Tissue from: Right scapula Accession #30318

Clinical Abstract: A 66-year-old woman with a history ofRaynaud 's syndrome and arthritis presented with a 6.0

x 4.0 em mobile subcutaneous mass at the tip of the scapula, adherent to the serratus anterior muscle. The mass was dissected free of the muscle and excised.

Gross Pathology: The specimen consisted of two firm nodular pink-tan, sol\ tissue fragments, individually 5.6

and 2.0 em in greatest dimension. Sectioning revealed fibrofany tissue.

Suecial Studies: Elastic stain- Positive.

Contributor: Phillip Gordon, M.D. Case No. 4 - October, 2007 B Winter Haven, FL

Tissue from: Scrotum Accession #30 194

Clinical Abstract: A 63-year-old man complained of a mass in the left scrotum.

Gross Pathology: The 43 gram, 12.0 x 4.0 em specimen consisted of tan and yellow-tan soft tissue with a myxoid

yellow-tan, fatty to gelatinous cut surface.

Sludy Cases, Oclober, 2007; Subscriplion B 4

Contributor: Jozef Kollin , M.D. Case No. 5 - October, 2007 B Lakewood, CA

Tissue from: Knee Accession #30010

Clinical Abstract: Twelve years after bilateral knee implants, this 69-year-old woman underwent revision of the

left total knee arthroplasty.

Gross Pathology: The I 0.0 x 8.0 x 1.5 em fiat piece of soft tissue had a smooth gray-tan surface with firm light

brown papillary projections on the inner aspect.

Contributor: Dennis Kasimian, M.D. Case No. 6 - October, 2007 B Van Nuys, CA

Tissue from: Right palm Accession #30317

Clinical Abstract: A 24-year-old, right hand dominant man presented with a progressively enlarging mass in the

palm of the right hand.

Gross Pathology: The 2.5 x 2.5 x 1.5 em specimen consisted of an encapsulated ovoid soft tissue fragment with a

gelatinous, friable gray cut surface.

Special Studies: Positive: Negative:

S-1 00 protein, Smooth muscle actin (focally) Desmin

Study Cases, October, 2007; Subscription B s

Contributor: LLUMC Pathology (nhp) Lorna L inda, CA

Tissue from: Right upper arm

Clinical Abstrad:

Case No. 7 - October, 2007 B

Accession #30246

After noting a mass in the right upper arm, this 33-year-old man requested excision.

Gross P athology: The specimen consisted of a 57.3 gran1, 7.0 x 3.2 em pink-tan skin excision cut to a depth of

3.2 em. Serial sectioning revealed a 4.2 em, well-circumscribed, hemorrhagic subcutaneous mass.

Special Studies: CD34 negative in lesional cells

Contributor: Rober t Zuch, M.D. Case No. 8 - October, 2007 B Baldwin J>ark, CA

Tissue from: Left hip Accession #290 I 7

Clinical Abstract: A 21-year-old man sought treatment for a bulging mass in the left hip area with accompanying

pain. cr scan showed a 15.0 em mass, as well as multiple nodules in bilateral lungs. A needle biopsy was performed, and the patient was started on chemotherapy. A radical resection was performed one year after therapy.

Gross P athology: The specimen consisted of a left hip resection specinlen, including femoral head and pelvic

bone. Within the specimen was a 10.5 em mass invading soft tissues, hip and pelvic bones.

Special Studies: Positive: CD99

Sl\tdy Cases, October, 2007; Subscription B 6

Contributor : Peter Morris, M.D. Case No. 9 - October, 2007 B Santa Bar bara, CA

Tissue from: Bilateral ovaries Accession #30268

Clinical Abstract: An 18-year-old nulliparous woman presented with increasing abdominal girth and lower

abdominal pain with radiation to the back. Her last Pap smear and pelvic exam one month previously were reported as normal. Ultrasound and CT scan confirmed the presence of a pelvic mass felt to be separate from the uterus.

Gross Pathology: The 359 gram, 12.1 x 9.0 x 7.0 em right ovary was replaced by a firm, relatively homogeneous,

light tan solid neoplasm with 1-2 mm cystic areas. The 618 gram, 11.5 x 12.0 x 8.5 em nodular left ovary bad a smooth surface and was replaced by a firm, light tan sol id neoplasm with an irregular central pink to gray area.

Special Studies: Positive: Keratin, CAM 5.2, EMA, Vimentin, Dcsmin. Negative: CD45, S- 100 protein, Synaptophysin, Keratin 5/6, Keratin 7, Keratin 20, CEA,

lnhibin, CD99, PLAP, HCG, AFP.

Contributor : Mark Carter, M.D. Case No. 10 - October, 2007 B Lackland AFB, TX

Tissue from: Left thoracic mass Accession #30230

Clinical Abstract: A 25-year-old man underwent an excision of an intrathoracic/mediastinal mass.

Gross Pathology: The mass measured greater than 15.0 em in diameter.

Special Slu die!i: Positive: Des min, Muscle specific actin, and Myo-D I. Negative: S-100 protein, GFAP, CD31, CD34, Kermix, EMA, LCA, Synaptophysin,

NSE, CD99, Smooth muscle actin.

Study Cases, October, 2001; Subscription D 7

CALIFORNIA TUMOR T ISSUE REGISTRY

"Soft Tissue Tumors"

Minutes - Subscription B

October, 2007

SUGGESTED R£ADING (General Topics from Recent Literature):

Endothelial Lesions of Soft Tissues. A Review of Reactive and Neoplastic Entities with Emphasis on l ·ow·Grnde Malignant (''Borderline") Vascular Tumors. O'~larn CD and Nascimento AG. Adv Anal Pathol 2003; 10(2):69· 87.

Protocol for the l>xam ination of Specimens From patients with Soft Tissue Tumors of Intermediate Malignant Potential, Malignant Soft Tissue Tumors, and Benign!Locally Aggressive and Malignant Bone Tumors. Rubin BP, Fletcher CD, Inwards C, et al. Arch P(11hol Lab Med; 2006; 130{11): 1616-1629.

Lipoblastfc Nerve Sheath Tumors. Report of a Distinctive Variant of Neural Soft Tissue Neoplasm with Adipocytic Diferentiation. Am J Surg Patho/ 2006; 30(3):337·344.

Detection and Diagnostic Utilization of' Placental Alkulinc Phosphatase in Muscular Tissue and Tumors with Myogen ic Differentiation. Am J Swg l'nrho/ 2002; 26{1 2): 1627-1633.

l-eiomyosarcoma of Somatic Soft Tissues. A Tumor of Vascular Origin with Multivariantc Analysis of Outcome in 42 Cases. Am J Surg Parhal 2002; 26(1): 14-24.

California Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy

Loma Linda University School of Medicine 11021 Campus Avenue, AH 335 Loma Linda, California 92350

(909) 558-4788 FAX: (909) 558-0188

E-mail: cttr@linkline.com Web site & Case of the Month: www.cttr.org

FILE DIAGNOSES

(Preferably submitted on website at www.cltr.org. Click "subscriptions", then "submit answers.")

