CALIFORNIA TUMOR TISSUE REGISTRY

"NEUROENDOCRINE TUMORS"

Study Cases, Subscription A

October 2006

California Tumor Tissue Registry c/o: Depa rtment of Pathology and Human Anatomy

Loma Linda University School of Medicine 11021 Campus Avenue, ~·335 Loma Linda, California 92350

(909) 558-4788 FAX: (909) 558-0188

E-mail: cttr@linkline.com

2

Tmet audienu: Practicing pathologists and pathology resident•.

Goal: To acquaint the participant with the histologic features of a variety of benign and

malignant neoplasms and tumot-tike conditions.

Objectives: The participant will be able to recognize morpbologic features of a variety of benign

and maligtUll)t neQplasms and tumor-like conditions and' relate those pn>ceSses to pertioept references in the.medicalliterature.

Educational methods and media: Review of representative glass slides with associated histories. Feedback on consensus diagnoses from participating pathologists. Listing of selected references from the medical literature.

Principal faeultv: Donald R. Chase, MD

CME Credit: Loma Linda University School of Medicine designates this continuing medical

education activity for up to 2 hours of Category I of the Physician's Recognition A ward of the American Medical Association.

CME credit is offered for the subscription year only.

Accrec!itation: Lorna Linda University School of Medicine is a<:credited by the Accreditation

Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Study Cases, October 20o6, Subscription A

Contributor: JozefKollin, M.D. Case No. 1 - October 2006 A Lakewood, CA

Tissue from: Stomach Accession #30180

Clinical Abstract: A 28 year old woman presented with symptoms of gastric outlet obstruction.

Gross Pathology: The 17 x 10 em specimen consisted of distal stomach and proximal duodenum. At the gastric

outlet was a 4.7 em round mass, elevating the mucosa, with a central hemorrhagic umbilication. There was no definite ulceration. The tumor extended through the gastric wall and abutted the serosal surface.

Special Studies: Positive: CAM 5.2, Chromogranin A, synaptophysin, CD 56, CK7, CEA Negative: CK20, CD~, gastrin, somatostatin, glucagon, insulin

Contributor: LLU Pathology Group (we) Lorna Li.nda, CA

Case No. 2 - October 2006 A

Tissue from: Pancreas Accession #30360

Clinical Abstract: A 16 year old girl was found to have a pancreatic mass.

Gross Pathology: The 1,232 gram, 17.0 x 13.5 x 8.0 cmpancreatic mass was weU circumscribed. The cut surface

was partially cystic with areas of hemorrhage and necrosis as well as solid dark-red areas.

Study Cases, October 2006, Subscription A 3

Contributor: Catherine Odell, M.D. Case No. 3 - October 2006 A Riverside, CA

Tissue from: Right neck Accession #30341

Clinical Abstract: This 37 year old woman was found to have a right neck mass.

Gross Pathology: Not available.

Contributor: Catherine Odell, M.D. Case No.4 - October 2006 A Riverside, CA

Tissue from: Right adrenal gland Accession #30343

Clinical Abstract: A 16 year old girl was found to have a right adrenal mass.

Gross Pathology: The 686 gram, 15 x 12 x 8 em adreoal was largely replaced by a well circumscribed, whorled,

lobulated, yellow-tan mass with no areas of hemorrhage or necrosis. intact adrenal cortex was seen around the periphery.

4 Study Cases, October 2006, Subscription A

Contributor: Chisa Aoyama, M.D. Case No. S - October 2006 A Sylmar,CA

Tissue from: Pancreas Accession #30JJ8

Clinical Abstract: Over a period of about a year, this 43 year old man bad been worked up for abdominal masses,

visualized by cr as being in the pancreas and left adrenal, but with inconclusive biopsies.

Gross Pathology: A composite resection of tail of pancreas and spleen included a 359 gram, 11.0 x 8.5 x 7.3 em

mass replacing the pancreatic tail. The well circumscribed mass had a variable yellow-tan necrotic and red-brown spongy cut surface.

Special Studies: Positive: Chromogranin, synaptophysin, Congo red (with polarization)

Contributor: Mary Fieber, M.D. Case No. 6 - October 2006 A Oklahoma City, OK

Tissue from: Left Adrenal Gland Accession #30443

Clinical Abstract: Following sudden onset of left lower quadrant pain, this 66 year old woman was found to have

a 5 em mass anterior to the upper pole of the left kidney. Serum cortisol and aldosterone levels were within normal limits. She had had a long history of hypertension.

Gros.~ Pathology: The specimen consisted of a 7.2 x 4.7 x 4.4 em encapsulated mass with a homogeneous pink­

tan cut surface.

Study Cases, October 2006, Subscription A 5

Contributor: M. Rose Aki.n, M.D. Case No. 7 - Odober 2006 A Fresoo,CA

Tissue from: Skin of shoulder Accession #30175

Clinical Abstract: A 71 year old woman was found to have a mass in her right shoulder, in the region of a

previous biopsy.

Gros., Pathology: The200 gram, 14.5 x 8.0 x 4.5 em specimen included an elljpse of skin with underlying

subcutaneous tissue and skeletal muscle. Cut sections show a 5.4 x 5.1 x 5.0 em lobulated fleshy tan­white tumor.

Contributor: Arthur Falk, M.D. Case No.8 - October 2006 A Simi Valley, CA

Tissue from: Right Testis Accession #23759

Clinical Abstract: Following 3 months of a fever of unknown origin, this 42 year old man was found to have an

enlarged and tender right testicle.

Gross Pathology: The cut surfuce of the testis showed a 3.5 x 2.5 x 2.3 em irregular nodular firm mass, which

was variably firm yellow to softer dark yellow-red.

6 Study Cases, October 2006, Subscription A

ConiTibutor: John Phillips, M.D. Case No. 9 - October 2006 A Fresno, CA

Tissue from: Lung Accession #24091

Cli.aiql Abstract: A 76 year old man was known to have a lung mass for 17 years. He died following an

apparently unrelated episode of gallstone pancreatitis and an autopsy was performed.

Gross Pathology: An 8 x 8 x 5 em sharply circumscribed, encapsulated mass was present in the upper portion of

the right lower lobe of lung. The cut surface was light tan and soft. There were no gross areas of necrosis.

Contributor: Robert Zucb, M.D. Case No. I 0 - October 2006 A Baldwin Park, CA

Tissue from: Right Scapula Accession #30473

Clinical Abstract: A 73 year old woman had a right shoulder mass.

Gross Pathology: The 16.0 x 16.0 x 8.5 em radical excision of scapula, proximal humerus and associated soft

tissue included a 14.2 em white rubbery tumor, which produced bony destruction.

Special Studies: Positive: CD99, EMA Negative: Keratin, CK7, CD34, desmin, chromogranin, synaptophysin, LCA, MSA

Study Cases, October 2006, Subscription A 7

CALIFORNIA TUMOR TISSUE REGISTRY

NEUROENDOCRINE PATHOLOGY

Minutes- Subscription A

October, 2006

SUGGESTED READING (Gener111 TopiC! from Recent Literature):

Sinona.w Undincrentiated Can:inoma Uas Distinct Features. Ejaz A and Wenig BM. Adv Anat Palho/2005; 12(5):134-143.

Locali7.ed Serosal Mass May Be Locali>:ed Malill"nnl MesoU>elioma. Allen TC. Cagle PT. et al. S11rg P<Itho/ 2005; 29 (7):866-873.

Incidence and Survival Rllle$ Differ Among Colorectal Carcinoma Subtypes. Knng H, 0' Connell HI, et al. Dis Colon Rectum 2005; 48 (6):1161-1168.

Grl!ding Invasive Lobular lln:ast Carcinoma Provides Important Information. Bane All., ljan S, cl al. Mod Patlrcl2005; 18(5):621-628.

Basal Cell Uypetplasia Difficult to Oi88J>OSC O<l Prostate Needle Biopsy. Hosler GA and Epstein Jl. Hum Pmhol 2005: 36(5):480-485.

California Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy

Lorna Linda University School of Medicine 11021 Campus Avenue, AH 335 Lorna Linda, Ca.lifomia 92350

(909) 558-4788 FAX: (909) 558-0 188

E-mail: ct!!@Jinklioe.com Web site & Case of the Month: www.ctlr.org

FILE DIAGNOSES

(Preferably submitted on website at W\\'W.cttr.org. Click "subscriptions", then submit answers".)

CTTR Subscription A October, 2006

Case 1: Carcinoid tumor (low grade neuroendocrine carcinoma), stomach

T-63000, M-82401

Case 2:

Case3:

Case 4:

Case 5:

Case6:

Case7:

Case 8:

Case 9:

Solid-pseudopapillary tumor, pancreas T-59000, M-03090

Paraganglioma (carotid body tumor), neck T-Y0600, M-86801

Ganglioneuroma, adrenal gland T-93000, M-94900

Pancreatic endocrine neoplasm (islet cell tumor) T-59000, M-81500

Pheochromocytoma, adrenal T-93020, M-87000

Merkel cell carcinoma (cutaneous neuroendocrine carcinoma), shoulder T-Y1220, M-80423

Carcinoid tumor, testis T -78000, M-8240 I

Carcinoid tumor, lung T-28000, M-82401

Case 10: Primitive small round cell tumor most consistent with Ewing's sarcoma/PNET, scapula and humerous

T-Il 280, M-92603

C1TR, October 2006 "Minutes" (Subsc.ription A)

