23/08/2008 - Botucatu

DIAGNÓSTICOS

1.  Saul Suster – Case 
SS1 
– 69 y/o, male. Deep tissue mass in the gluteous muscle in an old man with no other history (the mass was unrelated to bone).     
– Malignant giant cell tumor of soft tissue.
(The tumor measured 18 cm in diameter and there was no bone involvement. The tumor recurred as a high grade fibrosarcoma. Li CF et al. Am. J. Surg. Pathol. 32: 587-99, 2008; AJSP 24:386-95, 2000)

2. Patocito, Bahia, Hosp. Aliança – Case
– 67 y/o, woman. A retroperitoneal, right para-renal mass.
– Angiomyolipoma, lipomatous variant (HMB45, Actin, Melan A, Human melanoma positive; Arch Pathol Lab Med, 2001; 125: 751-58; Virchovs Archiv, 2008; 452: 119-32)

3. UNESP Botucatu – Case
– 36 y/o, woman. An abdominal, 23 X 22 X 11 cm mass adherent to the small intestine and abdominal wall. Previous intestinal resection due to polyposis.
– Mesenteric fibromatosis – Gardner syndrome (S-100 neg.; Vim, Desmin and 1A4 positive; b catenin inconclusive; C-kit negative) 

4. PUC – Case
– 
A 26 y/o, woman presented with headache, mental confusion and cognitive loss for 15 days. CT: extra-axial mass in the left frontal region. 
 Meningioma grade I-OMS- with metastasis of breast ductal carcinoma (EMA, AE1-AE3, Estrogen and Progesterone receptor positive). The patient had an invasive ductal carcinoma, grade II excised in 2005 (Malner et al. Int J Cancer, 2000; Custer et al. Am Cancer Soc 2002; Am J Clin Oncol 2002; Watanabe  et al. Int J Surg Pathol, 2003)

5. Hosp Santa Rita,  Vitória, ES –  Case 
 558/08 
– 50 y/o, woman. A tumor in the left ovary: solid-cystic, heterogeneous, with a whitish, yellowish tissue.    
– Sertoli- Leydig tumor (poorly differentiated) (inhibin, calretinin positive; EMA, Ck7 negative). (Am J Surg Pathol 2007; 31: 592-97) (Case seen in consultation by Dr. Esther Oliva, Boston, USA)

6. Bauru – Case  
HB08/1714
 – 23 y/o, woman. An encapsulated, 1246 g, 19 X 14 X 11 cm, pancreatic tumor. At the cut surface: made up by a soft tissue with a papillary appearance. 
– Pseudopapillary solid tumor of the pancreas (PAS with diastase positive; AE1-AE3 negative; E-caderin, chromogranin, synaptophysin negative; Progesterone receptor positive; CD56, b catenin positive) (Adv Anat Pathol 2008; 15: 39-45; Human Pathol. 2008; 39: 251-58) 

7. Salomão & Zoppi – Case
IH0105-111 – 
41y/o, man. A 2.5 cm in diameter, nodule in the submandibular gland region.
 Mantle cell lymphoma (The patient presented with lymphoma since 2002: liver involvement, stage IV, in 2002; in 2005, recurrence with involvement of salivary and lacrimal gland) (CD20, D1 cyclin, CD5 positive; CD 10, CD3 negative; Ki-67 low) (Jares P. et al. Nature Rev Cancer 2007; 7: 750-62). 

8.  EPM – Case
B08/10927 
– 66 y/o, male. Renal Transplantation. Suprapubic nodule.    
– Cyto-lipophagic histiocytic panniculitis due to Herpes virus (IHC positive for Herpes virus and negative for CMV) (J Amer Acad Dermatol 2001; 45: 325-61; 1998; 39: 721-36).

9.  Michal Michal – Case
M6514/03 – 
78 y/o, male. Hemorrhagic tumor in the kidney, diam. 9 cm.
– Oncocytic papillary renal cell carcinoma (Racemase positive; C-kit negative; trissomia 7; loss of Y) (Hes O et al. Ann Diagn Pathol 2006; 10: 133-9). 

10.  EPM – Case
B08/12482
 – 25 y/o, woman. Bilateral nephrectomy. Tuberous Sclerosis.   Polycystic renal disease.   
– Tuberous sclerosis: Kidney with multiple angiomyolipomas + cysts + renal cell carcinoma as described associated with polycystic kidney. (Case seen in consultation by Dr. Mahul Amin – Emory University) (Tickoo et al. Am J Surg Pathol 2006; 30: 141-53; Gobbo et al. Am J Surg Pathol 32: 1239-45, 2008)