Case 1:

Case2:

Case3:

Case 4:

CaseS:

Case 6:

Case 7:

Case 8:

Case 9:

C'ITR Subscription B

Fibromatosis T-Y4100, M-76100

Cutaneous fibrous histiocytoma (lipidized), leg T-Y9400, M-88300

Elastofibroma, scapula T-11280, M-88200

Aggressive angiomyxoma, scrotum T-79400, M-88400

Diffuse tcnosynovial giant cell tumor (pigmented villonodular synovitis}, knee T-05145, M-Y9200

Benign peripheral nerve sheath tumor, palm T-Y8740, M-95600

Low grade mesenchymal neoplasm, favor varient of fibrous histiocytoma, arm T-Y8210, M-91501

PNET/Ewing's sarcoma T-YISOO, M-92603

Desmoplastic small round cell tumor, ovaries T-87000, M-49000

Case 10:

2

Pleomorphic rhabdoyosarcorna, intrathoracic/mediastinum T-Y2200, M-89003

CT'TR, OoooQ<r, 2007: "Minuoc:.s" (Subscription 8)

Case No. 1 - Accession No. 30347 October, 2007 B

Glendale - Abdominal JibromatOsis J.os Angeles <USC MccJicai Center} - Neurofibroma, solitnry Newnort Beach • Oennoid tumor SM piego (Naval Medjcal Center! • Fibromatosis Sao Franci~o 1!/njvwity ofCalifomja Sfl • Dcsmoid Woo<lland Hills CWOO<lland Hills Medical Center! • Fibromatosis (desmoid fibromatosis) Alabama. Mt OHve • Fibromatosis Florida. Winter Park • Solitary fibrous tumor Georgia. Decatur .. l' ibromatosis ll! joojs (Heartland Rcnional Medjcal Center> • Abdominal Jibromatosis Illinois (Sarah Bush Uncoln Heath Cemerl • lnlnl-abdominnl fibromatosis (desmoid tumor) KMsas CCoffevvme Raiooal Medi<al Center) - Neurofibroma Kan.sas <PeterSQn Lnboratorv Servjeefl • Fibromatosis Kansas (Physicians Reference Laboratory> . Desmoid Lqs Vegas <Sunrise llospilal> - Solitury fibt'ous tumor Mussachuseus <Oeverly Hospital) - Dcsmoid nbromatosis Michigan CHenrv ford Homital Residents Group).- fibromatosis Mjssouti (SL John"s Rcgjonal Medical Center) - Abdominal fibromatosis New Mexico fiJniycailv of New Mexico> . Dcsmoid 1umor New York <New york Stony Brook Unjversitv Center RcsidenlSl • fibromatosis New York £SUNY Downstate Medicnl Cc;nler) - Desmoid type fibromatOsis New York (Westche,stpr Medjcal Center) • Dcsmoid tu,nor Nqrth Carolina I Wake Forest University School of Medicine) • Ocsmoid type fibromatosis North Catolina CWomnck Artn\' Medical Ccn!er) • Desmoid wmor (5) Pennsylvania (Conemaugh Hospital) - Fibromatosis J•$f1nsyJvania mmsel Unh·crsitv of Mcsfjcinc) · Fibromatosis Puerto Rico <Univsajty of Puerto Rico> • De.smoid type fibromatosis Rhode Island IRI Hosnj(a!l • Deep desmoid type fibromatosis Soulh Carolina fl-lj!ton Hcnd Hosoitall - Uterus, placenta, unknown dingnosis Texas, Crvstal Bench - Abdominal UCSI'nOid tumor T!ixns Lubbock · Otsmoid tumor Wa.<hjogiOn. DC • Fibromatosisldesmoid tumor Wisconsin. ModjSOQ • Fibromatosis (dcsmoid tumor) West Vire:inia l\VV Vnj't'rnitv HosoitaJl · (De.smoid) fibromatosis AusuaJjq CSullivan Njcolaides Patholosyl - 0C$ITIOid fibromiltosis, abdominal wall Cunada IPas~ • Fibromatosis Cnnada fShcrbrooke University Hosnitllll '" Desmoid tumor Jnnftn l ... sa!Jj Oencrnl!iosoitpll - Abdo1nlnal fibromatosis lJnhcd Kingdom <Oxford Study Groug) • Fibromatosis

Case I - Diagnosis: Fibromatosis

1'-Y4100, M-76 100

Case I - References: Durkin AJ, Korkolis DP, AI-SaifO. ~rvos EE: Full-Term GeStation And Transvasinal Delivery Aficr Wise Resection of An

Abdominal D<:smoid Tumor During Pr<g~Ut~cy. J Surg Oncol, 2005 feb I; 89(2):86-90. Picariello L, Tonelli F, Brandi ML: Selective Oe$trogen Receptor Modulators In D<:smoid Tumours. &put Opin /m•<JIIl Drugs,

2004 Nov; 13(11 ): 1457~8. Review. Teo HE, Peh IVC, Shek TW: Case 84: Dcsmoid Tumor of the Abdominal \Vall. llndiology, 2005 lui: 236(1):81-4. Cusilla,• J, Sais GJ, Greve JL, et al: lmBJ:ing Of Intra- and Extro·Abdominal Oesmoid Tumors. 1/adiugrapllics. 1991 Nov;

11 (6):959·68. Kunieda K, Saji S, TMuka Y, ct al: An Abdominal Dc.!moid Tumor Involving The Xyphoid and Co£tul Chondrium Associated with

Pregnancy: Rcponofa Case. Surg Today, 1999; 29(9):927-JO.