Case No. 1, Accession No. 30180 October 2006

Alameda £Alameda County Medjcul Center> - Gastric carcinoid tumor R.ldwin Park IKaisq Pmnanentcl - Neuroendocrine carcinoma (4} fontana <Kaiser Pcnnancntc> · Carcinoid tumor, stomach Granada Hills - Small cell cardnoma Haywanl/Fremont . WONET (carcinoid) l.a .I!JIIa (Scrip!)$ Clinic tlema!ooAtholocy fellowshjol - Carcinoid twnor La Jollo (Scripps Health) - Gastric carcinoid Long Rroch <VA Long Beach Health System) - Neuroendocrine carcinomo Monterey fCommunity Hospital of the Monterey Ptnjn:rula) - Well-di!Jerentiated endocrine neoplasm MonJea:v Park COarficld Me4ical Center) - Carcinoid tumor Orange COrangc Countv Medical Grouo) - Carcinoid Orange Counrv (Kaiser J>qnmnentcl - Neuroendocrine tumor Orange CUniverslty of California lryjne Resjdent~) - Low gr~de neuroendocrine rumor (carcinoid rumor) Oxnard ISL John's Rceiopal Medical Center! - Carcinoid (S} Rancho Mirage CEjsenbowq Medjgl Ce!l(q\ - Ctu'Ciooid SaaamCD!o (UC !)ayjs Residents) - Carcinoid tumor San Digo CNavlll Medical Center> • Gastric neurocndocrlnc tumor (carcinoid) San Djeoo CUCSD Medigl Centql - Can:iooid Snn Frru~cjsco <San Francjsco GencrdJ Hospital) - Carcinoid San rrapcig;o aJCSF Rgjdeotsl - Gastric neuroendocrine tumor Sfnta Rosa csanra Rosa Memorial Hospital! - Ctu'Ciooid rumor (3) Woodland Hills !Kaiser PennancnLC Me41ca! Cen!erl • Wc!l-dif!Crentiated nowoen.docrine tumor (carcinoid tumor} WO!ldland Hj!ls ISuda"s SoldiCilll • Neuroendocrine neoplasm (entcrc:hromoffin-Jike cell tumor) Arlsan<a,< CUnjveaitv of Arkansas for Mc!lieat Seimces) - Ctu'Cinoid rumor. stomoc:h f lorida (Jackson Memodq! Hospjlal.l - Wcll-differc.ntiated neuroendocrine tumors Florida ID•Iah•c:w: Pathology A SW9iatesl .. WDNET/carcinoid Florida CW"m!er Haven Hospital) • MalisnMt carcinoid (2} Jllioois. Burr Ridoe • Neuroendocrine rumor Jllinois ll,ovola Universliy Medi(ipl Center> - Neuroendocrine carcinoma Jgdiana !t!oward Regional Medical Centro - Carcinoid LouisjM!\ CLouisjnna State tlnh•ersjty l-tcnlth Science Center) - Carcinoid (2) Mmvland CNort!Jwest Hospjtal Center) • Nouroe:ndoaioe tumor Marvland CUniymjw ofMwlandl - We!l-differentia!ed neuroendocrine carcinoma MIISS!!Chusct!S COO!kshire Medical Center) • Carcinoid rumor M•ssorbJ!SdtS !Tufts· New Enaland Modig l Cen!er Resjdentsl - Neuroendocrine carcinoma wcU-dinerentiatcd (alypic~tl carcinoid) Michim {Qakwoqd HomjJall • Gastric endocrine twnor Minnesota CFWryicw Ridges HosnjtulJ - Gastric neuroendocrine tumor (carcinoid) Montana, Missoula - Carcinoid tumor Nebraska (Crejghton University) · Carcinoid New Yod< /Nassau !Jnivcrsjtv Medical Ccptcrl - Carcinoid tumor, gastric New York !SUNY Downswe Rq!den!Sl • Carcinoid tumor (2) North CJI!O!ina CMoun!AiD Are!! Pnthologyl • Carcinoid rumor (3} Nor!h CQlolion ll'otbologj:us McdjCII) Laboratory) • Gastric carcinoid (1); Neuroendocrine carcinoma (I) Ohio CMcCullou!!h-Hydc Memorial Hospjta]l - Islet cell tumor/neuroendocrine Permsylvanja/Co!IC!!l8!Jflh Memorial Medical Ccntql • Ctu'Ciooid rumor Pcnnsylva.nia <Drexel Uniyersity College of Medicine) - Gastric carci_noid tumor Penosylyania (Lebjgh Valley Hospital) • Carcinoid PennsylvaniafMt Njnany Medical Center> .. Carcinoid rumor, stOmacll Pennsvlyania {))ennsvlvnnju Hospitnl Rcsjdent~l - Neuroendocrine CI.U'Cinoma Puc!!o Rico IUniyqsity ofPver!o Ricol - Wdl-dilfen:ntiated gastric endocrine neopl!151ll TI'YJ!<5. t.ybbock - Carcinoid tumor rem CMclhodjst Homitnl) • Carcinoid TCl<l!S IPmPath Sqvicesl • Carcl.noid rumor Texas ($son & White Mernoriol HospitaO • Ctu'Cinoid Wesl Vjrgioja <Greenbrier Valley Medical Centcrl - Gas• ric adenocarcinomn We!#. Vjll!jnja IWC!Z&I Coun!V Hosoita]l • Carcinoid Austn!li• (Queensland Pathology Group} • Alypical ean:iooid AUSI!ll!ia <Royal Hobart !losnital) • Neuroendocrine carcinoma stomach (type lfl cnn:inoid) Aus!Gli• £Royal Prince Alfred HO!!pitall • Carcinoid tumour AustmHo !Sullivan Nieo!Ndcs Pa!l!ologyl • Well-differentiated neuroendocrine rumor ("""'inoid)

3

Canada fPasouo Hospjlan .. Carcinoid tumor Canada fSberllmoke Unjymjtv Hosnitall - Wclklifferentiatc:d oc:uroeodocrinc rumoc (careiooid) Cmnany flnstilut fur Pathologic UKE> .. Neuroendocrine carcinoma Hogg Kong fPamclo Xoude Nethersole Enstem Hospita1) • Carcinoid tumor !a:hwd ()(erry Geneml!losOita!l • Wcll-4iffcrcntiated neurocndooine tumor (caa:inoid) Japwt CKyoto Univcrsjtv Hospital) - Cllttjnoid tumor Oaw {liamad Mc:djcnl Comorarion) • Caa:inoid tumor Saudi An!hi• (Kino fAhad National Guard HosojtaJl • Neuroendocrine tumor, benign Saudi Arabia <MCHl - Carcinoid tumor Sjogef19!!>(!(]{ Women's and Childa:o's Hospital) - Wcll-dilfermtialed endocrine neoplasm (carcinoid) The Nc!herland\ Amstclvcen - Large ecll nturoe1ldocrinc carcinoma of the stomoch Uojled Kinodom COx ford Study Group) • Stomach wall neuroendocrine caa:inom11

Case l .. DiagnosiJ: Carcinoid tumor (low grade neur·oe.nd~rine carcinoma) .. stomac.b

T -03000, M.&401

Case 1 References: Mulkeen A and Cha A. GastticCaa:inoid. Current Opinion In Oncology2005; 17(1):1-6. 13oa:h K, Ahren II, Ahlman H, c1 al. Ousttic Carcinoids. lliologic Behavior and l'rog!losis After Oiflerentiatcd Treatment in Relation to

Type. Ann Surr 2005; 242( I ):64-73. Modlin IM, Lye KD and Kidd M. A 50-Year Analysis of S62 Gastric Carcinoids. Small Tumor or Lar&cr Problem? Am J Gastroenltrol

2004; 99(1 ):23-32. Jiang SX. Mikami T, Umezawa A. ct at. Gastric Large Cell Neuroendocrine Carcinomas. A DiSiinct Clinicopatboloaie Entity. Am J

Surr Patho/2006; 30(8):945-953.

Case No. 2, Accession No. 30360

Alameda (Alameda County Medical Ccn~pt\ - Solid pscudopapillary tumor Baldwin Park <Kais!;r Pcgnanentel - Solid pseudopapillary tumor (4) fontana <Kaiser Pc(!JJ!UJcntel - Solid and pscudopapillary tumor of pancreas Gooada Hills - Cystic endocrine tumor t!oyward/Frcmont - Solid pscudopapillory tumor Lololla (ScriPPS Clinic Hema!opatholoov fellow,;hip) - Solid-pscudopapillnry tumor (pancreas) !.a Jolla (Scripps Henlthl • Solid-pseudopnpillary tumor oF the pancreas Long Beach <VA !,{)Oil Beach Hcalth Svs!cml - Solid pscudopupillary tumor Monten:v fCommupjtv Ho•pital of the Montcn:y Peninsula\ - Solid pseudopapillary tumor Monterey Parle CGBrlield Medical Ccn!crl - Solid pscudopapillnry tumor Pmn•• fOmnoe CooniV Medical Groonl - Solid pscudopapillaty rumor Omnge County fKailsr Permanentel - Solid cystic pscudopapillory tumor Omnge (University of California Irvine Resjdent:::) · Solid pscudopapillary rumor

October 2006

Oxnard (St. John's 1\cojonal Medical Ccnterl - Endocrine carcinoma, NOS (2); Endo~rioe neoplasm (2); Pancreatic endocrine neoplasm (I):

Rancho Mime <Eissnhowcr Me4ica1 Center\ - Solid pscudopapillary tumor Sarnmspto (!!C Davis Residents) - Solid pscudopapillnry rumoc San Diego <NaVAl McsHea! Center) - Medullary lh}'TOid C<~r<:inoma San Diego CUCSD Medical Ccntcr\ - Solid und cystic pseudopapillory tumor S!ID Francisco !San Eroocjsoo \.encrnl Hosojtal\ - Solid pseudopapillnry tumor San francisco CUCSF Rcsjdent<l - Solid/pseudopapillary tumor San!A Ro<:a <SantA Ro:;a Memorial Uomj!Ail - Solid pscudopapillary neoplasm (3) Wooc!lanc! Hills CKnjyr Pqm;!nente Me4ical Cep!ql - Solid-psaldopapillory rumO<

Woodland Hills !Suda's Soldiers) - Solid and pseudopapillory epithelial neoplasm Arkansas CUojyersity of Arkansas for Mcdjcal Sciences) - Solid p,;cudopapillnry tumor, pancreas f lorida !Jackson Memorial Hosoitall - Solid pscudopapillory tumor of the pancreas

4 CTTR, October 2006 "Minutes• (SubJCripcion A)

El~[idg (Talii!!JI!.<!l!l~ falboi<)Q~ A~ciat!<1) • SPPT, Solid p seudopapillary tumor of p:~ncrcas r{2) Florida(Wjmcr Haven Hospjf!!)l • Solid pseudopapillary tumo

llliniljS, Burr Ridge • Solid and pscudopapillary tumor Ulin2i3 1J..!l~gla Uoiversil~ Mll!!i!d!l C9llll!:l · Solid pseudo papillary tumor of fl'lllCtt"S

lllary tumor Jm!ianl (Howard !!~iooal M$l!!i9IJ Qg]Jili} · Solid pscudopap 101~1111! !1!!u">illll§ StAte !JoivcCiill! B~ll!th ~icn~ !&nJ!li} • Solid pseudopapillary tumOr (2)

llary tumor ldatVI!IIJd iliRI!!l":W fi!!ali!!l ~l!<r} · Solid and pseudopapi ldi!O!I!IIld (!lojverill:l: of M!!I:XIWI~) · Solid pstudopnpillary tu mor M~~lll'!<IJ.:i!ll~~bitl< Mll!!ical ~m!~!:l · Islet cell tumor ~~-~ busdts ITufts.N 'w llD&!!!!I~ Medi!O!! ~ter !l,esid~otsl Michigan IOa!swood Hospilall · Solid cysticoj)Bpillary neop

• Pseudopapillary tumor, poncn:BS lasm

Minnesota II!i!l!i£ll!: Rill~ llom il!ll • Pancreatic endocrine neoplasm Monl!!!)a. MiSijOUID · Solid cystic papillllry tumor ~B!wl>!l (QJ:~iGbiRn !.lnivmiiXl · Solid psctldopapillary tu mor ~ :Y~ llil~i!U Universil): M~i~ ~tcr} .. SoUd cystic papillary epithelial neoplasm, p.ancreas l:!~w :XR[)<; (SUNY DID~:osta!!l !l,esj~ents} . CySiic solid papill ary can:inoma (I); Solid pseud<l}1"1'illaty tumOr of the pancreas(\) No!!h Garoljna (Moun!ain Arsa Pa!hologyl • Solid pseudopapillaiy tumor (3)

