california tumor tissue registry protocol tumors of …

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CALIFORNIA TUMOR TISSUE REGISTRY

LOS ANGELES COUNTY · UNIVERSITY OF SOUTHERN CALIFORNIA

PROTOCOL

FOR

MONTHLY STUDY SLIDES

SEPTEMBER 1980

TUMORS OF THE KIDNEY

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CONTRIBUTOR: Robert J. Rosser, M. D. Van Nuys, Cal ifornia

SEPTEI~BER 1980 - CASE No. 1 . .

TISSUE FROM: Right kidney ACCESSION NO. 22340

CLINICAL ABSTRACT:

Historf This 69 year old woman was admitted to the hospital on June 17, 1~6 for exci sion of a scalp nodule present for 5 weeks. While convalescing in the hospital, work up for anemia revealed a right renal mass on intravenous pyelogram, two radiodensities in the left lung and multifocal defects in the calvarium.

Past history revealed a well differentiated adenocarcinoma of the uterus 2 years earlier.

SURGERY:

On 7-1 -76 a right nephrectomY was performed .

GROSS PATHOLOGY:

The right kidney had an 8 x 8 x 8 em. multicolored multilobular mass arising from its superior pole . The specin~n weighed 470 gm. Tumor obliterated the upper cal ices and had invaded the renal' vein. The superior and posterior margins of resecti.on were found to be involved with tumor.

FOLLOW-UP:

The patient expired within six months of her hospitali zation at home. She had been begun on chemotherapy but had refused further therapy after a brief time.

CONTRIBUTOR: Roger Terry, M.D. los Angeles, California

SEPTEMBER 1980 - CASE NO. 2

TISSUE FROM: left kidney ACCESSION NO. 22544

CLINICAL ABSTRACT:

Hi story: This 61 year old Caucasian male had a 3 day. history of gross hematuria . He had been admitted one month previously at which time a decompressive lami nectomy for bi·lateral leg paralysis was performed at T 10-11-12. Metastatic tumor was found at that site. There was also a 42 lb weight loss over an 8 month period.

Cystoscopy revealed no bladder lesion but an IVP showed a mass in the lower pole of the left ki dney.

SURGERY:

On 1-22-71 a transperitoneal nephrectomy was performed.

GROSS PATHOLOGY:

The left kidney weighed 200 gm. and measured 12 x 7 x 6 em. In the lower pole was a 6 em. diameter lobulated yellow tan lesion that protruded through one surface of the kidney, but not through the capsule. It appeared to be encapsulated and had some necrotic and hemorrhagic areas. There was , however, extension into the renal vein.

FOLLOW-UP:

In February 1971 he received a total of 3000 rads to the spine for treatment of the metastatic lesion. He devel oped flexion contractures of the lower extremities and became extremely emaciated. He expired on May 9, 1971 in an convalescent home.

CONTRIBUTOR; Marthe E. Smith, M.D. SEPTEMBER 1980 - CASE NO. 3 San Francisco, California

TISSUE FROM: Left kidney ACCESSION NO. 22459

CLINICAL ABSTRACT:

History: A 68 year old woman complained of left flank pain and gross hematuria for 36 hours. Because fever, an elevated WBC and toxic changes in the PMNs were noted, antibiotics were given for a suspect abcess. Beta strep was cultured from the brownish urine.

. Radiographs: An intravenous pyelogram on admission showed poor vi sua 1-

ization of the left kidney with a probable mass. A repeat intravenous pyelogram revealed a poorly ca lcified mass in the mid portion of the left kidney. Angiography proved the mass to be highly vascular. By echogram both solid and cystic elements were noted.

SURGERY:

On 1-24-77 a left transabdominal nephrectOmY and adrenalectomY was performed.

GROSS PATHOLOGY:

. The total kidney \~eight was 255 gms. A 6.5 x 5.8 x 7.5 em. circum-scribed tumor was found in the renal parenchyma. Polypoid bulging of the tumor was noted in one calyx, but the tumor did not penetrate the renal capsule or invade the renal vein . On cross section one half of the tumor was involved with a thick-walled cyst containing watery fluid. The remaining· portions were strikingly brown in color with fibrous trabeculation and focal calcification. The adrenal gland and remaining renal parenchyma were free of tumor.

