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CALIFORNIA TUMOR TISSUE REGISTRY

October, 2007 Study Cases, Subscription B

Soft Tissue Tumors

California Tum or 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· 0188 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 ofa variety ofbcnign and malignant 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 ofse lected 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 ofCategory 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 #30347

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 . ·The cut surface was tan rubbery-firm, moist, and glistening, generally homogeneous with focal hemorrhagic spots.

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

Tissue from: Right 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

Clinica l 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: S-1 00 protein, (focally) Negative:

Study Cases, October, 2007; Subscription B s Contributor: LLUMC Pathology (nhp) Case No. 7 - October, 2007 B Lorna L inda, CA

Tissue from: Right upper arm Accession #30246

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

Gross Pathology: 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>a rk, 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 . A radical resection was performed one year after therapy.

Gross Pathology: 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 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 solid 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 Uni versity School of Medicine 11021 Campus Avenue, AH 335 Loma Linda, California 92350 (909) 558-4788 FAX: (909) 558-0188 E-mail: [email protected] Web site & Case of the Month: www.cttr.org FILE DIAGNOSES

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

C'ITR Subscription B

Case 1: T-Y4100, M-76100

Case2: Cutaneous fibrous (lipidized), leg T-Y9400, M-88300

Case3: Elastofi broma, scapula T-11280, M-88200

Case 4: Aggressive angiomyxoma, scrotum T-79400, M-88400

CaseS: Diffuse tcnosynovial giant cell tumor (pigmented villonodular synovitis}, knee T-051 45, M-Y9200

Case 6: Benign peripheral nerve sheath tumor, palm T-Y8740, M-95600

Case 7: Low grade mesenchymal neoplasm, favor varient of fibrous histiocytoma, arm T-Y8210, M-91501

Case 8: PNET/Ewing's T-YISOO, M-92603

Case 9: Desmoplastic sma ll round cell tumor, ovaries T-87000, M-49000

Case 10: Pleomorphic rhabdoyosarcorna, intrathoracic/mediastinum T-Y2200, M-89003

2 CT'TR, OoooQ

Glendale - Abdominal JibromatOsis J.os Angeles

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

Case No. 2 - Accession No. 30223 October, 2007 n

Glendale •

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 (6); Atypical fibrous xll!llhoma (4) San Francjgo - 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 fl brou$ histiocytoma Lus Vegas (Sunrjsc l!osni.m!} - Xnnthognmuloma MDSSJlchuscus Je Medical Centorl - Fibrous histiocytoma (dermatofibroma) N~w York !WgtChC$t« Medical Center) - Histiocytoma North Carolj!lil C\Voke Forrst Universj1V SW!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/, I994 ; 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/, I994: I 8:668-76.

4 CITR, October, 2007: "tvlinutcs"' (Sub~eription B) Case No. 3 - Accession No. 30318 October, 2007 B

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 fHcnn lnnd 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

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. 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.

CITil. Occober. 2007: "Minut

Glendale • Benign angiomyofibroblastoma Los Angele.~ - Spindle cell 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 .. Aggressive angiomyxoma Illinois /Sarah Bush Lincoln Heath Center) • Kan5as fCoffe}IVilte Re-gional Medical CMteO - Aggressive tmgiomyxoma Kansas (Pe!frson LnbomtoN Services) .. Aggressive angiomyxoma Kansas CPhvsicians Reference Laboraton•) • Myxoid neurofibroma Las Veea'\ . - Ag,sressive an&iomyxoma New Mexico (Universjtv of New Mexico} - Atypical lipomatous tumor New York

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~'i vc Angiomyxomn oflhe Epididymis. Con J Uro/ 2005; !2(4):2772·2773. Chuang Ff•, Wu ST, [.ee SS, et al. 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 ~nov itis 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 fH eanland Reaiwal Medical Cemcrl - Syoovial reactive histiocytic infoltrntc with >'illous hypertrophy {roreign body reaction) lllinois (Sarah Bush Unooln Heath Ce.ucrl - Detritic sxnovhis Kon sa.~ · 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 (Co n e~wmgh Hospital) • Pigmented villonodular sy11ovitis Ptnnsylvnn ja (Dre.'< cl University of 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 ' Group) - Pigmented \'illonodular synovitis