No!lb Carolina (Pillhologists Medical L.abornJory} • Solid cystic papillary epithelial neoplasm (1); Pnncrcatic endocrine tumor (I) ObjQ IMcQ!IIou!!I!·H~de Memorial Hosoif!!l} • Poncn:atoblastoma PcnnsvJvanja lConernJ!ugb Mernodal Mll!!jeaJ Cen!llil · Solid pscudopapillary tumor of pancreas PciUlsylv!!!) ja iDrexel UnjversiiY College ofMcdicjnel · Solid pSC11dopnpillary tumor Pennsylvania fl&big!J Valley lfospjiall • Solid pseudopapillary tumor Pennsyiyll!li• IML Ni!IAn~ Me<lical CenfO[) • Solid psudopapillary tumor, pancreas Pennsvlvania CPeonsylyania Hosnit.al Rsridentsl - Gastri.noma Pyerto !l,jco (!loiv@IV of Puerto Rjco) • Solid cystic papillary epithelial neoplasm Texas, Lubbock • Islet cell rumor Icx~~.< IMeibodis HOSPilall • Solid pseudopapillary tumor Top s (ProPalb SCiyiW · Solid pscudopapillary tumor Texas (Scou &. White Memorial Hospita!l • Solid pseudopapillary neoplasm West Virginia ffi!SC!!bricr Valley Mooical CcDferl • Ductal pancrcotic adenocarcinoma West Yirgjnja !Wetzel Coumy BospjtaO • Solid-cystic papillary epithelial neoplasm Ausl!alia <Ouccn<lll!ld Pathology Grouol • Pancreatic endocrine can:inoma Ausii'Aiia <Rowlllobart Hospjial\ • Solid pseudopapillary neoplasm pancreas AustmJja CRowl Prince A]fisd Homitall • Solid-pscudopapillary nooplasm Austm!ia !Sullivan Nicolaides Palhology} • Solid pstudopapillary neoplasm, pancreAS Canadn IPasouo Hospi!nll • Solid cystic papillary ncoplu.m C!ll1l!da ISherb!l!C)kc.Unj>-ersitv HosniWl . Pancreatic endocdne neoplasm German~ Onstitut tur Potholoaje UK£) • Solid pscudopapillnry tumor tlong Kong Q>amela Yous!e Nethersole £1!S!e!J) Hospital! • Solid pseudopapillary tumor ofpanetcaS !rel!!!)d CKeny Geperal Hoazj!A]l • Pancreatic endocrine neoplasm lf!Pan !Kyoto \Jnj~ersity HQSPjtall • Solid-pscudopapillary neoplasm On!ar IH8JD8d Mcc!jcal Co!J!0!'8tjon} • Solid cystic papillary neoplasm of pancreas Saudi Arabia IKing fahad NoHgna! Guard Hosnita!l • Solid pseudopnpillllry Saudi ArabjaiMCW • Papilllll')' and solid epithelial ocoplasm Sjo•apore(KK Womeg'sand Children's Hosgiial) • Solid pscudopopi)lary neopiMOI lbe NeY!erlflllds. Ams!Cl~eeo · Solid pscudopapillnry tumor of the pancreas Uojted !Cin!!dom IOxfon! SIUC!y Group) • Pancreas. solid pseudopapiliary tumOr

Cpse 2 - Diaposl•: Solld-Pteudopaplllary tumor, pancreas

T -59000, M-03090

ClTR, Oc:U>bc:< 2006 "Minutes" (Subscription A) s

Case 2 - References: Notohlltll K, Hamazaki S, Tsuka)•ama C, ct al. Solid-Pseudopapilhuy Tumor of th~ Pancreas. lmmunohiotoohcmical Locali281ion of

Neuroendocrine Marlcers and COIOI Am J ofSurg Patho/2000; 24(10):1361-1371. Klimslr.l OS. Wet1ig BM and HeiT= CS. Solid-Pseudopapillary Tumor of the Pancreas. A Typically Cystic Carcinoma of Low

Malignant Polential. &m in Diagnostic Patho/2000; 17( I ):66-80. Soo HE, Lee MK Lee YO, ct aL Solid-Pscudopapillary Tumor of the Pancreas. J Clin Gasrroentero/2006; 40(10):919-m. Geers C, Piorre M, Jean-Francais 0, ct uJ. Solid and Pseudopnpillary Tumor of the Pancreas. Review and New Insight< into

Plllhogcncsis. AmJ Surg l'otho/ 2006; 30(10):1243-1249. Prankcl WL. Update on Pwtcrcatic llndoerlne Tumors. Arch Patlwl Lob M•d2006; 130(7):963·966.

Case No. 3, A~on No. 30341

Alameda IAI&meda County Medical Cmtql • Extra adrenal paraganglioma Qaldwjn Pi!!k<Kaiscr Permanentel- Porapng!ioma(4) • Fon!Wl• /Kaiser Permancntc\ - ParagangJiomn, neck Qrunado Hills - MetaStatic neuroendocrine tumor Huywnrd/fn:mont - Paragnnglioma I.a lolln (Scripps Clinic Hcmatopatholony fellowship) - Parngnnglioma (carotid body tumor) La Jolla <Scripps Health! - Carotid body tumor Lon• lkach IVA Long &ac!J liealtb SY'1cml - Paraganglioma Mooterev <Community Hospital of the Montercv Peninsula} - Paraganglioma (carotid body tumor) Montmy Parle. (Garfield Medical Cmterl - P8111g811glioma Qranoe lOnw!!C County Medical G!l)Unl - Panlgallglioma Orange County IKaisq Pennancntel - Porapnglioma Orange CUojygsjty ofCalifomia lrvjne Resjdentsl - Paraganglioma Oxnard !St. JoM's Regjonal Medical Center) - Paraganglioma (5) Rnnebg Mirage <Eisenhower Medjcn! <&ntcr\ - Carotid body tumor Saommento !llC Davis Residents\ - Carotid body twnor Snn p!ego !Naval Medical C.:ntcr\ - llxlnl·adrcnal paraganglioma San p!ggp CUCSP Me4ica1 Center! - Paro,ganglioma Son fnancisoo (San Francisco Genemll lgsnitall - Paraganglioma San fnancjS9Q !!JCSP Residents) - Paraganglioma (carotid body tumor) Santa RoM !Santa Rosa Memorial Homjtoll - Parapnglioma (3) Wooc!land Hills fKaisc:r Perrnaneme Me4ical Center) - Paraganglioma Wooc!land Hills (Soda's Soldiers) - l'aragllnglioma Attngas Nojversity of Atbnsas for Medical Sciences) .. Carotid body pwagangJioma. neck florida «""'w• Memorial Hosoita!l - l'anlgMglioma Flgrida ITallahassee Pathology A<soclatesl - Medullary carciJioma Florida (Wjnter I Iaven ~lospital\ - Purua:mglioma (2) ll!inois. Burr Ridge - Paraganglioma (chemodeC1orna) llljnois !Loyola University McdiClll Center\ - Puragunglioma !ndjunn Woward Regional Medical Ctntcrl - Mucoepidermoid carcinoma L9ujsiana CLoujsjana Slate University I lg!lth Scjence C£nter\ - ParagMglioma (2) Mnrvland !Northwest Hospital Center) - l'araganglioma M!!.!YI!!Qd (Uojvrnit:v ofMarvlandl - Pllt8gMglioma Ma.<HCbusctts fBet!<shire Me4ica! Center) - ~angtioma

October2006

Mn•h•JSct!S ITufts-New Eooland Me4ica! Cmta Rcsjden!sl - Paraganglioma (rule out mctaswic medullary thyroid carciooma) MichiSM (Qalc!rood Hosoitltl\ - Paraaan&Jioma Minneota (faiMew Ridges Homiqll - Paraganglioma MOQIMRs Missoula - Paraganglioma NcbrP!!kn (Creighton University\ - Carotid body paraganglioma New york CNassau University McdjcW Ceoterl - Carotid body tuntor New Yor!c I SUNY DownSlatc Residents) • Medullary careioomu (I); PamgW1glioma (I) North Carolina (Mountain Area Palholonyl • Paraganglioma (I); Insular ClltCinoma, rule out medullary carcinoma (I); Neuroendocrine

carcinoma, medullary thyroid vs.? {I) North Carolina (psthologisJs Medical Laboratory\ - Carotid body neurofibroma (2) Objo CMcCullough·Hydc Mcmorjal Hosritall - Carotid body tumor Pennsylyania CConqna.ugh Memorial Modjcpl Centql - Paraganglioma

6

Psnnsv!wnjo (J)mcel UnivrnilV Co!!e•e of Mc<licine) - Paroganglioma Pcnnsvlvaola !lehigh valley Hosoltnll - Chemodectoma Pennsylvanja {Mt Niluuw Medical Cenler) • Paraganglioma (carotid body tumor), right neck Pennsylvania !Pcnnsylyania H(!SJ!j!al Residents) - Paraganglioma Puerto Ri(l) !University ofPug!o Rjcol - Carotid body rumor Tex!),'\, Lubboc!c - p.,gallglioma Texas {Mc~todist Hosojtall - P""'8an&lioma Texas IProl'lllh Services) - ParagMglioma Jew fSeon & l'ihitc Mqnorial Hospjtall - Paraganglioma West Vircinja IGn;enbrjer Yalley Medical Center) - Carotid body tumor Wt.-,1 Viroioja!Wetzel Countv Hosnitall - Paraganglioma Au<tr!lia COyeensland Plllhofogy Oroypl - Malignant peripheral nerve sheath tumor Au<tr!lia !Rova! Hpb!!n Hosoitall - Pan~ganglioma

Australia CRoyal Prin"' Alfred Hospjtal) - Paraganglioma Australia !SuWvao Njeolajdes Patho!ocvl • Paraganglioma (carotid.body tumor) Cl!l!!da (Pa.<guo Hospital! - Paraganglioma <;pdll !Shqbroolce !Jnjvrnity Hospital! - l'anlganglioma Gmnany Uns!itut fur Pa!holooie VKEl - P&n~ganglioma Jlong Kogg Q>amela Youde Nethe[§Qlc Eastern Hospital) - Paragnogliot!'a Jrei!IQd (Kcrrv General Hgsojtal) - Paraganglioma (chemodectoma) loran CKysuo Univeairv Hospilllll - Paraganglioma (glomus jugularc tum<><) Oatar CHamad Medical Comonllionl - Paraganglioma SD!Jdi Arabja CKjng F!!had National Guard Ho;;pitall • PnnJganglioma Saudi Arabia (MCHl - Paraganglioma Sjngaoore ()(K Women'• and Cbildn:n's HO!!pitall - Paraganglioma The Ne!hedonds Atnstelyeen • Pnmgang!iomo of the bead and neck l!nited Kinadom <Oxfor<l Study Group) - Paragaogliomn (carojid body tumor)

em 3 Diagnosis: Paraganglioma (carotid body tumor), ntc:k

T-Y0600, M~l

Ca~ 3 • References: Elder EE. Elder G and Larsson C. Phoochromocytoma and Functional ParogllJlglioma Syndrome. No longer the 10'/o Tumor. J ofSurg

Onco/2005; 18(1):193-201.

Dahia PL. Evotving Conecpls in Pbeocbromocytoma and ParagangliOOllL Cllffl!nl Opinion in Oncology 2006; 18( l ): 1-8. Plaza JA, Wakely PE Jr .. Moran C, et al. Sclerosing Pan~ganglioma. Report of 19 Cases of an Unusual Variant of Neuroendocrine

1\J.morThat May Be MiSUlken for an Aggressive Malignant Neoplasm. Am J ojSurg Patho/2006; 30(1):7-12.