Case No. 2 - Accession No. 30223 October, 2007 n Glendale • Dermatofibroma

CTrR. October, 2007; "Minutes .. (SubsCJiplion B) l

Los Angclc1 CUSC Medical Center) ~ Dermatofibroma, benign librcus histiocytoma Ncwoon J'Jepch • Fibrous histiocytoma Sll!l Dieoo INa val Medical Cemerl - Cellular fibroma (6); Atypical fibrous xll!llhoma (4) San Francjgo <Unjvmjty of California Sfl ~ Benign fibrous histiocytoma. lipidized Woodland Hills CW09dland t!ills Medical Ccn1crl - Dermatofibroma (fibrous hiSiiocytoma).lipidized Alabama. Mt Olive - Tuberous xanthoma Florida. Wioter Park • Xanlhomatous dermatofibroma Georgi& Decatur • Benign fibrous histiocytoma Illinois (I lean land R£gjopa! Medical Center) - Dc:nnatofibroma.. lipidiztd variant Illinois CSarnh Uush Lincoln Heath Cemec> - Atypical fibrous histiocytoma Kan~a~ CCgfl'eyvmc Regional Medjcal Center) · fibrous histiocytoma with bone formation. malignant Kansas CPctcn;on I ,!lhnmtorv Services) . Fibrous hisliocytoma Kansns (Physjchms Reference Labol'atonr} - Lipidizcd flbrou$ histiocytoma Lus Vegas (Sunrjsc l!osni.m!} - Xnnthognmuloma MDSSJlchuscus <Pcycr(y llosnjtall ~ Xruithoma Michinan <Ucnrv Ford HosoitaJ Reside.nl;; Group) · Dcnnal Obrous hiSiiocytomo Missouri (St. John's Regional Medjcal Center) .. Dermal fibrous histiocytoma New Mcxjcp <UniyersilV of New Mexico) - Benign fibrous histiocyloma. lipoid type New York (New york Stony Brook Universitv C~ntcr Rcskfcntsl .. Deep dermatofibroma New York !SVNY Down.<t>Je Medical Centorl - Fibrous histiocytoma (dermatofibroma) N~w York !WgtChC$t« Medical Center) - Histiocytoma North Carolj!lil C\Voke Forrst Universj1V S<hool ofMedi~inel - Juvenile xonlhogronuloma (2) "Nonh CaroliM CWomack Armv Medical Center\ - Benign fibrous histiOCytoma()) P~nnsvlyanio CCoosmaugh HosnitaD · Benign fibrohistiocytorna Pennsvlvanja Cprspscl Uni~rsiry of Medicine) ~ Atypical fibroxnnlhoma Puerto Rico (Uoj\·er;siry ofPueno Rico) - Fibrous histiocyloma. hemosidero11c Rhode lslond CRIIio•nitall - Dermatofibroma (fibrous histiocytomo) South Carolina CHilton Head Hosnitan - Relropcritoncum. lipoldomyoma Texas. CrvsJo! Beach - Dennal fibrous histiocyroma Texas. Lubbgck · f'ihroxonthoma Washington. QC .. Fibrous histiocytoma Wjsconsjn. Madjson • Pibrous histiocytic tumor (dernuttofibromtt) West Virejnjp (WY Unjyersity HospitaJ) • Oermatofibromtl Australia CSu!!!ynu Nicolaides Patholoavl - F'ibrous histiocytom:l, clto:ar cd! variant Can ado <f>W!ua Hospital\ - Dermatofibroma Cnnada CShsrbrookc Uojyersirv l-lospitall • Xanthogrunulomo Jaoan (A:mhj General llospitall · Lipidized dermatofibroma United Kinodom (Oxford Srudv Graul!) - Benign fibrous histioc:ytoma

Case 2 - Oingnosl.: Cutaneous fibrous histioctyoma (lipidized), leg

T-Y9400, ~·88300

O utside Consultation: Andrew Folpe, M.D.; Emory Univen;iry: "Lipidized benign fibrous histiocytoma."

Case 2 - References: Behwn A, f-IC!Cher CD: Atypical "l'seudosarcomatous" Vuriant Of Cutnncous Benign Fibrous Histiocytoma: Rcpon of 8 Cnses.

1/tsroparllo/ogy, 1990; 17:167-9. BurgdorfWI-J, Duray P, Rosai J: lmmut1ohistochcmical ldcntUicntion orLipozyme in CUtaneous Lesions of Alleged Hisliocytic

Nature. Am J Clln Par/Jot, I 98 I; 75: 162-7. Calonje !J, Fletcher CD: Aneurysmal Benign Cutaneous Histiocytoma: Clinicopathologic Analysis o!'n Tumor Frc<1ucntly

Misdiagnosed os a Vascular Lesion. flistoparlrology, 199S; 26:323-3!. Calonjc E, Fletcher CD: Cutaneous l'ibrous Histiocytic Tumors: An Updntc. Atf,. ;lnnr Pnt!ro/, I 994; I :2-15. Calonje 6. Mentzel T, Fletcher CD: Cellular Benign f ibrous I lislioeytoma. Clinicopathologic Analysis of 74 Cases o!' • Distinctive

Variant oi'Cutoneous Fibrous Histiocytoma with Frequent Rccurr=e. Am J Surg Patho/, I 994: I 8:668-76.

4 CITR, October, 2007: "tvlinutcs"' (Sub~eription B)

Case No. 3 - Accession No. 30318

Glendale - Elastofibromu Los An•clcs ruse Medjcpl Ccnlerl - Elaslolibroma dorsi Ncwpon Ilei\ch · Elnstofibroma San Diego !Nnval Mcdic!tl Center) • 131ostofibroma San fmncjscg CUnjvel'sity ofC31ifomja SF> - Elastoribroma. Woodland !ijlls !WoodlAnd Hills Medical Center) - Ulostofibroma Alabama. Mt Olive • Elastofibroma Florida. Winter Park - Elnslofibroma Georgia. pecatur - Elastonbroma Illinois fHcnnlnnd Regional Medical Center) - Elastofibroma dorsii JJ!inois CS!Ulb Bu.coh Lincoln Heath Cemcrl - Ektstofibroma Kansas !Coffeyville Regional MediCAl <&nlcr) - EIIIS!ofibroma Kansas (Peterson Labomtgrv Services) .. Elastofibromn KMsas (l)hysicinns Reference Laboratorv) - Elastofibroma Las Vesa.l !Sunrise Bosnhul) - Elastofibroma Massachusetts (Beverly lio:mitall • Elnstofibroma Mkhi•an Qjenry Ford HOll)ital Residcms Group) - Elast6fibroma Missouri <St. John's Regional Medical Ctntcrl - Eto.s1ofibroma New Mexjco <University of New Mcxjcol • Elastofibroma New York CNcw York Stony Brook Unjvcrsitv Center Rcsjdent'i) - Elnslofibromo New vor!s ISVNY Downs1ate Me<!i<al Center\ - Elastofibroma New York 1\Vestchestcr Me!lical Center) • Elas10fibroma Nonh Coroljna !Wake Forsstllniver.<ity School ofMcdjcinel - EIIISiofibroma (2) Nonh CyoljnaiWomaek Army Medical Center) - Elastofibroma (') Pennsylvanja <Conemaugh Hospitnll - Glastofibromn Pennsylvania <Drexel Unh•ersjtv ofMcdjcincl - E.lastofibroma Pucno Rico !University of Puerto lOco) - Elaslofibroma Rhode bland CRI Hosni!!lll - Elastofibroma South Cnro!Jna £Hilton I lend J-los.pilnll - Vulva, angiomyofibroblnstoma Texas Crvstnl Beach - Fibromatosis Texas. l.ubboek - ElastoObroma Washington. DC - Elastofibroma Wisconsin. Madison • Elasloma West Virsjnia CWV llnjycrsity Hoslli.U!J.} - Elastofibroma Australiu <Sullivan Nico!ojdcs L.,atholoQyl .. Elastofibronm dorsi Canada !Pgsgua Hosoilall - Elastofibroma CJinasla <Sbcrbrooke Unj,·qsity Hospjla!\ - Elastofibroma Japan <Mahj General HospjlaO - Elastofibroma dorsi Uni[ed Kingdom !Oxford Sludy Group> - Elastofibroma

Case 3 - Diagnosis: Elastofibroma, scapula

T-11280, M-88200

Case 3 • References: Dixon A Y. Lee SH: An UltraslruCiural Study of Elastofibromas. /fum Pothol, 1980, II :257-62. Gartmann H, Groth W, Kuhn A: Elastofibroma Dor1i. Z Houtler, 1988; 63:525-28.