FOLLOW-UP:

Patient was last seen on May 8, 1980 at which time there was no evidence of recurrent tumor.

CONTRIBUTOR: Roger Terry, M.D. SEPTEMBER 19.80 - CASE NO. 4 Los Angeles, California


CLINICAL ABSTRACT:

H1storr: A 51 year old man complained of painless gross hematuria and weight oss of 30 lbs .

Radiographs: An IVP showed a filling defect in the infericr pole of the right kidney. Angiography proved the tumor to be ·quite vascular.

SURGERY:

On 3-30-71 a right radical nephrectomY was performed. Several enlarged periaortic lymph nodes were resected.

GROSS PATHOLOGY:

The ' right kidney weighed 300 gms. Along the posterior aspect of the inferior pole was a yellow fungating lesion firmly adherent -to the renal capsule. On cross section the mass extensively involved the parenchyma at the inferior pole. The tumor was yellow brown in color and soft to necrotic in consistency. Fragments of tumor were found in the lower calices. The renal vein appeared grossly free of twror. reriaorti.: lymph nodes contained metastatic tumor.

FOLLOW-UP:

Metastatic tumor involving the right inguinal lymph nodes was treated with 4800 rads 6 months post op. A 1 eft 1 ower guadrant mass was discovered in March 1972. The patient began radiation treatment to this site but soon became lost to follow-up.

Patient expired in 1972.

CONTRIBUTOR: Aaron Dubrow, M.D. SEPTEMBER 1980- CASE NO. 5 Sherman Oaks, California


CLINICAL ABSTRACT:

History: A 56 year old woman requested an upper GI and gallbladder study due to persistent episodes of dyspepsia and epigastric discomfort. Previous studies had suggested peptic ulcer. This time the gallbladder study suggested extrinsic compression of the gallbladder along its lower margi.n with the patient in the Trundelenburg position. A follow-up IVP suggested the presence of a large cyst in the right kidney. The patient denied any previous urologic problems although she had had an IVP 10 years ~arlier which was apparently normal. '

SURGERY:

On 11-18-74 exploratory surgery revealed a large mass in the right kidney and a right nephrecto~ was performed.

GROSS PATHOLOGY:

The kidney weighed 329 gms . A 10 x 8 x 6 em. firm well-circumscribed and somewhat encapsul ated mass was present along the lateral wall of the kidney. On cross section it was yellow to gray in color with apparent large zones of hemorrhage and necrosis. Remaining renal parenchyma was unremarkable. The calyceal system, ureter, and renal vasculature were unremarkable .

FOLLOW-UP:

Patient is alive and well with no evidence of disease as of July 24, 1980.

CONTRIBUTOR: Weldon K. Bullock Pasadena, California

TISSUE FROM: Left kidney

CLINICAL ABSTRACT:

SEPTEMBER 1980 - CASE NO. 6

ACCESSION NO. 22286

History: A 69 year old man was noted to have gross hematuria. Three months earlier he had suffered a stroke. He was not currently on anticoagulation medication.

Cystoscopy and cytology showed only chronic inflamation and bladder diverticuli.

Radi ogralh_: An il)travenous pye 1 ogram revea 1 ed a filling defect in the left renal pe vis.

SURGERY:

On 7-1-75 a radical left nephrectomy and partial ureterectomy was performed .

GROSS PATHOLOGY :

The l eft kidney weighed 156 grams and .measured 11.5 x 6 x 5 em. Upon opening the pelvis a 3.5 em. pink-white, firm, papillary, bulging tumor was found arising in the middle portion of the calyceal system with minumal invasion into surrounding renal parenchyma. The lower renal pelvis , uret er, and renal vasculature were univolved by tumor.

FOLLOW-UP:

As of December 18, 1979 patient is free of disease.

CONTRIBUTOR: H. V. O'Connell, M.D. SEPTEMBER 1980- CASE NO. 7 Bakersfield, California

TISSUE FROM: Pararenal tissue right flank

CLINICAL ABSTRACT:

ACCESSION NO . 22187

History: A 51 year old woman presented to her physician with hypertension (170/100) and an altered sensorium. In 1969 a hysterectomy was performed. Details of the surgical findings and surgical pathology report remain unavailable.