Douwes Dekker PB, Kulpers-Kijkshoom NJ, Baelde liJ, cl aL Basic Fibroblast GroWill Factor and Fibroblastic Growth Foetor Receptor­! May Contnlxtte to Read and Neck Paraganglioma Development by an Autocrine or Pll!l!crine Mechanism. Hum /'athol 2006: (8).

Atefi S, Nikeghbalian S. Yarmohommadl H, et al. Surgical Manngemeot of Carotid Body Tumours. A 24-Year Surgical Experience. ANZJ Surg2006; 76(4):214-217.

Case No, 4, Accession No. 30343

Alamedl! !Ahncc!a Coynty Me<lical Center) - Ganglioneuroma Baldwin Park (Kaiser Psnnanente) - Ganglioneuroma (4) fonlllna CKnjser l'ermanentel - Ounglioneuroma, adrennl gland Granada UWs - Ganglioneuroma Hamydifn;mont - Gangliooeuroma, matunl l3 Jolla CScdpp~ Clinic Hsmarop;nhologv FsllowshiD) - Ganglioneuroma l.u Jolla CScdpps Heal !h) - Ganglloncuroblastoma J.ong Beach CVA Long Beach HcaUh System) - Ganglioneuroma Monterey (Community Hospital o(Jhe Monterey Peninst!a> ~ Ganglioneuroma Monterey Park <Garfield Medical Center} - Ganglioneuroma Orange COnwge County Medical Group> - Oanglioneuroma OrangeCoynw CKaiscr Permancnlel - Ganglioneuroma

CITR. October 2006 • Minutes" (Substdption A)

October 2006

7

Orange (llniYcrsily of California Irvine ResidentS) · Ganglioneuroma Oxnard 1St John's Re!!jonal Medical Ccnterl - Ganglioneuroma (S) Rancho Mjrnge !Ei:;enhowcr Medicn! Center) - GangHoneuroma Sacramento <UC Davis R,~sidentsl - Ganglioneuroma San Dieao !Naval Medical Center\ - Ganglioncurom• San Dieao C\JCSD Medjcal Center) - Ganglioneoroma San frpneisco (San fl'llllCisco Geneml tlosoital\ - Ganglioglioma San Francjsco flJCSF Resjdentsl - Ganglioneuroma Santa Rosa (S!l!llll Rosa Memorial !ipsnilaJl - Ganglioneuroma (3) W09dland Hills {Kal:;er Pcnnanontc Medical Cen!erl - Ganglioneuroma Woodland Hills (Suda's Soldiers\ - Ganglioneuroma ArJsansas <Universjty of Arl<mlsas for Medical Scimccsl - Ganglioneuroma. ad~al gland Florida U!Wkson Memodnl Hospital) - Ganglioneuroma Ftorida O:n11nha~ce Pathology Assocjotesl · Ganglioneuroma Florida (Winter Haven Hospital\ - Ganglioneuroma (2) Olinois, Bwr Ridge - Ganglioneuroma Illinois !Lovola Univmity Medical Ccpterl - GonaJionewoma Indiana !Hom Reeional Medical Ccptcrl - (Piexifono) neurofibroma LouisjQOp CLouisjaon State (Jniversicy liealth Science Center) 4 ·Ganglioncuromn (2) Marvhmd <Northwest HospilAI Center) · Ganglioneuroma Mmland CUnrversjty of Marvlaodl - Ganglioneuroma Ma<SOcl!usct!S <Bq!cshjrc Medical Ceot..-1 - Ganglioneuroma Ma•5!fb!J5ctts (Thfls.New England Me<lical Center Re:;idcntsl - Ganglioneuroma, adrenal Michigan (Oakwood Ho•'!lilnll - Ganglioneuroma Minnesotp (fajryiew Ridges Rosnjtall · Ganglioneuroma MonJMa. Missoula- Ganglioneuroma Ncb!l!S!sa !Creigl!ton Uojyersirvl - Ganglioneuroma New York fNespn UnjvcOOty Medigl Ca~terl - GWlglioneuroma. adrc:nal New York ISUNX P!lwostale ResjdeQJS} - Ganglioneuroma, ma!\lre (2) North Carolina <Mountain Area Pathology) - Gan&JiODCW'Oma (3) North Corolina (Patho!ogjsl• Medical l.nboratorvl - Adrenal neurofibroma (I); Ganglioneuroma (I) Ohio <McCuiJough-Hyde Mcmorjol!iosoita!l - Ganglioneuroma PenosyiYMia IConemaJIGh Memorial Medical CeD(et) - Ganglioneuroma PcnnsylvMi• CDrexel Upjyersitv College of Medicine} - Ganglioneuroma l'ennsy!yanja ILebich valley Hosnitall - Ganglioneuroma PennsyiVJnia CML Njt!a!ly Medical Center) - Ganglioneuroma, ad~al gland PennsylvNJjo CPc:nnsvlvMja Hosnital Rsidentsl .. Neurofibroma Puerto Rico CUnfversity of Pueno Rjco) - Gaog1ioneuroma Texas. Lubbock - Gan&lioncuroma Tcxa.• {Mefhodist Hosnj!Ail - Ganglioneuroma Texas IProPath Services) - MalUre ganglioneuroma Texas !Scou & Wbiu: Memoria) Hospitall - Ganglioneuroma West Vlroinia !Grecnbder Valley Me<lical Center) - Pnmary adrenal neurofibroma West VjrgioiaOVetzc! Coynty Hosnjtnll - Ganglioneuroma Australia IOucensland P!lthology Groynl - NeuroObroma Ausl!ll!jo <Royal Hobart I lospitall • Ganglioneuroma, adrcnaJ Australia !Royal Prince Allied Rosnita!l • Gangliooeuroroa Ausrralia !Sulliyan Njcplaidcs PJ!hologyl - Ganglioneuroma Canoda IPasquo R!lSflitall - Ganglioneuroma Canodll !Sherhrookc Uojycrsity Hospitqll - Ganslioncuroma Gennany CloSJifUt fur Patho!ogje IIKEl - Ganglioneuroma Hong KooofPamela Youcle Ne!hersols Eastern HMpitall - Ganglioneuroma Ireland !Kmy Gcocmli'IMpitall - Ganglioneuroma Janan CKyoto University Hospitall . Ganglioneuroma Oarar 11-!omad Medical Comomtlopl - Ganglioneuroma Saudi Arabia <King Faba4 National GuJll'd Hospital) - Ganglioneuroma Sfndi Ar!bia (MCHJ - Ganglioneuroma Sin!!l!!!!!re CKK Womtn's and Childn:n '• .. ospita!l - Ganglioneuroma The Netherlands, Amslclvcen - Ganglioneuroma of the adrenal gland United Kjngdom COxford Study Grounl - Adrenal, ganglioneuroma

8 CTIR, October 200<1 "Minutes" (SubscriJ>tion A)

Case 4- Diagnosis: Ganglioneuroma, adrenal gland

T-93000, M-94900

case 4- References: Domanski HA. Fine-Ne<:dlc Aspiration of Ganglioneuroma. Diog C)>topatlwl200S; 32{6):363-366. Merchant Stl, Hcnnan CM, Amin MB, ct al. M)'<'lolipoma Assoeiated with Adn:nal Ganglioneuroma. Arch ofPathol & Lob Med 2002;

126{6):736-737. Zogmfos GN, Mari<ou A. Agcli C. et al. Laparoscopic Surgery for Adrenal Tumors. A Rclrospccti\·e Analysis. llormone. 2006;

S(I):S2-S6. Stasik CN, Giordano TJ and Gauger PO. Ganglioneuroma Manifcstiug os on lncidenllll Adrenal Moss in WI Adult wilh Turner's

Syndrome. Endocr Pracr200S; 11(6):382-384. Lora MS, Waguespack SG, Molcy JF, ct aJ. Adrenal Ganglionewomas in Children wilh Multiple Endocrine Neoplasia Type 2. A

Repon of Two Cases. J Ciin Endocrinol Metab 200S; 90(7):43834387.

Case No. 5, Accession No. 30118 October 2006

Alameda {Aiame!ln Coynty McsHea! Ccn1crl - lnsulinoma Baldwin Pans (Kaiser Pemianentel - lslel cell rumor with amyloid (4) Fon!al!a (})niser Pqmanentel - Islet cell tumor, pancreas Granada liills - Porusanglioma Hayward!Fn;mont - PWlcrcallc neurocndocrine·1umor with utnyloid stroma La Jolla !Scripps C(iojc H!'!!11!l!l!!l!!logy fcllowshjp) - Pw:rcalie endocrine neoplasm with amyloid deposition, fuvor insuliooma La Jolla !Scripps tlcal!h) - Pancreatic endocrine neoplasm (favor insulinoma) Lone Beach IV A Lon• Beach Health System) - Islet ccllmmor consistent with lnsulinoma Monterey !Communily Hospjtol of the Monterey Peninsula) - lslcl cell tumor (amyloid sugscstS insulinoma) Monterey Park <Garfield Medjcal Center) - Carcinoid consistent v.ith amyloid Onmoe <Oranse Coynty Medjcnl C'.roup) - Islet ce)llUmor Onmge County fKai:;q Penyncnte) - Neuroendocrine twnOr? isld cell Onmge Wni.vcrsity gfCaljfomja Irvine Rcsidenlc;) - Pancreatic endocrine tumor with amyloid Oxnard !St. John's Rcgjona! Medjcal Ccpter\ - Poorly differentiated endocrine carcinoma (2); Endocrine carcinoma (2); Pancreatic

endocrinenooplasm (I) Rancho Mjrage (Eisenhower Medical Center) - Pnncrcatieendocrine tumor Saqa.mcnto OJC DAvjs ResidcnLc;) - Pancreatic neuroendocrine tumor San Diego lNava! Medical Center) - !nsulinoma

San Diego <UCSD Medical Center> - Pancn:atic neuroendocrioc tumor San Francjsco (San Frnncisco General Hospital) - Islet cell rumor Son fn!nciscoliJCSE Residcn!S) - Panereatic neuroendocrine neoplasm (insulinoma) Sanm Rm (Santa Rosa Memorjal Hosojtall - Pancreatic islet cell tumor with amyloid (3) WMdland Hills (Kaiser Perrognepte Medical Center) - Endocrine tumor with amyloid Wood!!!Jd Hills ISuda's So!djt!$) - Pancreatic endocrine neoplasm (insulinoma) Mansas OJniver:;jty of Ar!sansas for Medical Sciences) - l'ancreatic neuroendocrine tumor with amyloid deposition florida !li!Ckson Memorial Hosoitall - Islet cell tumor with runyloid deposition florida IIaJlah•w:e Palhology Assocji!!CS) - MeduUill}' carcinoma florida !Wjntcr Hayen Hosoitall - Pancreatic endocrine cell neoplasm (2) Illinois, BurrRjdge - Neuroendocrioe tumor with amyloid deposit !11inois ILowla Unjymity Moclical <&mcrl - Pancreatic newoc:odocrinc neoplasm with amyloidosis Indiana ftloward Regional Medical CC!I!trl - Carcinoid with amyloid Louisiann ILouisi!IQn State University Health Science Center) - Islet ~II tumor ( 1 ); Carcinoid (Vipoma) (I) Men1nnd CNonbwcsJ jlospi!AI Center) - Neuroendocrine tumor with massive amyloid Marvland !University ofMarvlandl - Well·diffcrentiatcd neuroendocrine lUmOr, law grade malignant (insulinoma)