October, 2007 B

Schwan>. T, Oppolzer G, OltSchet P. e1 nl: UlcerAting Elastofibromn Dorsi. JAm Acad Dermatol. 1989; 1142-4. Erkilie S. Koccr NE tuul Sivrikoz C. Subscapular Elostofibromo lntcm>ingled wilh Adipose Tissue. Varinnl Type of F.lastofibronu

or Lipornn? Ann Dill811 f'atlro/2005; 9(6):327·329.

Hayes AJ. Ale.<andcr N. 0 1111< MA, st a!. Elastofibroma, A Rare SoO Tissue Tumour with a Palho8J1omonic Analomkal Location and Clinieal Symptom. £ur J Surg Onco/2004; J0(4):4S0-4SJ.

CITil. Occober. 2007: "Minut<s" (SUbseriplion B)

Case No. 4 - Accession No. 30194

Glendale • Benign angiomyofibroblastoma Los Angele.~ <USC Medjca! Cen1er> - Spindle cell lipoma vs. neurofibroma with fatty overgrowth Newport Beach .. Angiofibroma San Diego (Naval Medical Center) - Aggressive angiomyxoma San Francisco £University of California SF) • Aggressive angiomyxoma Woodland Hills /Woodland Hills Medical Center\ . Aggressive angiomyxoma Alabama, Mt Oljve · Angiomyolibroblasioma Florida Winlcr Park .. Aggressive angiomyxoma Georgia. Decatur • Ple.xH'orm neurofibroma lllillojs <Hearl! and Regional Medical Center> .. Aggressive angiomyxoma Illinois /Sarah Bush Lincoln Heath Center) • Myxoma Kan5as fCoffe}IVilte Re-gional Medical CMteO - Aggressive tmgiomyxoma Kansas (Pe!frson LnbomtoN Services) .. Aggressive angiomyxoma Kansas CPhvsicians Reference Laboraton•) • Myxoid neurofibroma Las Veea'\ <Sunrise Hosnital) - Neurofibroma . Massachusens CBeverlv Hospital) - Atypical lipomatous tumor Michlgan (Henry Pord Hosoitaf Residents Group} . Aggressive angiomyxoma Missouri (St. John's Rea:ional Mei:!ical Cenuir>. - Ag,sressive an&iomyxoma New Mexico (Universjtv of New Mexico} - Atypical lipomatous tumor New York <New York Stony Brook University Center Residents) · Aggressive angiornyxoma New York (SUNY Oownsmte Medical Center) · Agg,cssivc angiomyxoma New york fWestchcs1er Medical Centcrl - Aggressive angiomyxoma North Carolina (Wake F'orc.st Univcrsitv School of Medicine) - Aggrc.~ive ailgiomyxoma North CarolinaiWomack Annv Medical Center) - Neurofibroma. myxoid varimH (5) Pennsylvania <Conemaugh J:Josltlli!l} - Low grade fibromyxoid sarcoma Pennsylvania (Drexel University of Medicine) - Aggressivc .angiomyxoma Puerto Rico <University of Puerto Rico) ~ Aggressive angiomyxoma Rhode Island (RI Hospilall · Ne.urofibroma South Carolina CHilton Head Hospit.aJ} ~ Vulva, malignant neoplasm consistent with sarcoma Texas. Cn·stal Beach ~ Angiomyxoma (aggressive?) Te."<as Lubbock - Aggres.o;ive~ulgiomyxoma Washington DC - Spindle col! lipoma 'Wisconsin Madison • Well-differentiated liposarcoma (vs. spindle ccll1ipomn) West Vir£1inia oyy Universjtv Hospital) - Myxoma

October, 2007 B

Australia (SulliVan Nicolaides Pathology) • Atypical lipomatous tumor/wcH·di.ftbre.ntiated liposarcoma Canada (Pasqua Hospital) • Neurofibmma Canada CSherbrooke Unjversjty HOspllfl!l - Low grade myxoid sarcoma Japan fAsahi Gt:neral Hospital) - Aggressive angiomyxoma United Kingdom <Oxford Studv Group) - Aggressive angiomyxo1na

Case 4 - Dingnosis: Aggressive angiomyxoma, scrotum

T-79400, M-88400

Case 4 • References: Grnnlcr M, Nuc-ci MR, Pletcher CD: Aggress-ive Angiomyxoma: Reappraised of Its Relalionship to Angiomyofibroblastoma In a

Series of 16 Cases. Hisloparhology, 1997; 30:3· !0. Manivel C. Steeper T. Swan.son J>, Wic.k JM: Aggresshre Angiomyxoma OfThc Pelvis: An Jmmunoperoxida"ie Sludy. Lab lnve.tl,

1987; 56:46A. AI·Omar M, Kwan K, Tweedie E, cl al. Aggro~'ivc Angiomyxomn oflhe Epididymis. Con J Uro/ 2005; !2(4):2772·2773. Chuang Ff•, Wu ST, [.ee SS, et a l. Aggressive Angiomyxoma oft he Scrotum. Arch Andro/2002; 48(2): 101· !06.

Case No. 5 - Accession No. 300.10 October, 2007 B

Glendale - Pigmented villonodular synovitis l:os Angeles (USC Medica] Center) • Pigmented villonodular syno\'itisitcnosynovial giant cell tumor

6 CTTR. October. 2007; "Minutes"' (Subscription B)

' '

Newport Beach - Ornnular cdl n.tmor vs. rca~lio.,-c synovitis Sao Diego (Naval Medjcal Center) .. PiQ,mcntcd villosynovial ~novitis

