—  SPECIALTY CONFERENCE  —

Genitourinary Pathology
 Thursday, February 16, 2006 - 7:30 PM
Centennial II



Moderator:

Peter A. Humphrey
Washington University School of Medicine
Barnes-Jewished Hospital
St. Louis, MO

Prior to this Annual Meeting, slides and case histories for this Specialty Conferences were posted below so they may be reviewed in advance. During the meeting, the slides and protocols were also available for study in the microscope room (Chicago B - F Room) for participants who wished to review them prior to the evening session.

Click here for the handout from this conference.


Click on each slide thumbnail image for an enlarged view
Case 1

Submitted by:
David J. Grignon
Wayne State University
Detroit, MI

Clinical Summary:

A 74 year old woman is found to have a 3 cm complex cystic mass involving the right kidney. A partial nephrectomy is performed. Grossly the lesion measures 2.8 x 1.8 x 1.8 cm and bulges from the cortical surface. It is multicystic with thin septae and no solid areas. The cysts contain translucent pale yellow fluid.


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Case 2

Submitted by:
Esther Oliva
Massachusetts General Hospital/Harvard Medical School
Boston, MA

Clinical Summary:

A 70-year-old man underwent a transurethral resection for urinary retention secondary to bladder outflow obstruction. Relevant prior clinical history includes invasive esophageal carcinoma diagnosed and treated in 1995 and an incidental prostatic adenocarcinoma Gleason score 6/10 (present in 3 of more than 100 chips) in a background of florid benign prostatic hyperplasia diagnosed in a transurethral resection done for urinary retention in 2003.


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Case 3

Submitted by:
John R. Srigley
McMaster University/Credit Valley Hospital
Mississauga, ON, Canada

Clinical Summary:

A 53 year old male presented with non- painful left scrotal enlargement of several months duration. Clinical and ultrasound examinations revealed a hydrocele without any obvious mass lesion and a left hydrocelectomy was performed


Case 3 - Figure 1
2.5X
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5X
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10X
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40X



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CK5/6
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CALRET




Case 4

Submitted by:
Rodolfo Montironi
University of Ancona School of Medicine
Torrette, Ancona, Italy

Clinical Summary:

September 1992. A 71-year-old Caucasian man presented with a 1-year history of increasing urinary obstructive symptoms. A diffuse enlargement of the prostate was documented by transrectal ultrasound and digital rectal examination. Supra-pubic (simple) prostatectomy was performed. The preoperative total serum PSA was 2.5 ng/ml. After the operation PSA decreased to below 1.0 ng/ml. The diagnosis was benign prostatic hyperplasia associated with diffuse BCH. The patient was clinically well until 1996 when he presented again with urinary obstructive symptoms. Transurethral resection of the prostate (TURP) was performed in June 1996, following which a temporary normal voiding was achieved. The pathology report included basaloid carcinoma of the prostate vs. transitional cell carcinoma. The reporting pathologist favored the latter diagnosis. In March 1997 the patient underwent a second TURP. A permanent normal voiding was achieved. The pathology report, which included the revision of the previous two histological examinations, was basaloid carcinoma with extension to the extraprostatic tissue. A local recurrence was documented in 2000. This was a progressively growing mass (20 cm across) originating from the prostate and compressing and obstructing the rectum. There were no urinary voiding problems. The patient was not given any therapy (i.e., chemotherapy or radiotherapy). A computed tomography scan performed in 2003 did not reveal secondary deposits in lymph node and distant parenchyma. The PSA remained below 1.0 ng/ml. He died because of heart failure in mid-2003. An autopsy was not done.


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Case 5

Submitted by:
Lawrence D. True
University of Washington Medical Center
Seattle, WA

Clinical Summary:

This 65 year old male presented with a bulky pelvic tumor. Nine years prior to admission a routine physical exam revealed an asymmetrically enlarged prostate. Prostate biopsies showed a "prostate adenocarcinoma, poorly differentiated." The tumor was treated with 6,800 Gy of radiation to the pelvis. The patient remained asymptomatic for 9 years, at which time he developed bladder outlet obstruction. A biopsy revealed tumor, which was treated by radical cystoprostatectomy. Based on evidence of residual tumor, additional radiation therapy, followed by en-bloc resection of residual tumor and rectum, was undertaken. The slides are from this latter specimen.


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