9

Mas:;achusetts IBerlssbire McdicsJ Cepterl • Islet cell tumor. probable isulinoma MeWfhusetts !Tuft.t.New England Medical Center Residen!$) • Pll!l<Ralic endocrine tumor, non-functiooal (WHO) Michigan COal;wood Hospjtall • Panm:atic endocrine tumOr Mjnocsota CFairvjew Ridges Hospjm!l • Amyloidoma!NE1' Montana. MjSSQylg - Insulinoma Nebraska CCreiohton Univcmtvl • Islet cell tumor of pancreas New York CNapu Unjvcrsitv Modieal Center> - Endocrine twnor with amyloid deposit New York CSUNY Oownstatc Residents) • Endocrine neoplasm, insulinoma ( I); Pancreatic endocrine tumor rule out medullary thyroid

cateinoma (I) Npr!h Carolina (Mountain Area Pathology) • Pancreatic endocrine tumor (2); Pancreatic endocrine tumor, possible insulinoma ( I) North Carolina !J>nthologi§!S Medical L.abnratoryl • Pancn:utic endocrine tumor curcinama/insulinoma (2) Ohio (McCullpysh·tiydc Mcrnotialllospila!\ · Islet cell tumor with stroma! amyloid deposits Pcnnsvlvanja CCnncrnaugh Memorial Medical Center) • Neuroendocrine (islet cell) tumor with amyloid deposition Pennsylvania <Drexel UnivetSilY Coline ofM!!Iicine\ • lnsulinoma Pennsylvania() .ebjsb Yalley Hosoj!Ail • Islet cell neoplasm PcnnsylVJ!!1i• !ML Ninany Medical Ccptcrl . Islet cell IUII)or (pancreatic endocrine ncopla.o;m) with islet amyloid polypeptide (I

APP) Pennsylvania O)ennsyJyania Hosoital Residents) - lnsuHnoma Puerto Rico <Unjymjty of Puerto Rjeol - Pancreatic endocrine neoplasm Tws Lubbock - Islet cell tumor Texas fMe!hndiSJ Hcw>jhlll • Islet cell tumor Tcl!l!S <PmPath Scrncc.•l . Neuroendocrine (islet cell) tumor Texas <Scon & White Memorial Hospjtall - Pancreatic neuroendocrine tumor West Virginia !Greenbrier Valley Modisnl Center} · Amyloid in a well-diffcn:ntiuted pancreatic endocrine curcinomu West Vinrinia !Weq.eJ Countv HospilaJ> - Endocrine neoplasm Australia <Ouccnslond Pathology Groyo\ • WcU-diJferentiated endocrine care! noma-trabecular varicnt Austrnlia CRoval Hobart ~lospita!l • Pancreatic endocrine neoplasm with extensive amyloid deposition Ausl!alia CRoynl Prince Alfred Hospilllll • Pancreatic endocrine neoplasm. favor insulinoma Australia !Sullivan Nicolaides Patho!oavJ • Amyloidosis os:;ociutcd wilh a pnncreatic: endocrine neoplasm C!!n8da (Pa.wuo Hosojl!!]\ • Pancreatic endocrine neoplasm probable insulinomu CAnada <Shcrbmokc Unjversitv-Hosoitoll - Pancreatic endocrine neoplasm. insulinoma Ocnnanv Onstirut fur PAtholooie UK£) · Neuroendocrine carcinoma Hopg Kong fPamsla youde Nethersole fe:ilm:n Hosoitall • Pancreatic endocrine rumor, insulinoma lo;IWJd (Keny Gcnml Hospital) • Neuroendocrine neoplasm of uncertain histogenesis lt•PW! (Kyoto UnjvcQjtv Hosnila!l • Islet cell tumor with amyloid deposit Oatar CHama4 Medjca! Comoration) • l'llnc.reatic endocrine neoplasm, insulinornu Saudi Arabia (King fahad Natiooal Gunrd Hospita!l • Islet cell wmor of panere:'IS (insulinoma) Saudj A!l!bia(MCHl • Islet cell rumor (insulinoma) Singapore !KK Women's and Childn;n's Hospjla!l • Wcll-difT=ntiated pancreatic endocrine rumor (insulinoma) '!be NelheriWJd'i. Awte!ycep · Pancreatic t:ndocrine neoplasm with amyloidosis United Kinodom !Oxford Swdy Groun\ • PancresJic endocrine nooplasrn (in.wlinoma)

Case 5 ·Diagnosis: Panertatie endocrine neoplasm (Islet cell rumor) DiicctoTS Not.e: Some slides showed amyloid stroma. (dre)

T ..59000, M-31500

Case 5 · .References; House MG and Schu!icl<RD. Endocrine Twnors of the Poncrcus. Curr Opin 2006; '18(1):23·29. Cbctly Rand Asa SL. DucWies in l'oncreatic Neuroendoo'Tine Tumo.rs. Am J Surg Patho/ 2003; 27(4):46 I -468. llrcn\iCilS R and Saltz L. Islet Gel! Tumors of the Pancreas. '!be MedicsJ Oncologist's Pe<speaivc. Surg Oin of NOI'th A mer 2001 ;

81 (3):527-$42. Azimuddin K and Cb!llllberlain RS. The Surgical Man&&cment of Pancreatic Neuroendocrine 1'umoTS. Surg Clin of North A mer 200 I;

81 (3):511-SlS Frankel WI... Update on Pancreatic Endocrine Tumors. Arch Patho/ Lab Med2006; 130(7):963·%6.

10 C1TR, October 2006 "Minuocs• (Subscription A)

'--

Case No. 6, Accession No. 30443

Al&m!:!la Cg~ntx M~ical Q~nter) • Pheochromocytoma Baldli]n P!!!k {Kai8;[ Pm~~Q!!ente} • Phcocbromocytoma ( 4) Eoo!Bna (Kaisq l'ennll!ltmtc} · Pheochromocytoma, adrcoa I gland Gtwd!! Hills • Oncocytoma Ha\•ward/Frcmont • Phcochro.mocytomn 1&12111 (£gjQJ2S CliDiSC: HemB12nmbSllogx ~JlOW1biO) · Ph eoclu·omoc)1oma Lalolla !Sc;rjpps Health) - PheochromOCytOma ~g Jlcacb CiA !.&Dg ~!l!<h Hc~llb S~s!~l!l} • Pheocbrom ocytoma M2!!Uasx (Cgmmunifl: Hmilll of 1~ Msml~ J!mjn.'\yll) - Pheochromocytoma Mlllll~~ 1.!11!11 {Gw:ficld M!l!!i!a!l!:;,nt..-} • Pheocllromocyt oma

oma 9!lm8• {O!!lll~e !&YD!:I! Mgjjjcal Qmup} • Pheochromocyt Qmn" CounlX £K.Ai~£C Peananenl£l - Phcocbromocytoma Qm!ls" (JJnix~rsiD:: g(~Blifc,u:nia lo:in~ B'~ideoW - Phcoc hromocytoma

ocytoma(S) mocytoma

Oxnard ~. lobo's Bai!!!lll Medial !&n~l • Pheocbrom Ran£b!l Mirna~ f!li:s~how~ Medi~!ll Cmlm:J • Pheochro Sactameoto Cl.IC !LA~i~ B~i~~nL•l · Plleochromocytomo S!l!! Qi~o !l:laval M!l!!ical Q~nter} · PlleochromocytOma S!!ll lli!l!l!! (ll!::SD Medical !:;cnte[) • Pheochromo91omn San El!!!c~ {San Francl~ ~n~IJII H~oital} • Phcoc hromocytoma S!!!! Ellll!ci!!S!! (Jg;;sf Besislsn~l • Pbeoc:hromocytomn llinll Roa (S:i!!!la Bosa Mm~ori~ll:loa~iloll · Phoochrom ocytoma (3) W!l!!!lll!!!! !:Iii I~ !K!ili!i!: Pennanen~S; Medical Cenl&!) • Ph eocllromocytoma IVoodll!l!d Hill~ (Su~~·~ SpJdj,rs) • Pheochromocytoma Albrum !Poiv~it~ o[Ar.kAo~s fQr M"i~ S!(jg]ces) - Pheochromocytoma, adrenal g!antl FIQ[i!l~ (la~~~n MmJoria! tJomilllll • P11eocllromocytoma Fl2!)!1l {Tall&bas!!!;2 eatho12&X Associates} • Phoochromoc ytoma Florida Cllfl!l!5t H••SIIIi!!S!i!ID • Pbeochtomocytoma (2) Jl!jooj:L Burr Bidge • Pheochromocytoma ll!in2il1Lovola Unj~rsi!X Medico! !,;;ent~c) • Phcochromo cytoma

uroma lndi!llla Q:!ol:!ill!l R~aigoa1M!:!li911 !:&ntsr} - Gangtionc k2YJliana U~guiSiWlA Smt, Llniyzitt H~BIJ.h S~jgJce ~~Qtc r) - Phcochtomcytoma (2)

ma ~!m!and INortbwest H!!a!il!! !&IJJer} • Pheocllromocyto Marvlll!!d illDi~""iiX pfM~!an!i) • Pheochromocytoma M--!iih~ (Bertc~i~ Modi£11 Cent~) - Pheochromoc ytoma Mi!ISI!<huseas (!:ufi.'i-Ncw Jln!!!l!nd M!<!!~l !&Dr~ R~id entol • Pheochromocytoma. adrenal Micbiaan (Q~oud l>lospiUlll • Pheochromocytoma ~iinn~a (fairview Bislsg Hs»:RiJal) - Pheochromocyto ma Monhlna. Mi!!S()ula • Pheochromocytoma ~[lsl:a (CmigbJQq Univ!:C:!ilY} .. Pheochromocytoma ~ Xork w•~oc.~sn, JJnivcrsilX Mgli~ r&DIW . Pheocbromocytoma !lew ::lork {~lmY J:!gwnmn~ Besid~otsl • Phcocbromo cytOmn (2) l:!!!l!b ~lioa !M!!II!!IIDD {lrca fAII!olggx} • Phcochrom No!liJ !:;atolioa ~a!hglogi~~ Medi~JII Lal!!!mm!J!l • Pheo<:

ocytoma (3) hromocytoma (2) pheochromocytoma eocltromoc:ytoma

beochromocytoma ma

ObiQ (McCu!loul!!!·tlxdc M12!!2ri!!ll!osRi!l!ll • Malign""t PennsYlvania tConcmJJ•ab MG!!!2!HI Medial ~tgl · Ph ~nnlvDQil a2~!QI Uninrsill! CQII~ g[M!:!Sii~ine} - P Pmnl):lvania (LehiJih Vall~ l:!oa~i!l!ll • 1'1\eochromocylo ~~nn~Jvania {ML tlilll!!l~ Mrni>W C~!S[) · Atl=ocotti cal carcinoma

omocytomn ma

PmUJ~Iv!llliA (Peno:;xlvaala Hosnlll!J R~iidcntsl • Phcochr Pueno Ri!!! Cllniver.!i!X o[Puerto Biw • Pbeochromocyto Texa<, l,uhhgck • Pheocllromocytoma Texas fM<:!bodis! Hosoital) • Pbcochromocytoma Texas CProPn!h Services) • AdreMI pheochromocytoma T~ (Scot!£ Whj!Q M•mpri~l !:lo~'J!ital} . Phcochromoc ytoma

cocllromocytoma W~ Vi!gjaiA {G~bri13: Val!s;x l!:i!l!!iCIII ~IW · Ph w~ YiWnim {We!Z&I Cguan: Homitall • Cortical adeno rna Australia (Qyeensi!!D!I P!!!!l!!locv Qm!!ll) • J'heochromocy tom• A•!!!llil (Rgl:ll Hglz!!! l:l!m!i!J!} • Pheochromocytoma Au$l(alia !Royal Prince Alfred Hosoitall • PhcochromQcyt orna