San Francisco OJniyccsjty of CoHfomin SE> - l'igmcnted villonoduhlt synovitis Woodland Hills (\Vqodlaud Hills Medjcal Center) - Synovllls {prosthesis related) Alabama. Mt Olive • Particle disease secondary to polyethylene florida. Winter Park - Te11osynovitis due to railed onhopedie prosthetic device Qsorgia, O;;caJ:ur - Pigmented villonodulo.r synovilis Illinois fHeanland Reaiwal Medical Cemcrl - Syoovial reactive histiocytic infoltrntc with >'illous hypertrophy {roreign body reaction) lllinois (Sarah Bush Unooln Heath Ce.ucrl - Detritic sxnovhis Konsa.~ <Coffeyville Rcgjonal Medical \..enter) .. Diffuse tenosynovial giant cell tumor (pigmented villonoduJur synovitis) Kansn.s (l'eterson Labomtorv Se.rvices) .. Particle disease (granulomatous pscudotumor) Kansas (physicians Rcfcrpnce LaboratoD'l - Pigmented viUonodular tenosynovitis !,as V<!!as (Sunrise llo<pitall - Detritic synovitis (Rxn to implant) Massachygera fficvs:dy tlospitall • Villonodulor synovitis Michigan CHenrr Ford Hospital Residents Group) - Pigmented villonod·ular synovitis Missouri <StJohn's Regional Medical Center) .. Diffuse lcnosynovial giant cell wmor New Mexico (Univcrsj'Y ofNew Me-xico) - l'igmentcd villunollulnr synovitis New York {New York Stony .Brook Unjver:sjty CentuResidents> · J'igmented villonodular synovitis New York (SUNY !)gwnstatc Medical eemcrl • Pigmented villonodular synovltb New york (\Vestchgter Medical Center) • Villonodular synovilis Nooh Carolina CWnkc Forest Universirv School ofMedidnel • Oinnt cell tumor or tendon sheath Nonh Carolina (Womack Annv Medicp! Center) - Pigmented villonodular synovitis (S) Pennsylvania (Cone~wmgh Hospital) • Pigmented villonodular sy11ovitis Ptnnsylvnnja (Dre.'<cl University o f Mcd!cjnc> - Pigmented nodular villous synovitis Pyerto Rico fUniyershy of l)ucrto Rieol - TcnoS)'OO\•ial tiant cell tumor Rhode Island fRI Hosojtall - Giant cell tumor or tendon sheath, diffuse type South Carolina milton H«~d Hospital) - Brenner tumor, ovary Texas Crvstal Beach - Vi!!onodular synovitis Tqgs. Lubbock · Piamcnted \'illonodulor synovitls Wnsbington. DC - Ginnt cell tumor of tendon sheath 'j!'jsconsin. Madjsnn - Villonodular synovitis We-~1 Virginia CWV Unjyersity Hospital) - Pseudo diffuse villonodular synovitis Au:;tralia (Sullivan Njcolaides Pathology> - Detritic synovitis Canida (PasgU!! Hospha!l - lliStiocytic r<:action to foreigo material C.nada (SherbrooJsc !Jnjvcrsitv HQsni9!1 - Tcnosynovial gi3nt c:dltu.oor Jnpan CAsahi General t(ospitaJ) - Pigmented villonodular synovitis United Kjngdom <Oxford Stud>' Group) - Pigmented \'illonodular synovitis

Cnse 5 - Diagnosis: Diffuse tcnosynovial giant cell tumor (pigmented villonodular synovitis), knee

T·OS 145, M-Y9200

Case 5 - References: Dursun M, Yilmaz S, Ercr B, et al. Clinical Image. Pigmented Villonodular S)'novitis of the Knee, Artl~rlfls Rheum2006:

S4{1 1):3422. Alford JW, Tashijian Rand Terek RM. Pigmented Villonodular Synovitis of the Knee Presenting As Sciatica. J Knee

Surg 2003; 16(3):182-184. Oupla S and Mishrn RS. Cytologic Appearance of Pigmented and Recurrent Diffuse Pigmenled Vil!onodular Synovitis

of the Knee. Ama Cyto/2002; 26(4):728-730. Chin K'R, Barr SJ, Winalski C, eta!. Treatment of Advanced Primary and Recurrent Diffuse Pigmented Villonodular

Synovitis of the Knee. J Bone Jo/111 Surg Am 2002; 84-A( 12):2192·2202. Anazawa U, Hannoka ll, Shiraishi T, e1 a!. Similarities Dctween Giant Cell Tumor of Bone, Giant Cell rumor of

Tendon Sheath, and Pigmented Villonodular Synovitis Concerning Ulrrastructural Cytochemical Features of Multinucleated giant Cells and Mononuclear Stromal Cells. Ultr<UtniCJ Path 2006; 30(3): 151-158.

Case No. 6 - Accession No. 303 17 October, 2007 B

Glendale - Myoepithelioma or son tissue

crrR, October. 2007: '"Minutes .. (Subsc:nplion B) 7

Los Angs!cs CUSC Mcdjcal Center> 4 Myxoid ncurofibrom:a Newport nench • Myxoid neurofibroma San Dieeo INn val Me<Jical Center) - Extrnskeletal myxoid chondro.an:oma San Fmndsco CUnjye£$jtv of California Sfl · Nerve sheath myxoma Woos! land Hms(Wooc!laod Hills Medical Center) • Nerve sheath myxoma A!aoo!Dll. Mt O!iye • Soft tiswe myoepithelioma Georgia. [)eca(Ur • Extraskcleral myxoid chondrosarcoma Illinois <Hcanlan<l Regiooal Medical CentW . Benign m)'XOid peripheral nerve sheath neoplasm Il linois, CS3rnb Rush l.jpAAJn Heath Center) · Chondroma ' 'S. low grade chondrosarcoma Kan!!:M tCgfTey\+jl!e Rc2ional Medica) CenLer> • Myxoid ncuronbroma Kunsas {Peterson 4boraLorv Services) . E:<trltSkclcHll myxoid chondrosarcoma Kansa.'> Qt!wsjcjnns Reference L-aboratory) · Myxochondroma 1 .us Vegn~ CSuorjss HospiLal) • Myxoid neurofibroma Massachusetts lOcvcrly t-lospilal> . ? chondroid lipomo Michinan ll!cnry Ford tlo'llilllJ..B.esjdents Group) · Low grodc Obrornyxoid san:oma Missouri CSt John's Regional Medical Center) • MyxOid ncurolibromo New Mpdeo fUnj\fcrsity of New Mexico) · Schwnnnomn New York (New york Stony Qrook Universiw Center Rcsidsott> - Myxoid neurofibroma New yprk CSUNY Oownstme Medical Center) - Nerve shcath.myxoma New York CWcs:rchestcr Medical Center) . Schwnnnoma North Caroi!Dil I Wake Fortst Unjvssity School ofMcdicim:l • Myoepithelial Noah Cnrolipn IWomock Armv Medical Center) • Fibroma of tendon sheath (S) PcnnsylvMi' <Conemaugh Hospital> · Myxoid chondrosarcoma Pennsvlvpoia (Dre.'Sel Uojversitv of Medicine) - Extraskclctal myxoid condronl3 Rhode Island IR!Hospita!l • Myoepithelioma South Carohoa Qlihon Head Hospital\ . D)•sgenninoma. ovory Texas, Crystnl Bcaeb · Chondroma Texa.c: Lubbock • Neurilemmoma \Vnshjngton. DC · ExtraskeletaJ chondroma/soft tissue condroma Wisc:onsjn Mqd!son - Fibromatosis (dupuytren controcturc) West Virsinin IWY Unjvcrsily Hospila!l · Neurofibroma Austwlia !Sulli\IBD Nicolaides Pathologvl · Palmar fibromntosis/OOK neurofibroma Canada lPasguo llospha1) - Schwan noma Canada CSherhl'i}Qke llujyersjtv Hospitall · Schwan noma (myxoid} Jnmm (Asqhj Gscoernl Hosoitnl) .. Extraskclctal chond1·omu United Kingdom COxford Study Groun) . Schwnnnorna

Case 6 • Diagnosis: Benign peripheral nerve sheath tumor, palm

T-Y8740, M-95600

Case 6 • References: Casdii 01'. Scheithauer BW, Hirose T, ct al: Cellular Schwannoma: A Clinicopadtologic, DNA flow Cytometric nod Proliferation

Marl:er Srudy of70 Cases. Cancer, 1995: 75:1109-19. Kindb!om LO, Meis-Kingbloom JM, Havel G, Bosch C: Benign Epithelioid Schwannoma. Am J Surg Pat hoi. 1998; 22(6):762-70. Graadt von ROilSCII JF, Hogendoom PC and Flelthcr CD. Myxold Tumours of Soft Tissue. 1/istopatho/1999: 35(4 ):291-3 12. Zwnccnik M. llybrid Ncurofibroma/Schwannoma Versos Schwanlloma with AntOIIi B Areas. /listopatho/ 1998; 32(5):405-410.