Physical examination revealed a large mass filling the entire right flank from the umbilicus to the iliac crest to the rib cage.

A transabdominal needle biopsy was performed. Further studies indicated that the lesion was of probable renal origin.

SURGERY:

On 12-2-74 an exploratory laparotomy with right nephrectomy and excision of the abdominal mass was performed.

GROSS PATHOLOGY:

The remnant of a right kidney was compressed to one side with a large tumor presenting a whorled nodular appearance of reddish-gray and yel low color. The enti re surgical specimen measured 16 x 18 x 18 em. ·

FOLLOW-UP:

The patient was placed on chemotherapy. At the completion of her drug regimen in May 1978 massive pulmonary and hepatic metastases were present. She died on November 3, 1979 without benefit of an autopsy.

CONTRIBUTOR: Delver R. Cain, M.D. SEPTEMBER 1980- CASE NO. 8 Los Angeles, California

TISSUE FROM: Right kidney ACCESS ION NO. 21700

CLINICAL ABSTRACT:

History: A 45 year old woman developed persistent right flank pain lasting for 3 months.

Phlsical examination revealed a slightly tender palpable abdominal mass be ieved , to be of renal origin.

Radiograph: An intravenous pyelogram showed at mass in the lower pole of the right kidney.

SURGERY:

On 11-18-75 a multiloculated cystic mass was found in the lower pole of the kidney. The tumor was excised. The remainder of the kidney was left unresected.

GROSS PATHOLOGY:

The mass rneas.ured g x 7 x 4.5 em. and contained numerous cysts filled with cloudy dark yellow fluid and lined by smooth grey epithelium. The intervening stroma between the cysts was yellow in color. No hemorrhagic or necrotic foci were present.

FOLLOW-UP:

As of July, 1976 , the patient was alive an~ well without evidence of tumor. She has not been seen since then.

CONTRIBUTOR: Daniel J. de la Vega, M.D. SEPTEMBER 1~80 - CASE NO. 9 San Diego, California

TISSUE FRO~I: Left kidney ACCESSION NO. 17526

CLINICAL ABSTRACT:

Histora: ·A 56 year old woman was in good health until February 1968 when she ha an episode of bronchopheumonia. Her pulmonary symptoms resolved with antibiotics but a low grade fever persisted. Examination on May 1968 revealed microhema~uria and a left renal tumor was discovered by intravenous pyelogram!

Laboratory data: Routine laboratory findings were unremarkable except for hematuria.

Radiograph: An angiography showed the tumor to be avascular.

SURGERY:

On 6-3-68 an exploratory laparotomy revealed a large firm tumor virtually replacing the upper pole of the left kidney with tumor extension and fixation to the surrounding muscles posteriorly and to the adjacent peritoneum superiorly. A left nephrectomY was performed.

GROSS PATHOLOGY:

The left kidney measured 13.. 5 x 6.5 x 10.5 em. and weighed 480 grams . A 6 em. solid, firm, tan white tumor extended from the kidney pelvis superior laterally through to the renal capsule with extension into the perirenal fat .

FOLLOW-UP:

Post operatively the patient was treated with cobalt therapy. One year later she developed intractable pain and flaccid paralysis of her left leg. Tumor was di scevered erodi.ng through Ll. A pa 11 iative laminectomY was performed and dermotherapy given. The patient died in September 1969 without benefit of an autopsy .

CONTRIBUTOR: Roger Terry, M.D. SEPTEMBER 1980 - CASE NO. 10 Los Angeles, California

TISSUE FROM: Left kidney ACCESSION NO. 22883

CLINICAL ABSTRACT:

History: This 64 year old Caucasian female began having gross hematuria two days prior to admission. She had no history of prior urinary tract infections but did have stress incontinence. Further history revealed that she had diabetes mellitus controlled with ora·l agents, had a 20 year history of hypertension, and that she had a left radical mastectomY 13 years previous for breast carcinoma.

RadioTraphs: An' intravenous pyelogram demonstrated a possible mass in the left k dney, upper pole, with multiple filling defects in the left pelvis. A selective left renal angiogram showed a 3 x 4 em. mass density in the superior pole with vessel s transgressing the mass .

SURGERY:

On 5-9-73 a left nephrourecterectomy was perfonned.