Cnse 5 - Diagnosis: Diffuse tcnosynovial giant cell tumor (pigmented villonodular synovitis), knee T·OS 145, M-Y9200

Case 5 - Refere nces: Dursun M, Yilmaz S, Ercr B, et al. Clinical Image. Pigmented Villonodular S)'novitis of the Knee, Artl~rlfls Rheum2006: S4{ 11 ):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

Case No. 6 - Accession No. 303 17 October, 2007 B Glendale - Myoepithelioma orson 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 • Myxoid ncuronbroma Kunsas {Peterson 4boraLorv Services) . E: Qt!wsjcjnns Reference L-aboratory) · Myxochondroma 1. us Vegn~ CSuorjss Hosp iLal) • 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' · Myxoid chondrosarcoma Pennsvlvpoia (Dre.'Sel Uojversitv ofMedicine) - 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 Path oi. 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):405-4 10.

C n~ e No. 7 - Accession No. 30246 October, 2007 B

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

8 CTTR. October. 2007 ~ "MiriUtcs" (Sub$cription U) lllinojs (ileartland Regional Medical Center> .. Subct1taneous fibrous histiocytoma llljnois ISarab 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 . .. Subcutaneous fibrous histiocytoma New Mexico .. Monophasic synovial sarcoma New Yortc .. Fibrohistiocytoma with h~:mangiopericytic feature Pcnnsvlvania - Oermato·fi broma 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 Wash jngton. DC -Atypical fibrothccoma Wisconsin. Madison .. llemangiopericytoma West Vjrginia (\VV University Hospilall .. MonophMic synovlo.l sarcoma Austrulln (Sullivtln Nicolaides J)nthology> • fn flarnmotory 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 October, 2007 B

Glendale - Ewin&'siPNET I.o• Anaeles O!SC M

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

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

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 October, 2007 B

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 - Desmoplastic small round cell tumor Los Ve2as (Sunrise Hmjtal) • Desmoplastic small round c:ell tumor

MOSit\thu~ens • Desmoplastic small round cell namor New York Wew York Stony Qrook Unjyersiry Center Rcsjdcnts)- Dcs m op l a.~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

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-

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

Case No. 10 - Accession No. 30230 October, 2007 B

Glendale • Enlbryon"l rhabdomyosarcoma, anopl"stic variant Los Angeles IUSC Medical Center) · Embryonal rhabdomyosarcomo NewPOrt Beoch • Rhnbdomyosarooma Sno Diego

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

C'ITR. October. 2007~ ''Minutes" (Subscriplion 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) - P l como~>h ic rhabdomyosaroomo Nonh Carolina (\Vake fgrest Univcrsitv School ofMe dicine) - Embryonal rhabdomyosarcoma Noah Carolina I Womack Annv Medjeal Cenlcrl • Embryonal rhabdomyowcoma (5) Pennsylvania - 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 - Mn1 ignant Teiton tumor Texos. Lubbock - Embryonal rhilbdomyosnrcoma Woshingtoo. DC • Rhabdomyosarcoma, cmb1·yonnl Wjsconsin. Madjson - Rhnbdomyos3tCOma West Virginia CWV Unjyc;rslty Hospital) - Rhabdomyosarcoma Australia - Rhabdomyosarcoma Juppn CAsruti General Ho:;ni.Uill · Rhabdomyos:u'Colnt\ Uojtcd Kine:dom hic rhnbdomyosarcomo

C nse ! 0 - Diagnosis: Pleomorphic rhabdomyosarcoma, intrathoracic/mediastinum T-Y2200, M-89003

Outside Consultation: 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 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