SYLVIA L. ASA
University Health Network
Toronto, ON, Canada
This 66 year old woman presented with a neck nodule. She had a history of a long-standing goiter.
She was euthyroid; the goiter had been painless and non-tender. She had noted a sudden and rapid
increase in size of her right neck in the preceding few weeks. On examination she had an assymetrical
large goiter with a fixed 6 cm right nodule. She underwent thyroidectomy. The right lobe measured 6
x 5 x 5 cm and weighed 60 grams. It was multinodular with obvious infiltrating tumor. The left lobe
weighed 6 grams and measured 4 x 3 x 1 cm with multiple small nodules measuring up to 5 mm in
The slide submitted is a representative section of the right thyroid.
Wayne State University
A 70 year old man was found to have mass involving the right kidney during work up for right upper
quadrant pain. There was no significant past history. A radical nephrectomy was performed. The
gross description from the pathology report indicated that the kidney contained a "2.0 x 2.0 x 1.8 cm
white-grey, fleshy tumor. It is located within the center of the specimen, and appears to involve
part of the cortex and an entire pyramid."
Memorial Sloan Kettering Cancer Center
New York, NY
A 38 year old woman with a 3 cm palpable mass in the right axilla. The mass was excised. The photos
are from this lesion.
Vancouver General Hospital
Vancouver, BC, Canada
The patient is a 38 year old man who came to Vancouver from Hong Kong to seek treatment for a liver
tumor which he had been told was unresectable. 18 years prior to this presentation he had an
orchidectomy for a teratocarcinoma. At the present time his only symptom was recurrent febrile
episodes. On examination he was found to have a mass in the liver. This measured 20cm in diameter
and involved most of the left lobe and caudate lobe with compression of the portal vein and common
bile duct No extra-hepatic lesions were identified.
Radical surgical excision was considered
feasible. A mass weighing 1.5kg was excised. It was poorly circumscribed and the cut surface showed
multiple necrotic and hemorrhagic foci interspersed with tan-grey tissue. The areas of background
liver were non-cirrhotic.
GREGORY N. FULLER
MD Anderson Cancer Center
A 56-year-old man presented with a history of a left parietal lobe glioblastoma that was surgically
resected three months previously at a referring hospital, followed by radiation therapy. He reported
increasing frequency of severe headaches and progressive motor and sensory changes on the right side
of his body. A subsequent MRI scan revealed a new contrast-enhancing mass in the left parietal lobe
at the site of his prior tumor, which was associated with extensive edema of the surrounding brain.
The clinico-radiologic differential diagnosis included recurrent glioma, radiation necrosis, abscess,
hemorrhage into the tumor bed, and venous infarction. Re-operation was performed for resection of the
lesion to relieve the mass effect and provide tissue for a definitive diagnosis so that appropriate
treatment could be instituted.