SURGICAL PATH DIAGNOSIS
CLINICAL HISTORY: A case of retroperitoneal mass.
TISSUE ORIGIN:
- Retroperitoneal mass.
- Peritumoral fat.
- Psoas muscle.
GROSS DESCRIPTION:
- The specimen is received in formalin, labeled with patient's name and "retroperitoneal tumor". It consists of a well-defined encapsulated round mass measuring 13x10x7cm. Sectioning shows homogenous white whorly cut surface. A piece of fatty tissue attached the tumor measures 8x4x3cm. Tissue submitted in 12 blocks. A: inferior margin. B: medial inferior margin. C: medial posterior margin. D: anterior lateral margin. E: medial superior margin. F: lateral margin. G-J: Tumor. K-L: peritumoral fat.
- The specimen is received in formalin, labeled with patient's name and "Peritumor fat". It consists of one piece of fatty tissue measuring 8x4x1.5cm. Tissue submitted in 2 blocks.
- The specimen is received in formalin, labeled with patient's name and "psoas muscle". It consists of one piece of muscular tissue measuring 2x1x0.7cm. All submitted in one block.
DIAGNOSIS:
- RETROPERITONEAL MASS; EXCISION: Spindle cell sarcoma consistent with monophasic synovial sarcoma,grade 2 (FNCLCC). See note.
- PERITUMORAL FAT; EXCISION: Benign fatty tissue.
- PSOAS MUSCLE; BIOPSY: Benign skeletal muscle fibers.
NOTE: The tumor cells are positive for CD99 (weak to moderate), BCL2(focal) and EMA and focally positive for CK (AE1/AE3). They are negative for CD34, S100 protein, desmin, SMA, myogenin, and DOG-1. CK7 is positive in rare tumor cells.
No necrosis seen. Mitotic activity is around 7/10 HPF.
The nearest margin (anterolateral) is 0.8 mm away from tumor.