GROSS PATHOLOGY:

The specimen consisted of a 146 gm. kidney which measured 11 x 6 x 4.5 em. Bulging from the surface of the superior pole was a white to pink mass 3.5 em. in diameter. On sectioning it was relatively firm with prominent hemorrhagic foci and an eccentric cavity measuring 1.1 em. diameter and filled with reddish brown hemorrhagic material. The tumor extended into the collecting system but did not break through the capsule. The renal vein was free of tumor.

FOLLOW-UP:

As of May 29, 1980, the patient is alive and well without evidence of the disease.

CONTRIBUTOR: Arthur L. Koehler, M.D. SEPTEMBER 1980 - CASE NO. 11 Pasadena, California


CLINICAL ABSTRACT:

History: This 74 year old female has been in fairly good health until recently when she noted some epigastric distress. She denied hematuria, weight loss, back pain or other specific symptoms other than the mild epigastric distress.

Physical examination: Liver down 2 ems. in the .costal margin on deep inspiration.

Laboratory data: SMA 12 showed elevation of the alkaline phosphatase to 140 as well as elevation of the SGOT to approximately 75.

Radiograph: An upper gastro-intestinal series revealed a left upper quadrant mass. On intravenous pyelogram a large left upper quadrant mass was noted displacing and rotating the left kidney. Ultrasound· examination was felt to be consistent with the left upper pole renal mass.

SURGERY :

On 1-23-75 a left nephrectomY was performed. A massive tumor was found measuring up to 15 ems . in diameter replacing the entire upper 3/5 of the left kidney, extending past the capsule in to the adjacent fat. A few small lymph nodes were present in the perirenal tissues .

GROSS PATHOLOGY:

The surgical specimen weighed 900 grams . A 15 em. tumor replaced approximately three-fifths of the kidney . The renal capsule and peri renal fat were involved with tumor. Cut section showed whorls of yellow to graypink tissue in which extensive hemorrhage, necrosis and softening were noted with focal areas of cyst formation . The calyceal system and hilar vessels were uninvol ved with tumor .

FOLLOW-UP:

On January 7, 1976 a needle biopsy of an "abdominal mass" showed recurrent tumor. Patient expired on September 30, 1976 without benefit of an autopsy.

CONTRIBUTOR: Roger Terry, M.D. SEPTEMBER 1980. - CASE NO. 12 Los Angeles, California

TISSUE FROM: Right kidney ACCES.SION NO. 23879

CLINICAL ABSTRACT:

History: This 40 year old Caucasian female had a one year history of right flank pain . An intravenous pyelogram demonstrated a right renal mass 5 em. in diameter occupying the middle to lower pole area. The mass was hypovascular on angiogram.

SURGERY:

On April 11, 1980 a right radical nephrectomY was performed. Some large periaortic nodes were seen.

GROSS PATHOLOGY:

The specimen consisted of a 12 x 7 x 6 CJll., kidney containing an apparent sharply demarcated tumor mass in the mid. portion. The 6 em. diameter mass was roughly spherical and composed of yellowish gray tissue with scattered areas of necrosis and hemorrhage. The mass bulged into but did not disrupt the pelvis. The renal vein, ureter, and lymph nodes were not involved by any tumor. A 0.5 em. stone was found in the upper portion of attached ureter.

FOLLOW-UP:

Two weeks after surgery the patient was doing well.

STUDY GROUP CASES

FOR

SEPTEMBER 1980

CASE NO. 1 - ACC. NO. 22340

LOS ANGELES: Pleomorphic renal cell carcinoma - 10

FRESNO: Renal cell carcinoma - 6

CENTRAL VALLEY: Renal cell adenocarcinoma - 6

LONG BEACH: Renal cell carcinoma - 9

MARTINEZ: Mixed clear cell and fibrosarcomatous tumor - 12

RENO: Renal cell carcinoma - 13

SAN FRANCISCO: Renal cell carcinoma in part sarcomatoid - 8

SANTA BARBARA: Renal cel l carcinoma, sarcomatoid pattern - unanimous

SAN FERNANDO: Renal cell carcinoma, sarcomatoid differentiation - 9

COACHELLA VALLEY: Renal cell carcinoma (clear cell type) with spindle cell component - 8

FILE DIAGNOSIS:

Renal cell carcinoma, right kidney 1890-8313

COMMENT:

On review it was fel t that the original scalp nodule was a metastasis from the renal primary (si milar patterns) .

