—  SPECIALTY CONFERENCE  — Bone & Soft Tissue Pathology Sunday, March 21, 2010, 7:30 PM Salon 1 and Balconies Click the button above to add this event to your Itinerary Planner... Advances in the Molecular Biology of Bone and Soft Tissue Tumors Moderator: ANDREW E. ROSENBERG Massachusetts General Hospital Boston, MA 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. The speakers listed below have indicated they have nothing to disclose. Panelists: ROBERTO ANTONIO GARCIA, Mount Sinai Medical Center, New York, NY ANDREW E. HORVAI, University of California, San Francisco, San Francisco, CA VAIYAPURI P. SUMATHI, The Royal Orthopaedic Hospital NHS Trust, University of Birmingham, Birmingham, UK YONG-KOO PARK, Kyung Hee University Hospital, Seoul, South Korea JULIE FANBURG-SMITH, AIP Laboratories, Silver Spring, MD JOHN R. GOLDBLUM, Cleveland Clinic, Cleveland, OH Clinical histories are displayed below. For the fastest viewing of virtual slides, click: under each thumbnail image below. You must have Aperio ImageScope installed on your PC. If you do not already have Aperio ImageScope, Windows users with administrator privileges may download and install a free version in order to view USCAP Virtual Slides. Click the icon on the right to get your free copy:   Or, click on slide thumbnail images to view each slide in a Web-based slide viewer, which is somewhat slower. If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137. Case 1 Submitted by: Julie Fanburg-Smith - AIP Laboratories, Silver Spring, MD Clinical Summary: A twenty-four year old female presented with back pain. She was found to have a left posterior chest wall mass, primarily involving the L1 vertebra and the adjacent rib. The mass extended into soft tissue. A biopsy of the mass was performed that measured 3.5 cm (see slide). A definitive resection was performed elsewhere. Despite report that the patient received chemotherapy and radiation therapy, the patient died of disease one year later. Case 1 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 2 Submitted by: Vaiyapuri P. Sumathi - The Royal Orthopaedic Hospital NHS Trust, University of Birmingham, Birmingham, UK Clinical History: The patient is a 40 year old man who was referred to the Royal Orthopaedic Hospital for evaluation of left knee pain. The pain was present for six months but had become worse at the time of presentation. Imaging studies revealed a pathological fracture through a large lytic lesion in the distal femur. Following a biopsy the distal femur was resected. He was under close observation and 10 months following surgery he complained of left knee pain.Subsequently, 14 months following surgery he complained of chest pain and investigations revealed multiple nodules in both lung fields. One of the nodules was biopsied. 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 2 - Figure 7 Case 3 Submitted by: Andrew Horvai - University of California, San Francisco, CA Clinical Summary: A 65 year old woman with vague abdominal discomfort was found to have a 10 cm tumor of the retroperitoneum. The tumor was resected. Case 3 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer 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: Roberto Antonio Garcia - Mount Sinai Medical Center, New York, NY Clinical Summary: A 50 year old male presented with a large mass in the right iliac wing. He recently underwent right nephrectomy for renal cell carcinoma. A resection of the iliac mass 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 5 Submitted by: Yong-Koo Park - Kyung Hee University Hospital, Seoul, South Korea Clinical Summary: A 56-year-old woman presented with a 3-year history of diffuse, increasing bone pain at multiple locations. She also suffered from generalized fatigue and difficulty walking. There was a more recent history of protruding mass on her right foot sole. Laboratory data at the admission showed the following: serum phosphorus 1.1 mg/dl (normal range 2.5-4.5 mg/dl), calcium 9 mg/dl (normal range 8.2-10.8 mg/dl) and alkaline phosphatase 625 IU/l (normal range 96-254 IU/l). Urinary excretion of phosphorus was 392 mg/day and tubular reabsorption of phosphorus was markedly decreased at 59.6% (normal range 92-95%). Pelvic X-ray revealed a marked decrease in bone densities and multiple pseudogractures. Plain radiograph of the foot showed marked osteopenia and an ill-defined lobulated mass with pressure erosion of the second and third metatarsal bones. A bone biopsy was performed. Case 5 - Slide 1 Click to view with ImageScope Click to view with a Web-Based Viewer Case 5 - Figure 1 Case 5 - Figure 2 Case 5 - Figure 3 Case 5 - Figure 4 Case 5 - Figure 5 Case 5 - Figure 6 Case 5 - Figure 7 Case 5 - Figure 8 Case 6 Submitted by: John R. Goldblum - Cleveland Clinic, Cleveland, OH Clinical Summary: 12-year-old male with a 3.5-cm soft tissue mass of the left forearm. Pertinent Laboratory Data: Immunophenotype / molecular genetic findings AE1/AE3 negative Desmin focal positive CD99 focal positive EMA negative S100 protein negative SMA negative EWS FISH positive Case 6 - Figure 1 Case 6 - Figure 2 Case 6 - Figure 3 Case 6 - Figure 4 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.