—  SPECIALTY CONFERENCE  — Head/Neck/Endocrine Pathology Thursday, March 12, 7:30 PM Convention Center 312 Diagnostic Challenges in Head/Neck/Endocrine Pathology Moderator: MARY RICHARDSON Medical University of South Carolina, Charleston, SC Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. Virginia LiVolsi is a consultant for Veracyte. The other speakers listed below have indicated they have nothing to disclose. Panelists: LEON BARNES, University of Pittsburgh Medical Center, Pittsburgh, PA VIRGINIA LIVOLSI, Hospital of the University of Pennsylvania, Philadelphia, PA CELESTE N. POWERS, Virginia Commonwealth University Health Systems, Richmond, VA BRUCE WENIG, Beth Israel Medicine Center, New York, NY Clinical Histories and Still Images are displayed below. Click on slide thumbnail images for an enlarged view. If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137. Case 1 Submitted by: Leon Barnes - University of Pittsburgh Medical Center, Pittsburgh, PA Clinical Summary: This 60 year old man presented in 2004 with a widened nasal septum which was excised. The lesion has now recurred and involves both nares. There is no adenopathy or history of systemic disease. In addition, he has recently developed a 3 cm skin lesion of the right frontotemporal scalp that was first noticed several months ago. (Case courtesy of Damion Kistler MD, Mercy Health Center, Oklahoma City, OK.) Case 1 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 1 - Slide 2 Click to view with ImageScope Click to view with a Web-Based Viewer Case 1 - Figure 1 Case 1 - Figure 2 Case 1 - Figure 3 Case 1 - Figure 4 Case 1 - Figure 5 Case 1 - Figure 6 Case 1 - Figure 7 Case 1 - Figure 8 Case 1 - Figure 9 Case 1 - Figure 10 Case 1 - Figure 11 Case 2 Submitted by: Virginia LiVolsi - Hospital of the University of Pennsylvania, Philadelphia, PA Clinical Summary: This 48 year old man presented with difficulty swallowing. He had been a smoker but stopped 10 years ago. On exam, a 1.5-2 cm mass was noted at the base of tongue. Biopsy was done and frozen section was requested. Figures 1-3 are from the frozen section slide A diagnosis of SQUAMOUS CELL CARCINOMA was made both at time of frozen section and on permanent section control slide. Radiation and chemotherapy were recommended. The patient self referred himself to University of Pennsylvania ENT oncology service. The slides were in transit from the original facility when he was seen at Penn. Another biopsy was taken (shown in figures 4-6). Surgery followed by radiation was recommended. The patient decided to obtain treatment at the original facility. He received 11 radiation treatments and one round of chemotherapy. He was dissatisfied with his progress and came back to his Penn doctor. Case 2 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 2 - Figure 1 Case 2 - Figure 2 Case 2 - Figure 3 Case 2 - Figure 4 Case 2 - Figure 5 Case 2 - Figure 6 Case 3 Submitted by: Celeste N. Powers - Virginia Commonwealth University Health Systems, Richmond, VA Clinical History: 62 year old man presents with a 1.2 cm superficial abdominal mass that is hypervascular on ultrasound. No history of prior malignancy. FNA using 23 gauge needle is performed. Case 3 - Figure 1 Case 3 - Figure 2 Case 3 - Figure 3 Case 3 - Figure 4 Case 3 - Figure 5 Case 3 - Figure 6 Case 3 - Figure 7 Case 4 Submitted by: Bruce Wenig - Beth Israel Medical Center, New York, NY Clinical Summary: 69 year old women with a left parotid gland mass measuring 3 cm in greatest dimension. The tumor was rapidly growing with associated facial nerve weakness. An enlarged left cervical neck (Level II) was also present. A radical parotidectomy and neck dissection was performed. Case 4 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 4 - Figure 1 Case 4 - Figure 2 Case 4 - Figure 3 Case 4 - Figure 4 Case 4 - Figure 5 Case 4 - Figure 6 Case 4 - Figure 7 Case 4 - Figure 8 Case 4 - Figure 9 Case 4 - Figure 10 Case 4 - Figure 11 Case 4 - Figure 12 If there are glass slides for a conference, they will be available for study in the microscope room in the Convention Center Room 313 for participants who wish to review them prior to the evening session. Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting. A booklet containing an agenda for each Specialty Conference symposia and a list of speakers is provided at the meeting.