REFERENCE:

· Cancer 45:528-533 , 1980.

CASE NO. 2 ~ ACC. NO. 22544

LOS ANGELES: Renal cell carcinoma - 10


CENTRAL VALLEY:. Renal cell adenocarcinoma - 6


SEPTEMBER 1980

MARTINEZ : Clear cell carcinoma with blood vessel invasion - 12


SAN FRANCI SCO : Clear cell carci noma - 9

SANTA BARBARA: Renal cell carcinoma, clear cell type - unani mo us

SAN FERNANDO: Renal cell carcinoma , clear cell type - 9

COACHELLA VALLEY: Renal cell carcinoma (clear cell type) - 8

FILE DIAGNOSIS:

Renal cell carcinoma, left kidney 1890-8313

CASE NO. 3 - ACC. NO. 22459 SEPTE14BER 1980

LOS ANGELES: Renal cell carcinoma , granular cell variant (granul ar cel l carcinoma) - 10

FRESNO: Rena 1 ce 11 ca rei noma - 6

CENTRAL VALLEY: Renal cell adenocarcinoma - 6

LONG BEACH: Renal cell carcinoma - 8; oncocytic adenoma - 1

MARTIN EZ: Oncocytic tumor - 7; renal cell carcinoma, granular cell variant - 2; oncocyti c adenoma - 2


SAN FRANCISCO: Renal cell carcinoma , granular cell type- 7; oncocytic neoplasm - 2

SANTA BARBARA: Renal cell carcinoma, granular cell type - unanimous

SAN FERNANDO: Renal cell carcinoma granular cell variant - 9

COACHELLA VALLEY: Renal cell carcinoma, granular cell type - 6; proximal tubular adenoma with atypical oncocytic features - 2 (Cancer 38 :906, 1976)

FILE DIAGNOSIS :

Renal cell carcinoma, left kidney 1890-8313

CASE NO. 4 - ACC. NO. 22543 SEPTEMBER 1980

LOS ANGELES: Papillary adenocarcinoma of kidney - 10

FRESNO: (Papillary) renal cell carcinoma - 6; (? metastatic thyroid carc1noma)

CENTRAL VALLEY: Renal cell adenocarcinoma, papillary type - 6


I~RTINEZ: Papillary adenocarcinoma - 12

RENO: Renal cell carcinoma, papillary variant - 13

SAN FRANCISCO: Papillary adenocarcinoma - 9

SANTA BARBARA: Renal cell carcinoma, papillary pattern - unanimous

SAN FERNANOO: Renal cell carcinoma papillary variant - 9

COACHELLA VALLEY: Renal cell carcinoma, papillary pattern - 8

FILE DIAGNOSIS:


REFERENCE:

Urology 14:491-495, November 1979.

CASE NO. 5 - ACC . NO. 21 123

LOS ANGELES: Angiomyolipoma - 10

FRESNO: Angiomyolipoma - 6

CENTRAL VALLEY: Angiomyolipoma - 6

LONG BEACH: Angiomyolipoma - 9

MARTINEZ: Angiomyolipoma - 12

RENO: Ang1omyolipoma - 13

SAN FRANCISCO: Angiomyolipoma - 9

SANTA BARBARA: Angiomyolipoma - unanimous

SAN FERNANDO: Angiomyolipoma - 9

COACHELLA VALLEY: Angiomyo11poma - 8

FILE DIAGNOSIS:

An9iomyolipoma, right kidney

REFERENCES:

Urology 14:199-201, August 1979 Cancer 22:564-570, September 1968

SEPTEHBER 1980

1890-8860


LOS ANGELES: Papillary, transitional cell carcinoma, grade II, with superficial invasiqn - 10

FRESNO: Papillary urothelial carcinoma, grade II - 6

CENTRAL VALLEY : Transitio.nal cell carcinoma, grade II - 6

LONG BEACH: Papillary transitional cell carcinoma grade II {Scale 1 - 4) - 9

MARTINEZ: Papillary transitional cell carcinoma - 12

RENO: Papillary transitional cell carcinoma - 13

SAN FRANCISCO: Papi11ary transitional cell carcinoma, grade II of renal pelvis - 9