CITR. Oetob<r2006 "Minutes" (Subscription A)

October 2006

II

Au;;!!Jllia ISu!!iyan Njcolaides Pl\hology) - Pheochromocytoma Canada (pnsauo Hospital! - Pheochromocytoma Cana!la ISherbrooke University UospjtaJ) • Pheochromocyloma 0•-nnanv (!n.stltut fur Parhotosje UKill - Pheochromocytoma Bong Kong Cl'll!Dela YoudeNethersole Eastern Ho•pitall - Pheochromocytoma Ireland (J(eny General Hosoitall - PhoochromOC)'IOma Japan O<vo1o Univqs:itv Hosoitall - Pheochromocytoma Oatl!r IHMW! Medical Corpoooionl - Pheochromocytoma Saudi Ambiq <Kin• Fahad Nationnl Guard Hosgiln!l - Pheochromocytoma Saudi Ambia {MCHl - Pheochromocytoma Singapore (J(K Women's and Children's Hosnitall - Pheochromocytoma The Nethalands. Amstelveeo • Pheochromocytoma of lhc adrenal gland United Kingdom <Oxford S!!!dv Groupl - Adrenal phoochromocytoma

CPse 6- Olagno~is: Pheochromocytoma, adren11

T-93010, M-87000

Case 6 - References: Amar l , Bertherat J, BIUidin E, ct Ill. Genetic Tc>1ing in Pheochromocytoma or Functional Garaganglioma. J of Clin Onco/ 2005;

23(34):88 12·8818. Kimura N, Watenahc T, Noshiro T, ct al. Histological Grading of Adrenal end )lxtra-adrcnal Pheochromocytomas wtd Relationship to

Prognosis. A Clinicopathological Analysis of 116 Adrenal PheochromOCytOmas and 30 Extnh'ldrcnal Sympathelic Parttpngliomas Including 38 Malignant Tumors. Endoc Patho/ 2005; 16{1):23-32.

Amar l and Servais A. Gimenez·Roqueplo AP, ct al. Year of Diagnosis. Fearures al Presentation, and Risk of Recurrence in Patients with Pheochromocytoma or Secreting Pnras;mglioma. J o/Ciitl Endoc & Metab 2005; 90{4):2110-211 6.

Yeo H and Romnn S. Pheochromocytoma and Functional Plli!Ignns lioma. C11r Opio ln Onco/200$; 17(1):13-18. Magill SB, Fritsche CM, Klin&er DE, et a!. Evolution of a Pheochromocytoma. Endocr /'ract 2006; 12(5):545·55 I.

Case No. 7, Accession No. 30175 October 2006

Nameda CountY Medical Centql - Merkel cell carcinoma Baldwjn Parlr; <Kaiser Permanentc) - Merkel cell..ucinoma vs. melastalic small oell con:inoma (2); Merkel ccll tumQ( (2) Fonllma (J(uisr Permancntel • Mericclcclllumor Gmno4n Hills • Meticel cell carcinoma Hayw!ICdlfn:monl - Merkel cell carcinoma l..a Jolla ISedoo• Clinic Hemroonathologv Fel!owsbiol - Merkel cell carcinoma (S): J>rimitivc neuroectodermal rumor (PNET) (2) bong Beach IV A bon• """'k Health Svsteml - Merkel cell carcinoma Monterey (CommunilyHosoiW of lhe Monterey Peninsula) - Merkel ccU carcinoma Monterey Park CGarfield Medical Center) · Neuroendocrine carcinoma Onwge 10ran&e County Medical Grouo) - Merkel cell cardnom• Orange County <Knjser Pennanentcl - Merkel's Orange (tJnjversity of California Jrvine ResjdenL'\ .. McrkeJ's cell carcinoma Oxnard 1St John's Regional M<dica! Center) • Merkel cell rumor (5) ll!lncbo Mirage illjSC!!hower MC!Iical Cenn:rl - Small blue round cell IUJJlOr, filvO< lymphoma Sacramento rue Davis ResidcDJsl - Merkel cell carcinoma SW! Diego INoyal Medical Center\ • Merkel cell carcinoma San Diego <UCSI) Medical Center) .. Poorly differentiated neuroendocrine carcinoma San Francisco <San Fmncisco Oencral Hospital\ • Merkel cell rumor San FranCisco fUCSP Residents) - Merkel cell can:inoma Santa Rosa <Santa Rosa Memorial Hospital) • Merkel cell carcinoma (3) WOO<!I!!nd tlillz CKaiser PermMCIJtc Medjcnl Center) - Merkel cell carcinoma vs. metastatic small cell carcinoma Woodland Hills ISuda's SoldlcJl!l - !'oorly dif!Crentiatcd mali(lllRnl neoplasm (Merkel) Arkansas CUnjyersity of·Arkan.'S',~ for Medical Scjeoc.esl 4 Ncuroendocl'inecarcinomu, recurrent, cutaneous vs. metastatic., shoulder florida ()ack<on Memorial Hru;njtall - Merkel ceiiiUJDor Florida fTallabnW" Patbologv Associates) • Merkel cell tumor florida (Winter t laven llosoitall - Merkel a:ll carcinoma (2} Illinois. Sun- Rid® - Merkel cell CM:inoma vs. small cell carcinoma

12 CTTR, October 2006 "Minutes• (Subscription A)

Illinois <Loyola Univcr>iiY Medical Center> - Merkel cell carcinoma lndjana IHownr<l Regional Medjcal Center) - Merkel cell carcinoma Louisiana Q_.ouisiann Stme University Health Science Center) .. Merkel cell carcinoma vs. melilStatic small cell carcinoma ( 1 ); SmaJl

<:ell carcinoma (Azzopardi effect) (I) Mwy!and lNorthwes! HOS!lj!al CeJ!lql - Merkel cell can:inoma Mwlan<l <Unjymity o[Marylandl - Merkel cell can:inoma M11Ssach11~11s <Berkshire Medical Center) - Merkel cell cateinoma MD!isachus:cus <Tuft.<-New England Medical Center Residents) - Merkel cell carci.noma Michigan {Qa)swood Hospj!!lll - Merkel cell carcinoma Minneso!D (fajrvicw Ridaes Homi!all - Neuroendocrine carcinoma (small cell carcinoma) Montana. Missoula - Merkel cell carcinoma Nebraska ICrejlll!ton !Jnjyclllillil - Merkel cell carcinoma Npw York IN!I.SSau !JnjyCT,<iiY Medicql Center) - Merkel's cell carcinoma New York {S!INY Oo"nSJa!e Residcg!Sl - Merkel cell can:inoma ( I); Cutaneous ncurocodocrine can:inoma (Merkel cell carcinoma)

(I) North Carolina (Mountain An;a Pathology) - Small cell carcinoma, possible Merkel cell carcinoma (3) North Care!lna !PatholoaiSJS Medical Lalloratorvl • Peripheral primitive ncuro<>:todermal tumor (I); Merkel cell carcinoma (I) Ohio /McCulloysi>-Hvde Memorial Homitall - Merkel cell carcinoma Pennsvl>-ania IConemau•h Mgnorial Medical Centq\ - Merkel cell carcinoma P<:nosylvanja <Drexel !lnlycc;i!Y Colle&< of Medicine) • Small cell eareinomo/Merkcl cell carcinoma l'cnnsylvanjn (Lehigh Valley Hosoitall - Merkel cell tumor Pennsylvania CMt. Ni!Wiy Medical Cemerl - Merkel cell carcinoma, right shoulder Pqmsvlvania/Pgmsylyania Hospital Residents) • Merkel cell carcinoma Puerto Rico CUnjYerSity oCPuqto R'ico) - Neuroendocrine carcinoma Texas, Lubb9ck • Merkel cell tumor Texas (Methodist HosnjiJ!ll - Merkel cell carcinoma T<MS <ProM Services) • Peripheral neuroeaodermal tumor I<MS <Seon & White Mcmorja! HosnjWl - Merkel cell carcinoma West Viminja CG!tt!lbrier Yallcy Medical Center\ • Merkel cell carcinoma West Yirginja <Wetze! Countv Hospital\ • Merkel cell eareinomll, rule/out mct!IStatic neuroendocrine carcinoma Australja COuscnsland Pathology Grouol • PNET AU1!!3lia <Royal Hoban Hospj!all - Merkel cell carcinoma Australia CRoyal Prince Alfred Hospj(ftll • Small cell neuroendocrine cateinoma favor Merkel eel! carcinoma Austrn)ia (Sul!jyan Nicolaides Pa!holoavl • Ncuroendorcrine curcin.oma of skin (Merkel cell carcinoma) Canat!a IPasoun HOS!ljtal\ • Merkel cell tumor Cinada ISberbrooke !Jnivq:;ity Ho:mjta!l - Merkel cell carcinoma !lqmnny Onstjtut fur Potbolo&ie UKEl - Merkel eel! tumor Hong Kong CPruncla Youdc; Nethersole J!nstern Hosojtnll - Merkel cell carcinoma Ireland <Kerry General Hospjral\ - High gmde neuroendocrine carcinoma, Merkel Japan <Kyoto University Ho:.vitat> - Mentel cell corcinoma O.W <Hamad Medical Corpon!lionl • Merkel cell carcinoma Saudi An!bia CKing Fab&d National Gy81ll Hosnitall - Merkel eel! carcinoma Saudi An!bln CMCHl • Merkel cell tumor Sjogapore CKK Women's Md Children's Hospital> ... Neuroendocrine carcinoma, compatible with Mcriccl ceU carcinoma The Nei!JqiQDds. Ams!elyem • Merkel oeU carcinoma Vnitod Kin•clom (Oxford S!udv Group) - Merkel cell carcinoma (exclude melaS!atie small cell carcinoma), sbou!dc:r

Case 7. Diaanosis: Merkel c.eU earc.inoma (cutaneous nturoendouine carcinoma), sbouldtr

T-Yl220, M-80423

Case 7 - References: DoagHY, Liu W, Cohen P, et at. B-0:11 Specific Activation l'roteio Encoded by the PAX-S Gene is Commonly Expressed in Merkel

Cell ~noma and Small Cell Carcinoma. Am J of&rg PaJJwi200S; 29(5):687.{>92. McAfee WJ, Morris CG, Mendcnhal CM, et al. Merkel Cell Cnreinoma. Treatment and Outcomes. CUIICer 2005: 104(8):1761-1764. Llombart 8, Monteagudo C. l..op.,.,Guerrero JA, ct a!. Clinicopathological and Immunohistochemicnl Analysis of 20 Cases of Merkel

Cell Carcinoma in Search ofl'rognostic Mnrkers. Histopatho/ 2005; 46(6):622-634 . Fcinmcssc:r M, Halpern M, l<aglmovsky E, ct al. G-Kit r:.xprcssion in Primary and Metastatic Merkel Cell Careinoma Am J of

Dermatopathol 2004; 26(6):458-462. Poulsen M. Merkel-Cell C81'Cinoma of the Skin. Lancet Onco/2004; 5(10):593-599.

