Submitted by: Jae Y. Ro Asan Medical Center Ulsan University, Seoul, Korea
A 79-year-old man presented with gross hematuria of 1 month's duration. His past medical
history was remarkable for diabetes and hypertension for 10 years, but his family history was
unremarkable. Urinalysis demonstrated RBC 3+ with no protein or sugar. Other laboratory tests
were within normal limits except for slight elevation of PSA level (6.0 ng/ml) and fasting
glucose of 131 mg/dl. Chest x-ray was normal. Abdominal CT showed an intraluminal
protruding mass in the right anterior wall of the urinary bladder with wall thickening (Figure 1).
No enlarged lymph nodes were identified. On cystoscopy, two nodular masses (3 cm and 1.5 cm
in diameter) were found in the right antero-posterior wall of the bladder (Figure 2). Under the
clinical diagnosis of T1 invasive transitional carcinoma, transurethral resection of the bladder
tumor (TURBT) was performed. Microscopically, the tumor (Figures 3, 4 and 5) and mucosa
adjacent to invasive tumor (Figure 6) are illustrated. Figures 7 and 8 are CK7 and CK20 in
neoplastic cells, respectively. After TURBT, the patient received intravesical mitomycin C for 6
times. Follow-up urine cytology 3 months after the diagnosis demonstrated a few malignant
cells. The patient is alive with disease.
Submitted by: Thomas M. Ulbright Indiana University Indianapolis, IN
A 27-year-old man presented with a 3-week history of an enlarging right testicular mass. An
orchiectomy was performed. On gross examination, there was a 5.5 cm, fleshy, well-circumscribed tumor
that bulged above the adjacent parenchyma. A separate 0.6 cm nodule was also noted.
Submitted by: Stacey E. Mills University of Virginia Medical Center Charlottesville, VA
A 40-year-old man presented for elective sterilization and was found on physical examination to have a
previously undetected rock hard right testicular mass. Ultrasound demonstrated a 3 cm.
heterogeneous, partially calcified solid mass in his right testicle. A right orchiectomy was performed
with prosthesis insertion.