SANTA BARBARA: Papillary transitional cell carcinoma, grade II'. non-1nvas1ve, of renal pelvis - unanimous

SAN FERNANDO: Papillary transitional cell carcinoma renal pelvis - 9

COACHELLA VALLEY: Papillary transitional cell carcinoma of renal pelvis, grade II of IV, no invasion demonstrated - 8

FILE DIAGNOSIS:

Papillary transitional cell carcinoma, left kidney 1890-8893


LOS ANGELES: Leiomyosarcoma - 10

FRESNO: Leiomyosarcoma - 2; leiomyoma - 2; malignant schwannoma - 1; malignant spindle cell tumor- 1

CENTRAL VALLEY:· Leiomyosarcoma - 5; 1 ei omyoma - 1

LONG BEACH: Leiomyosarcoma ~ 9

MARTINEZ: Leiomyosarcoma - ·11; sarcoma, NOS- 1

I!ENO: Leiomyosarcoma - 13

SAN FRANCISCO: Leiomyosarcoma (metastasizing leiomyoma , possible primary in uterus) - 8

SANTA BARBARA: Leiomyosarcoma - unanimous

SAN FERNANDO: Leiomyosarcoma - 9

COACHELLA VALLEY: Benign metastasizing leiomyoma - 8

FILE DIAGNOSIS:

Leiomyosarcoma, pararenal tissue, right flank 1890-8893

CASE NO. 8 - ACC. NO. - 21700 SEPTEMBER 1980

LOS ANGELES: Renal cell carcinoma, cystic variant - 10


CENTRAL VALLEY: Renal cell adenocarcinoma - 4; multilocular cyst- 2


MARTINEZ: Clear cell carcinoma, cystic - 12

RENO: Cystic renal cell carcinoma - 13

SAN FRANCISCO : Benign.multiloculated cyst with clear cells - 3; cystic low grade adenocarcinoma - 5

SANTA BARBARA: Renal cell carcinoma, clear cell type, cystic pattern- unan1n

SAN FERNANDO: Renal cell carcinoma with cyst formation - 9

COACHELLA VALLEY: Renal tubular carcinoma , cystic - 6; xanthogranulomatous pyelonephritis - 2

FILE OIAGNOSIS:


REFERENCE:

Urology 14:512-514, November 1979.

CASE· NO. 9 - ACC. NO. 17526 SEPTEHBER 1980

LOS ANGELES: Malignant fibrous histiocytoma or fibroxanthosarcoma - 2; renal cell carcinoma, sarcomatoid variant (pleomorphic renal cell carcinoma) - 8

FRESNO: Sarcomatoid renal cell carcinoma- 1; malignant fibrous histiocytoma - 5 ·

CENTRAL VALLEY: Renal cell -adenocarcinoma, sarcomatous type- 2; rhabdomyosarcomatold· renal cell adenocarcinoma- 1; malignant fibrous histiocytoma - 2; rabdomyosarcoma - 1

LONG BEACH: Halignant fibrous histiocytoma - 7; renal cell carcinoma - 2

I~ARTINEZ: Pleorrorphic' rhabdomyosarcoma - 2; malignant fibroxanthosarcoma - 5; fibrosarcomatoid renal cell carcinoma - 5

RENO: Rhabdomyosarcomatoid carcinoma - 9

SAN FRANCISCO: Malignant fibrous histiocytoma - 9

SANTA BARBARA: Halignant fibrous histiocytoma - unanimous

SAN FERNAND.O: Renal cell carcinoma, sarcomatoid variant- 5; malignant fibrous h1stiocytoma - 3; rhabdomyosarcoma - 2

COACHELLA VALLEY: r~a li gnant fibrous histiocytoma - 7; rena 1 cell carcinoma, sarcomatoid variant - 1

FILE DIAGNOSIS:

Sarcomatoid renal cell carcinoma, left kidney 1890-8033

REFERENCE:

Cancer 22:545-570, September 1968.