CTII!, <l<:tobcr 2()06 "Mu1utcs" (Sub5aiption A) 13

Case No. 8, Accession No. 23759

Alameda !Alameda Coumy Meilical Center) - Testicular carcinoid (monodermnl teratoma) Baldwin P!!rk <Kaiser l'!;nnancn!el - Careinoid (4) font.ana (Kaiser PC!I!llllontel • Scrtoli-Lcydig cell tumor vs. carcinoid tumor, testis Gnmada!!ills. GaJclnoid tumor of testis Haywnrd.frsrnont - ''Pure;·• primary ct~.n:inoid tumor of testis La Jolla !Scripps Clinic Hcmatopatholqgv Fellowsbjp) • Carcinoid tumor (I) La Jolla !Scripps Hea)Ul) • Leydig cell tumor (1) Long 'ke$ (VA Lone brerb Health Sl'S!Cml • NCW'O<n<loerine taJCinoma Montay ICommunitv Hospital of !he Montqey Pcnjnsulal • Carcinoid Montcg;y Parle !Garfield Medical Centctl - Con:inoid Orange COrpnge County Medical Group) - Carcinoid tumor Owge Countv fl<.aiser Pcmumentel · Carcinoid lumor Orange l\Jnjversitv of California Irvine Resident~> · Low grade neuroendocrine Utmor Oxnard <St. lobo's Reciona! Medical Ccn!etl • Carcinoid (3) Rancho Mjrage !Eisenbowcr Medical Center\ - Can:inoid SacramontO (UC Dllvjs Res ideals) • Carcinoid of the testis San Di<go IN oval Medjcnl Center) • Primary carcinoid of testes San Diego I!!CSD Modjcal Centerl - Primary carcinoid of testis San frMCisoo !San f!1QciS£O GcncmJ Hospital) • Leydig cdltumor San F£Mci5s:o tUCSf Residents> - PriiDill)' neuroendocrine carcinoma onesticlc Santa Ro:;a (Santa Rosa Memorial Hospjtall - Carcinoid tumor of testis (3)

October 2006

Woodland Hills !Kaiser Pennanente Medical Cerner) • Carcinoid tumor vs. germ cell teratoma lumor with enn:inoid fcarurcs Woodland Hills !Sudn's Solwcrsl • Carcinoid(? concum.'tlt gemr cell, stains) Arlcansas Nniversitv of ArJsnnsas for Medjcal Sciences) - Carcinoid tumor, testis Florida Clpson Memorial Hospjta!l • Carcinoid Elorjda CTallahe!'Stt Pathology AsSQCjou:sl • Carcinoid Florida (Winter Haven !lospital) • Carcinoid (2) Illinois. Bua Ridge - CC&rCiooid. rule out seminoma Illinois <L.ovola Unjwr:tity Medical Center) • Sertoli·Lcydig cell tumor lndianalt!oward Regional Medical Ceoterl - Carcinoid Louisiana !Louisiana Stntc University llcallh Science Center) • Carcinoid ( I); Carcinoid with pseudopapillary pattern (I) Maryland !Northwest Hospital Cenrorl • Can:inoid tumor Mnrylapd CUnivcrsjty of Maryland\ • Monodermal teratoma (carcinoid tumor) Ms'SSMhmrm ffirrhhirr Medical Cmtql - carcinoid tumor Ma.ssachusei!S ITufts-Ncw England Me<!ical Center Rwideots) • Testicular carcinoid Michiean COakwood f lospitall - Carcinoid rumor Minnesotn !Fairview Rjdocs Hospital) • Neuroendocrine tumor (carcinoid} Montana. Mis,..,ula • Carcinoid rumor N.tvm!sn ICrei&!lton UnjyasiM • Carcinoid New Yor!c !Nassau t!njymity Medica] Con!erl • Testiculw carcinoid New York I SUNY Downstue Residents\ • Testicular carcinoid n1mor (I); Carcinoid ( I) North Carolina (Mountulg Area Pnthplogy\ • Carcinoid tumor (3) North Cnrolina!Pa!ho!ggists Modielll!.aboratory) • Carcinoid tumor or testis (2) Pennsylvania IConemau&h MemoriA! Mes!ical Ccnrql - Neuroendocrine {carcinoid) tumor Pgpm!nnia CDn;xc! Unjvmity Collge ofMes!jejnel • Neuroendocrine carcinoma Pennsvlyania (Lebioh valley HOSDil!\ll • Can:inoid PennsylvMjn <Mt. Ninony Medical Center> · Neuroendcx:rine carcinoma, testes Pennsylvania (pennsvlvuoja Hosniml Residents) - Clll'Cinoid tumor Pncrto Rico IUoiversiiY ofPncrto Ricol • GaJclnoid tumor of the testis Texa<, !.ybbocl< - GaJclnoid bUDOr Texas CMe!hodist Hosnitall - Leydig cell tUJll()r Texas (proPalh Serviccsl • Primary carcinoid of testes Texa.• ($coN & While Memorial Homjla!l - Carcinoid West Vjrgjnja Wreenbdq Valley Mes!jca! Center! • Testicolar enn:inoid West Vjrgjnia (We12e! Coontv Hospjtall • GaJcinoid Aus!ra!ia IOuccnsland Pa!hology Gmupl - Carcinoid tumOl Australia fRova] Hobart UospjtaJ) • Carcinoid wmor of testis Aos!r!!l ja CRoyaj Prince Alfred HOSDitall • Carcinoid tumor AUS!!'Jlli• CSulliyan Nicolaides Pathology\ • Carcinoid tumor. testis Canada (pnsouo HospjJal) • Carcinoid Canada ISbcrl!rooke llnjvcr:tity Hosgila!l • Primitive neuroendocrine tumor of the testis

14 Cl"t'R. ()etoile< 2006 "Minutes" (Subscription A)

GermanY Onstitut Cur Plllholotric UKE) - Caroinoid tlong Kong Cpnme!a Yoyde Nethersole Eastern Hosoitall - Cnrcinoid monodermal tcratomn lftiAnd <Kerry General Hospital) .. 1ntratestiC\Ihlt carcinoid tumour h!ppn (Kyoto Univcrsjtv Hospitut> .. Carcinoid tumor Ot!ar !HAmad Mec!jcal Gomo!l!ljonl - Carcinoid tumor $pudj Arabia {)(jog Fahad National Guard Hospital> - Ca:rcinoid Saydj Arabia CMCHl - Carcinoid tumo< Sjnqapore C.KK Women's and Cbjldreq's Hosnjtull - Carcinoid The Netherlands Amstclveen - Carcinoid ofthe testis United Kingdom <Oxford Study Orouol • lntratesticular De1Jroendocrinc tumor (carcinoid)

ems- Dillgn0$is: Carcinoid tumor, testis

T-78000, M-82401

Case 8 - References: Wurster K, Drodncr 0. Rossner JA, etal. A Carcinoid Oocurring in the Testis. llirchaw• Arch A Pathol Anal Jf/sto/1916; 370(2):185-

192. Blumberg JM, Scdbel'l)' Sand Kw.mi SO. Bilateral Asynchro11ous lvletastalic Carcinoid Tum<Jr of the Testis. Uro/ 2005: 65(1): 174. Fujila K. Wada R. Salalrai T, et Gl. Primary Carcinoid Tumor of the TeStis with Teratoma Metastatic to the Para-Aortic Lymph Node.

/ntJo{Uro/2005; 12(3):328-331. MeriooJ. ZullJ1188 A, Gutiet=·Tcjcro F, etal. Pure Temicular Caroinoid Associated with lntnliUbular Germ Cell Neoplasia J ofC/In

Patho/2005; 58(12):1331-1333. Son HY. Ra SW, Jeong JO, et al. Primary CIU'cinoid Tumor of the Dialcml Testis Associated wi!h Carcinoid Syndrome. lnt J of Urol

2004; 11(1 !):1041-1043.

Cue No. 9, Accession No. 24091

Alamqla IAiamec!a CouniV Msdjca! Ccmterl - Pulmonary can:inoid Bo!dwin Parle (Knjscr Pcrmanentcl - Carcinoid tumor (4) Eootnna £Kaiser Pem>anentc) - Corcinoid tumor, lung Gooada HUL< - Neuroendocrine hypCJplasio llai'W!!!!!/Frqnoot - Grade I, ncuroeodocrino carcinoma (pulmonary carcinoid) !,a Jolla <Scripps Clinic Hematopo!bo!cm Fellowship) - Can:inoid tumor La Jolla CScrinns tleal!hl - Carcinoid Long Beach CYA !.ong Beach Health Svstcm) - Neuroendocrine carcinoma Monterey!Communitv Hosnital of the Monterey Penjnsulal . Carcinoid Monterey Park COarficld Me<lical Ccuterl - Carcinoid Omnpe <Orange County Medical Group) - C~Rinoid tumor Orange CouniV !Kaiser Pe!!!UI!JO!!Ie\ • Carcinoid tumor Oranae CUnivcrsily oCCaJifomjn Irvine Residents) - Carcinoid twnor Oxnard CSt. John's Regjona! Modica! Ce!)lerl - A typical carcinoid (S) J!MCho MiraB• <Eisenhower Mec!ical Centcrl - Papillary carcinoid

- Carcinoid tumor or !he lung - Carcinoid tumor oflung - Carcinoid

• Clear cell (sugar) tumor tumor

- Carcinoid tumor neuroendocrine carcinoma)

- Mature carcinoid tumor, lung florida (1achnn Memorial Hospilall - Pulmonary carcinoid florida ITallahossee Pathology A<miatesl - Carcinoid Florida Qormtcr Haven HospitaD - Atypical carcinoid (2) lllinoj$, Burr Ridsc - Paraganglioma Illinois fLovolu University Medical Center\ - Carcinoid IDdiMt fr!oWllJl! Rs1rjooa! Medical Center) - Carcinoid LouiMm Onnjsj•ne State Unjymity HcaJth Science Ceotq) - Carcinoid (2) Maryland CNonbwe:;t Hosoita! Center\ • Carcinoid

C'ITR, Oc!obtr2006 "Minutes" (Subscription A)