Cn~e No. 7 - Accession No. 30246

Glenda It • Dermatofibroma. cellular variant Los 1\nse!es 1\ISC Medical Center) · Synovial sarroma Newwn !ls!!Ch • I !tmangiopericytomo San Dicgg (Naval Medigl Cenlerl - Hemangi<>pericytoma San Francisco 11/nivrrsi!v of California SF) · Angiomatoid fibrot.t< histiocytoma W90dlan<l Hms IWooc!land Hms ~edical Center) • t!emangiopcricytoma Alubama, Mt Olive • Synovial sarcoma Florid11. Wjmer Park - ? monophasic synovial sarcoma Gcorgi0- pccaiUr • Aneursyma.l fibrous histiocytoma

8

October, 2007 B

CTTR. October. 2007~ "MiriUtcs" (Sub$cription U)

lllinojs (ileartland Regional Medical Center> .. Subct1taneous fibrous histiocytoma lll jnois IS arab Bysb Lincoln Hcalh Center\ - Monophasic synovial sarcomn vs. CD34, hernangiopcricytoma Kansas ICoffevville Rcri>nal Medical Center\ - Hcmllllgiopericytoma Kansas (Peterson Lpboratory Scrvjces) · Monophasic synovial snrcoma Kansas <Physjcjans Refe-rence I .oboratoryl - Cellular benign tibrous histiocytoma Las Vegas <Sunrise Bosoital) .. Hcmangiopericytoma Marurhosens fficveriy Hospjta!) . Hemangiopcricytoma Mjchjgpn CHenrv ford Homjtgl Resident! Grounl · Motlophasic:: synovial snrcoma Missouri !Sl. John's Regional Medical Center>. .. Subcutaneous fibrous histiocytoma New Mexico <Unjyersitv of New Mexico> .. Monophasic synovial sarcoma New Yortc <New Yort Stonv Prook Univmjrv Center Residents) .. Hemang.iopericyton1a New York !SUNY !)ownstme Medical Center\ - Angiomatoid Obrous histiocytoma New York (Westchester Mcdjcnl CcntcrJ .. Fibrous histiocytoma Nonb Cnrolina <Wake Forest UniverSity School of Medicine) .. Benign fibrous histiocytoma North Carolina (Womack Anny Medical <&ntcr) - Malignant solitary fibrous tumor (S) Pennsylvania (Conemaugh Hospital> .. Fibrohistiocytoma with h~:mangiopericytic feature Pcnnsvlvania <Drexel University of Medicine> - Oermato·fibroma Rhode Island IRI Ho>-pita!\ - Deep benign fibrous hisliocytoma South Carolina !lijl!oo Head Hospital\ - Stromal tumor? cellular fibrothccoma Texo.:; Casta! Bench - Hemangiopcricyroma TcxM. l .ubbock .. Fibrous histiocytoma Washjngton. DC -Atypical fibrothccoma Wisconsin. Madison .. llemangiopericytoma West Vjrginia (\VV University Hospilall .. MonophMic synovlo.l sarcoma Austrulln (Sullivtln Nicolaides J)nthology> • fnflarnmotory myofibroblastie tumor Canadq fl>asgua HosnitaJ) - Hc:ntangiopericyloma Cwc!J IShqbrwkc Univcrtitv Hospi1a!\ - Solitary fibrous tumor(hemangiopcricytoma-like pattem) Japan !AIIllhi Crencrnl Hosnitu!l - Deep benign fibrous histiocytoma Yoited Kingdom !Oxford Study Groupl - Hemangiopericytoma (5); Solitnry fibrous tuonor (2)

Case 7 • Diagnosis: Low grade mesenchymal neoplasm, favor varinru of fibrous histiocytoma, arm

T-Y8210, M-9 1501

Director's Note: The rumor was negative for CD34. (drc)

Case 7 - References: Nappi 0, !tiller Jll, Bcninato G, Wick MR: Hcmangiopericytoma: Histopathologieall'auern Or Clinicopathologic Entity? Semi11

Dlag Pathol, 1995; 12(3):221-32. Knndal S, Ozmen S, Demir I l Y, ct nl. Aneurysmal Fibrous Histiocytoma of the Skin. A Rare Varillnt of Dermatofibroma. Piau

Rooonstr Sur11 2005; I 16(7):2050-205 I. Billin&S SO and Folpc AL. Cutaneous and Subcutaneous Fibrohistiocytic Tumors of lntenmcdiate Malignancy. An Update. Am J

Dermat0[1(lthol2004; 26(2): 14 I -1 SS.

Case No. 8 - Accession No. 29017

Glendale - Ewin&'siPNET I.o• Anaeles O!SC M<dical Center) - Ewing's sarcoma Newnan Beach .. Ewing sarcoma/PNlTI' San Djego (Navpl Medical Center) .. PNET/Ewing's sarcoma San Fnmcisco CUnjvc:xsitv oCO.Hfomia Sfl - Ewina ·s sarcoma Wooc!lnnd Hills !Woodland II ills Medic;tl Center) - Favor PNET/Ewing (mor<: immuno) Alabama. Mt Olive - Desmoplastic small round cell tumor. treated Florida. Wjntcr Pmk - Bxtr!•~kclctal ESIPNS Qeprgia. Decatur .. Atypicall~wing's sarcoma

October, 2007 B

Illinois !Heartland Rceional Medical eemerl - Primitive periphcrnl n<urocctod<:nnal tumor (PNET) (requires mor<: immunastains) lllir.ojs !Sarah Bush Lincoln Heath Center) - Embryonal rhabdomyosar<;Omo vs. PNET/Ewing's sorooma Krutsas CCoffeyvme Re.aionql Medical Center) • PPNE'l/Ewing's sarcomn Kanm CPeierson Laboratorv Services) - Extraskclctal Ewing's sarcoma Kansas IP!n-sioians Reference !.abomtorv) - PNET/Ewing's sarooma