LOS ANGELES: Renal cell carcinoma, giant cell variant- 6; xanthogranulomatous pyelonephritis - 2; malignant tumor, unspecified - 1

FRESNO: Pleomorphic renal cell carcinoma - 6

CENTRAL VALLEY: Renal cell adenocarcinoma - 2; malignant fibrous xanthoma - 1; melanoma - 1; benign fibrous xanthoma- 1;

LONG BEACH: Renal cell ~arcinoma - 9

MARTIN EZ : Giant cell hypernephroma - 5; pheochromocytoma - 1; fibroxant hosarcoma - 3; xanthosarcoma - 1

RENO: Mali gnant melanoma - 13

SAN FRANCISCO: Siderophagic anaplasti c hypernephroma - 7; alveolar rhabdo~osarcoma- 1; orgnaizing hematoma (pseudo tumor)- l

SANTA BARBARA: Pheochromocytoma - unanimous

SAN FERNANDO: Grnaular cell variant of renal cell carcinoma - 4; metastatic carcinoma - 3; rhabdo~osarcoma - 2

COACHELLA VALLEY: Melanoma, regressing- 1; pleomorphic rhabdo~osarcoma - 1; adrenal cortical tumor- 5; renal cell carcinoma, anaplastic- 1

FILE DIAGNOSIS:

Renal cell carcinoma , right kidney 1890-8313

CONSULTATION:

These slides were sent to Perry Lambird, ~1. D. from Oklahoma Ci ty and his diagnosis is pleomorphic adenocarcinoma.

CASE NO. 11 ~ ACC. NO. 21126 SEPTEI•IBER 1980

LOS ANGELES: rhabdomyosarcomatoid renal cell carcinoma - 10

FRESNO: Sarcomatoid renal cell carcinoma- 1; sarcoma- 4; no opinion- 1

CENTRAL VALLEY: ·Rena 1 cell adenocarcinoma, sarcomatoid - 5; hemangi operi cytoma - 1

LONG BEACH: Sarcoma, NOS - ·3; Sarcoma, NOS, favor leiomyosarcoma - 6 . . MARTINEZ: Rhabdomyosarcoma - 6; adult Wilms tumor - 3; malignant fibrous histiocytoma - 1

RENO: Sarcomatoid rena) cell carcinoma - 4; rhabdomyosarcoma - 9

SAN FRANCISCO: Rhabdomyosarcoma - 6; adult Wilms plus rhabdOmYOSarcoma • 3

SANTA BARBARA: Renal sarcoma with rhabdomyosarcoma component - unanimous

SAN FERNANDO: Renal cell carcinoma, anaplastic variant - 7; malignant mesenchymal tumor, NOS - 2

COACHELLA VALLEY: · Renal cell· carcino'ma, rhabdomyosarcomatoid variant - 5 malignant mesenchymal tumor- 2;· renal cell carcinoma sarcomatoid variant - l

FILE DIAGNOSIS:


CASE NO. 12 - ACC NO. 23879 SEPTEMBER 1980

LOS ANGELES: Adenocarcinoma, low grade, primary in kidney, renal cell carcinoma - 8; inflammatory conditis, pseudotumor - 2

FRESNO: Adult Wilms tumor - 6

CENTRAL VALLEY: Renal cell adenocarcinoma - 4; adenomitosis- 1; xanthogranuloma with adenomitosis - 1

LONG BEACH: . Rena 1 cell carcinoma - 6; adult lilil ms - 2; benign rena 1 adenoma - 1

MARTINEZ: Adenocarcinoma , kidney - 12

RENO: Rena 1 ce 11 carcfnoma - 13

SAN FRANCISCO: Renal neoplasm, not otherwise specified - g

SANTA BARBARA: Well differentiated renal cell carcinoma - unanimous

SAN FERNANDO : Renal cell carcinoma wi th distal tubular differentiation - 7; adult Wilms tumor - 2

COACHELLA VALLEY: Renal cell adenocarcinoma, regressive - 2; renal cell adenocarcinoma - 6

FILE DIAGNOSIS:

Renal cell carcinoma, ri ght kidney 1890-8143

COJISUL TATION:

These slides were sent to F. K. Mostofi, M. D., Chi ef , Genitourinary pathology, AFIP and his reply is as follows; . "We are not certain of the diagnosis. The most likely diagnosis is an epithelial hamartoma and probably not malignant. "

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