CTTR, October, 2007; "Minutes" (Subscription B) 9

LM Veeas!Sunrisc llo•pj!AJl - Ewing's sarcoma/PNET Mpssachuscns ffieycrlx IIQS)ilall • Ewing's sarcomaiPNET Michi•an (Henry ford Hospital ReyideniS Grounl - Primilive neurocctodonnaltumor (PNET) Miswurj CS1. John~s Regjooal Medical Center) • PPNET!Ewing~s Slll'Coma New Mexico {lJniversity pfNcw Mexicol - Ewing sarcoma New York (New York Stnny Brook University Center Residents> - Ewing snreomi\I'PNET New York (SUNY Downstme Medical Center} • Atypical Ewing's sarcon>a New York lWeytchest'r Medical Center) - Ewing's sarcoma/PNET Noah Caroline <Wake forest lJnjversllv School pfMcdjcinel - Ewing's sarcoma Nonb Carolina CWo!!l!!Ck Army Medical Center! • Alveolar rhabdomyosarcoma (5) Pcnnsvh·ania <Conern;wch liomital> · Extr.1renal rhabdoid tumor PsnnsyJvania illrcxel Unjvmitv ofMedititlCl · Ewing's sarcoma Rhode l5land CRI 1-lospjJAI) - PNET South C-arolina fHilto11 Hcnd Hospital) - Genn ccll lumor. ovary Texas. Crvstal Beqcb - Mnlignant peripheral ncurocc:todel'rnal tumor/Ewing Texn.o; Lubbock 4 Ewing sorcoma Washington DC • I'Nt';t urothdial rhabdoid featur<:s \Vi!(;onsin.. Madison 4 Ewing•s sarcoma West Vjrginia (WV Unjvmjtv Hospital) - Pm:unor B-ee! I lymphoma Australia !Sullivan Njcolajdg Pathology) - Ewing's sarc:oma/PI\ET CAA3da <Pasaua HosDjlall · Ewing's sarcoma Cnnruht (Shcrbrookc \Jnjycrsity Hospitall • Ewing•s tumor Jnpcm <Asahi Genernl Jlospii&J) • Poorly differcntintcd synovial sarcoma lini(cd Kjngdorn (0xf(1rtl Smdy Groull) - Ewing's/I'NET (6); Rhabdomyosarcomu (2)

Case 8 - Diagnosis: PNET/Ewing's sarcoma

T -Y1500, M-92603

O utside Consultation: Tim Triche, M.D.; Los Angeles Children's llospital : "PNET/Ewing's sarcoma",

Case 8 - References; Stevenson AJ, Chattcn J. Bertoni F, ct al: CD99 (p30/32) Neuroectodermal/t;wlng's Sarcoma Antigen As An Immunohistochemical

Marker: Revic:w Of More Than 600 Tumors nnd t.he Literature Experience. Appllmmunohlstochem, 1994; 2:231-40. GuM, Fantonescu CR. Goiter Q, et al: Cytokcnltin Immunoreactivity In "wing's Sarcoma. Prevalence In SO Cases Confirmed By

Molecular Diagnostic Studies. Am J Surg /'athol, 2000; 24:410-16. 'l'suneyoshi M. Yokoyama R, Hashimoto l-1, ct al: Comparative Study Of Neuroa:todcrmal Tumor and Ewing's Sarcoma of Bone.

Histopathologic, Immunohistochemical and Ultrastructural features. Acta Pathul Jpn, 1989; 39:573-81. Turc-Curcl C, Aurias A, Mugncret F, et aJ: Chromooomcs In Ewing's Sarcoma. An Evaluation Of 8' Cases ofRenhukablc

Consistency oft(l l-22) (q24;ql2). Cancer Gonet Cytogenet, 1998; 32:229-38. Moll R, Lee I, Could VIi, ct nl: Immunocytochemical Analysis Of Ewing's 'f111nors. Patterns Of Expression of Intermediate

filnmeniS and Dcsmosomal Protcinslndieatc Cell Type Heterogeneity in Primitive Neuroectodermnl1\1mors of Childhood. tim J Surg Pathol, 1987; 127:288-304.

Case No. 9 • Accession No. 30268

Qlcndale - Desmoplastic small round cell tumor Los Angeles (USC Medical \.snterl - De;mol>lastic small round cell tumor Ncwnort Beach . Gronulo5a cell tumor, maJignant San Oiego <Naya1 Mgljsgl Center) - Dcsmoplaslk small round cell tumor San l'!l!!JCisco runive!Jiilv of California Sf) - Desrnopl11Stic small round blue c:cll tumor W90dl•od Hills fWoodlnnd I !ills Medical Ccn(<r) - Small cell carcinoma of ovary Alqba~na, Ml O!jvo - Small cell carcinoma, hypercalcemic type Florida. Winter !'ark - l)esmoplnstic round cell turn or Georgia. Decatur .. Desrnoplnstic smaJI round ccll lumor

October, 2007 B

Illinois (Hcanland lWgjonnl Medical Cemer) - Small ccU nnaplo~tic.: carcinoma (with ""pulmonary diiTen:ntiation") !lljnois <Sarah Bush Lincp!n flealh Center) - High sradc: carcinoma Knnsa..s <Coffcyviltc Resjona! Medical Center) - Poorly differentiated malianunt Orenner tumor Kansas <Peterson LaboroJC)!y Services) - Desmopla,llic small round cell tumor

tO CIIR, O<lob<r, 2007; "Minu1es'' (Suhscroptoon B)

Kansas <Physicians Rcterence Laboralory> - Desmoplastic small round cell tumor Los Ve2as (Sunrise Hmjtal) • Desmoplastic small round c:ell tumor MOSit\thu~ens <Beycr!y Hosw.m!) a Small cell cfircinoma, hypercalcc;mia type Mjchi2an (Henry Pord Hosoital Residents Grquru - Desn\oplastic smaJI round ccll lumor Missouri IS!. Jobn's Regional MediCl!l Center) • Desmoplastic small cell tumor New Mexico <Universitv of Nt.•w Mexico> • Desmoplastic small round cell namor New York Wew York Stony Qrook Unjyersiry Center Rcsjdcnts)- Dcsmopla.~tic small round cell tumor New Yori: ISUNY DownSiate Medical Center) • DesmoplllStic small round blue cell tumor New York (Westchester Mcdisnl Center) • Dcsmopla.stic roond c:ell tumor North Caroljna <Wake forest Universitv School ofMediclop) - OesmophlStic small round cell Hamor North Carolina IWotD&ck AnDY Medical Center) • Rhabdomyosorcoma (S) PennSYlvania IConcmouoh Hospjtall • Desmoplastic small round cell tumor Pcnnsvlvanjfl (Drexel Universily of Medjcioe) - SmaJI ~II t:arefnoma of ovary Rhode Island CR! !iospitall · Dcsmoplll$tic small round cell tumor Sooth CuroUnaiHillon HCl!d llosoitall • Sarcoma, uterus Tcxos, Crvstol Beach • Small cell carcinoma Texas. Lubbock · UndiiTerentlutcd small cell carcinoma IYa<hington., DC ·Desmoplastic small round cell tumor Wisconsin Mqdison a Desmoplastic small cell tumor ~ West Vjrgin!a (WV University tlosnilnD ~ Desmopltistic small round cell tumor AU!!ralia !Sullivan Nicolaides l'nthology) • Desmoplastic small round cd lturnor Canada IP!l5!lua Hosojlall • Desmoplastic small round cell tumor Cnmlda-<Shcrbrooke Universily H~ - Desmoplastic small ccU tumor Jnoon <ASAhj Gcnernl Ho~])itan .. Malitnant Brenner tumor United King!loro (Oxford Stu<!y Group) • Desmoplastic small round cell tumor

Ca.•e 9 · Diagnosi.<: Desmoplaslic small round cell tumor, ovaries

T-87000,~·49000

Outsid~ Consultation: Stanford University: ··Dcsmoplasaie small round cell tumor."

Case 9 · References: Young R: Ovarian Involvement By the lntm-Abdominal Desmoplastic Small Round Cell Tumor with Divtrgcnt Dilfercntiotion.

Hum Pm/10/, 1992; 23:4S4-64. Gerald WI., Rosai l . Ladanyi M: Charnctcrizatlon Of Genomic Break Point And Chimeric Transcripts In E.IYS-WTI Gene Fusion

Of Desmoplastic Small Round Cell Tumor. Proc Nat/ A<od Sci USA, 1995; 92:1028-1032. Kushner BH, La Quaglia MP, Wallner N, ct al: Desmoplastic Small Round Cell Tumor: Prolonged Pro&I'C$Sive·Fm: Survival With

Aggre!.livo Multimodality Therapy. J Clin Oncol, 1996; 14: I S26·31. Lcuschncf I, Radig K, Harmes D: Desmoplastic Small Round Cell Tumor. S•min Diarn Pathol, 1996; 13:204·12. Ordonez NG: Desmoplastic Small Round Cell Tumor: L A Histopothologic Study of 39 Cases With Emphasis On Unusual

Histolo&kal Patterns. Am J Surg !'(I( hoi, 1998; 22( I I): 1303·13.

Case No. 10 - Accession No. 30230

Glendale • Enlbryon"l rhabdomyosarcoma, anopl"stic variant Los Angeles IUSC Medical Center) · Embryonal rhabdomyosarcomo NewPOrt Beoch • Rhnbdomyosarooma Sno Diego <Ng.va1 Mcdjcal Center} • Rl1Dbdomyo:;.1rc.oma Sqn Fr.tnciJco tUnivcrsiw ofCalirorniu SFl - Rha.bdomyosurcomn, embryonal Woocllansl IIIIIs 1\Yoos!land II ills MediCl!l Center) • Rhabdomyosarcoma. piL'Omorphic type Alabama Mt Olive • Embryonal rhabdomyosan:oma Plotjda. WioJer Park a Embryonal rhabdomyosarcoma Gtonzia. Decatur · lligh grade sarcoma, rule out intimal s:>rcoma Illinois !Heartland Regional Medical Center) • Rhabdomyosarcoma, favor pleomorphic type llljnois <Sarnh 13ush Lincoln Bcnlh Ccnts:r) - Alveolar rhobdomyo.~arcoma Kansas ICoiTcyville Rcajonal Medical Center) • Rhabdomyosarcoma Knn5as <Peterson LabomtOO' Services) ~ Rhabdomyosarcoma Kun~us <Physicians Reference: l.nboratoryl .. Embryonal rhabdomyosarcoma Las Vceas <Sunrise I losnitall • C.mbryonol rhabdomyos:trcoma

C'ITR. October. 2007~ ''Minutes" (Subscriplion B)

October, 2007 B

II

Mo.«aehi!!C!!S (Beverly Ho>pital\ - Embryonal rhabdomyosarcoma Mjehigan fHcnrv Ford HOI!JhAI RosidcniS Groopl - Pleomorphic rhabdomyosnrcoma Missouri 1St. John's Regjonol Medical Center) - Pleomorphic rhabdomyosarcoma New Mexico lUnivc:rsi'Y of New Mexico> - Pleomorphic rhabdomyosarcoma New York (New York $ (OIW llrook University Center Residents) .. Rhabdomyosarcoma New York CSUNY Downsuuc Medical Center) - Pleomorphic rhabdolllyosarcnma New York (Westchester Medical Center) - Plcomo~>h ic rhabdomyosaroomo Nonh Carolina (\Vake fgrest Univcrsitv School of Medicine) - Embryonal rhabdomyosarcoma Noah Carolina I Womack Annv Medjeal Cenlcrl • Embryonal rhabdomyowcoma (5) Pennsylvania <Conernausb llospitaD - Rhabdomyos.trcoma PconsvlvaoiaiPrexel Uni\•rnitv of Medicine> - Rhllbdomyosarcoma, embryonal type Rhode !s!Md fRl Ho,'J)jta1l - Embryonal rhabdomyoslll'COma South Carolina fHihon I lead llo>yitall -Epithelial neoplasm Texas. C1vsml Beach - Mn1ignant Teiton tumor Texos. Lubbock - Embryonal rhilbdomyosnrcoma Woshingtoo. DC • Rhabdomyosarcoma, cmb1·yonnl Wjsconsin. Madjson - Rhnbdomyos3tCOma West Virginia CWV Unjyc;rslty Hospital) - Rhabdomyosarcoma Australia <Sullivan NicolajdAA Pnthologvl · Embryonal rhabdomyosarcoma Canada (P!lS!Iua Hospj!all - Rhabdomyosarcoma Canada <Sherbrookc Unjvcrsity Hospil!J> - Rhabdomyosarcoma Juppn CAsruti General Ho:;ni.Uill · Rhabdomyos:u'Colnt\ Uojtcd Kine:dom <Oxford S1udy Group) .. PlcomOI'I>hic rhnbdomyosarcomo

C nse ! 0 - Diagnosis: Pleomorphic rhabdomyosarcoma, intrathoracic/mediastinum

T-Y2200, M-89003

Outside Consulta tion: Andre Oliveira, M.D., Mayo Clinic Rochester: "High grade spindle cell sarcoma, most consistent with MPNST".

Case I 0 - References: Newton WA Jr, Gchan EA, Webber BL, ct al: Closslncation Of Rhabdomyosarcomas und Related Sarc<>mas: l'lllhologic Aspects

and Proposal lor a New Clnssillcation. Inter Group Rhabdomyosarcoma Study, 1995; 76: I 07l-8S Sorenson PH, Lynch JC, Quolmon SJ. el al: PAX3-FKHR and PAX7-FKIIR Gene Fusions Are Prognostic lndicatotS to Alveolar

Rhabdomyosarco~: A Report From The Children' s Oncology Groop. J Clln Orrco/, 2002; 20:26n-79. LaQualia MP, Belter G. Ghavimi F, ct al: The EfTeet of Age At Diag11osis On Outcome ln Rhabdomyosarcoma. Omc.r, !99-l;

73:109-17. Hol!owood K, Fletcher CI)M: Rhabdomyosarcoma In Adults. Semin Diagn Pntlro/, 1994; 4 7-57.

12 ClTR. Oclob<r, 2007 ... Minuu:s" (Subsmpllon B)