October 2006

JS

Marvland !University of Marvlandl - Well-differentiated neuroendocrine tumor (typical carcinoid) Massachusetts fBerJg;hjre Medjcal C.enterl - Carcinoid tumor Massachusetts !Tuils-New England Medical Center Resjdemsl - Well-differentiated neuroendocrine tumor (pulmonary carcinoid,

peripheral type) Michigan (Oakwood Hospital> · Carcinoid tumor Minnesota <Fairview Ridges Hospital! - Pulmonary neuroendocrille tumor (central carcinoid) Montana. Missoula - Atypical carcinoid tumor Nebraska CCrejghton tJniveN;i\yl • Carcinoid New York CNassau University Medical Center> - Low grade bronchioloalveolar carcinoma New Yorlc !SUNY DownsMc Residents) - Central carcinoid tumor, typical (1 ); Carcinoid ( 1) North Carolina <Mountain Area Pathology) • Carcinoid tumor (3) North Carolina (palhologists Medical Laboratorvl - Intrapulmonary glomus tumor (I); Well-differentiated neuroendocrine ean:inoma

(carcinoid tumor) (I) Pennsylvania (Conemaugh Memorial l\1edical Center) · Carcinoid tumor Pennsylvania CDrexel Universitv College of Medicine> - Carcinoid tumor of lung Pennsvlvania <Lehigh Valley Hosnital) - Carcinoid Pennsylvania (Mt. Nittanv Medical Center) - Carcinoid tumor, lung Peim~ylvania (Pennsylvania Hospital Resident~) - Carcinoid tumor Puerto Rico CUnivcrsirv of Puerto Rico) - Mature carcinoid neoplasm of the lung Texas. Lubbock - Carcinoid tumor Tex8SIMcthodist Hospitall - Carciri.oid tumor Texas (proPalh Seri>ieesl - Well-diJJen.'tltiated neuroendocrine tumor of lung (carcinoid) Tcxa.' !Scott & White Memorial Hospital) - Carcinoid West )lirginfa «Jreenbriq Valley Medica! Cente!'l - Bronchioloalveolar cell adenoma West Yirginia.!Wetzcl CountvHQSpilliJl - Carcinoid AustraJia £Queensland Pathology Group) - Cflrcinoi~ Austrn!ja (Royal Hoban Hospjtall - Pulmonary carcinoid (adcnopapillary pattern) Austrn!ia !Royal Prince Alfre<l Hospj!aJl - Carcinoid tumor · Australia !Sullivan Nicolaides Pathology) - Carcinoid tumor, lung C.anada <Pasquo Hospital) - Carcinoid Canada !Sherbrooke University Hosoital\ - Carcinoid (typical) Germany f!n;1itut fur Pathologic UJ<E) - Carcinoid Hong Kong (pamela Youdc Nethersole Eastern Hospital\ - Carcinoid Ireland <Keny General Hospital) - Carcinoid tumour of lung Jnnan <Kyoto lJoiversitv l·losoital> • Carcjooid tumor Qatar (Hamad Medical Corporation) - Carcinoid tomor Saudi Arabia !King l'ahad National Guard Hospital) - Carcinoid Saudj Ambia !MCH\ - Carcinoid tumor Singapore fKK Women's and Children' s Hospitall - Atypical carcinoid (focal necrosis) The Ncthcilands. Amstelvc-cn - Large cell neuroendocrine carcinoma, grade I United Kingdom <Oxford Studv Grouof - eareinoid, lung

Case 9 - Diagnosis: Carcinoid tumor, lung

t-28000, M-82401

Ca'<e 9 Refurences;

Du Ema Z, Goldstrnw P, Zacharias Jo, et ul. ITF-1 Expression is Specific for Lung Pri:ouuy in Typical and Atypical Carcinoids. TIF-1-Positive Can:inoids are J>redominanUy in P.eriphml Location. Hum Palho/2004~35(1):825-831.

Pelosi Giuseppe; Rodriquez Jaime, Vialc Giuseppe, ct ul. typical and f.typical Pulmo11ary Carcinoid Tumor Overdiagnosed as Small­Cell Carcinoma on Biopsy Sepcimens. A Major l'itfall in the Management of Lu~g Cancer Patients. Am J Surg Paillo/2005; 29(2): 179-187.

Asian DL, Gulbabee HE, Pambuceian SE, et aL Ki-97 Jmrnun.oreactivity in the Oifferelltial Diagnosis ofPulrrionary Neuroendocrine Neoplasms in Spccim<;ns withExtcnsive Crush Artifact Am J o[Ciin Patho/ 2005; 123(6):874-878.

Cai YC, Banner B, Glickman J, eta!. Cytokeratin 7 and 20 and Thyroid Transcription Factor I Can Flelp Distinguish Pulmonary from Gastrointestinal Carcinoid and Pancreatic Endocrine Tumors. Hum Patlw/2001;32(10):1087-1093.

Siegfried Oherndorfer. Origins and Perspectives of Carcinoid 1\omors. flum Patho/2004; 35(12): 1440-.1451.

t6 CTI'R, Oclob<:r 2006 "Minutes- (Subscription A)

Case No. 10, Accession No. 30473 October 2006

Alameda <Alameda COuOLY Medical Centerl - Synovial sarcoma !lt!dwin Park (Kaiser Pennanentc) - Ewing's/PNET {4) t'ontana CKnjser Pemt8Jlentcl - Ewing sarcoma, bone GJ1!!8da Hills - Synovial sarcoma llfi"'ald!F!'C1!!0!1t - PNET with osseous metoplasia !.n Jolla IScdnos C1inic HemB\OMJhology Fellowship) - Primitive ncuroectodcnna! rumor {PNEl) {6); Monophasic S)1lovia! sarcoma

(I) !.ooo !!rerh lV A l..ong Peach Heal!h System) - llwing sarcoma!PNET M!!!!!erey <Community Hospjl!! of the Monterey Pcnin:;ylal - PNET/E,.ing's vs. desmoplastic small blue ecU tumor MontereY Park CGarfje!d Medical Center) - San:oma, rule out Ewing's O!l!Dge IOnw•• Cqunty Medical Group) - PNET Orange eounw OCaiser permancnte> • s·ynoviol sarcoma Onn•e ltlnjymjtv ofCaljfomia lryjne Rcsjdcn!S) - Exuaskeleta! £'1\ing's sarcoma/PNET OxnanHSt.John's Regional Mc<ljCl!! Center) - PNET {~) llwl<bo Miratle <Eisenhower Medjca! Center\ - !;wing's sarcoma S!cnuntn!O cue Davis Resident•\ - Ewing's $lii"COtnaiPN!lT San Diego <Nova! Medjcal Center) - Mesenchymal chondrosarcoma {6): Small cell OSieOSareoma {4); Synovial sarcoma (2) SM Djeon CUCSD Medjcol Center> - Mesenchymal chondrosarcoma San Francisco <San Froocisoo Gcncml Hospital> - Peripheral neuroectodermal tumor (Ewing's sarcoma) Son F11111ci!iCo CUCSF Rcsjdentsl - Monophasic synoviliJ sarcoma Santa Rosa !Santa Rosa Manorial Hosoitall - Mesenchymal chondrosarcoma/PNET {I); Ewing rumoriPNET (2) Woodland tljlls (!(Bisq Pcrmapentc Me!lical Center) - E'l\ing's san:omo Woodland Hms ISuda's So!dlernl - Mcse.JchymaJ chondrOSW'Coma Arkansas aJnjycrsj['f of Arkansas for Medical Sciences) .. Primitive neuroectodermal tumor. shoulder florida fi!!Ck3on Memorial HOS!!itall - Synovial sa=ma Florida !Tallabassec Palbologv A«g'iatesl - E•viog's san:oma/PNET ~lorida (Win!!lr Haven Hospital) - Ostcosarooma (2) Q!joois. BWI Ridge - Synovial sa«oma Dlinois <Lovo!a Vnivmity Medical Center\ - Mesenchymal choodroso=ma !ndjWJa ft!gwNd Regionnl Medical Cegrerl - Osteosarcoma !.ouisiana !Louisiana State Unjversjty Hea!UJ Science Center) - PNET/Ewing's sarcoma ( I); iMonopho.<ic synoviAl Sllt'COma (I) MIQ'Iand !Nonhwest Ho:;pita! CcOJerl - Cclcil)oing S)1lOViaJ san:oma Mart!ancl CUojymitv of Maryland) - Small cell osteosarcoma MftSS8Chu$CilS fficrlcsbia; Mc<licaJ Center) - PNET Mnssachuscus ([uf\.•-Ngw England Medical Center Residents\ - Ewing's sarcomn!PNET Michigan l0alcw09d Hgmitall - Synovial sarcoma Mi!!!!eso!l\ (fairview Ridaes Hospital> - Synovial sarcoma Montana MII!SO!!la - Synovial :san:omu, small cell variant lldlraska !Creighton Unjycrsityl - Consistent with Ewing's family exllu-skelctnl carcinoma !lew Yorlc <Nossau VniyersityMc4ica1 Cenlcrl - Cbondrosan:oma ~~ey. yPdc CS!JNY DownS!ate RC3ldcntsl - Synovial sarcoma (2) North Caro!ina!Mountajn Area Pathology) - Mesenchymal cbondroMrcoma (!); PNET (2) Nortb Carolina <P!!!hologists Medlen! Laboratory) - Mesenchymal chondrosarcoma (I}; F..xing's snrcoma (pri1nltivc neurocetodermal

tumor)(!) Oltio !McCy!loug!>=HY'k Mcmgria! Hosoitall - Synovial sarcoma Pqmsvlvonia!Conemal!oh Memorial Medical Center} - Extra-skeletal Ewing's SDl()Qrna l'cnnsylyanjn IDrcxei University 'Col!e&e of Medicine\ - Primitive neurocctodennaJ 1t1mor (PNEl) Ptn!IS)ilvania O,ehioh Valley Hosnjtall - PNET/Ewing's san:oma f<Msylvania CMt Nj!!My Medical Center) - ESIPNET, right bwnerus Pmnsylvania <PamsvJ'yanja HOsoilul Resident$,) - Synovial sarcoma Puerto Rjto Olnivcrsity or Puerto Riool - PNETIES Ic.as. Lubbc>ek - Peripha;o! ncuroce:todcnna! twnor (PNE'f) Tem CMe!.hodiSI Hospjgl!l - Ewing sun:oma Ig,.. (proPmb Services) - Peripheral Ewing's sarcoma Texas !Scotl & Wbite Memoriallio.pitall - l'NilT Wes! Virginja !Greenbrier Valley Me!lical Center> - Chordroma West 'firginja(Wclze! County HospjJ!I]l - Peripheral neuroce:todcnna! tumor AUS!n!!ia (Qyeensland Patho!Ofrt Group) - PNET AySJrnlia (Royal Ho!wt Hospital) - Small cell osteosarcoma Aulln!.lia fRoyal Prince Alfred Hosnila!l - Synovial sarcoma

CTTR. October 2006 "Minutes" (Suf>,;cription A) t7

AI!S\ralja (Sullivan Nicolaides Pathology) • Synovial sarcoma ·Canada (pasquo Hosojtall - Synovial sarcoma Canada ISherbrookc:University Hospitall · Mesenchymal chondrosarcoma Gennany !Jnstjtut fur Pa!hologie l/KEl • PNET Hong Kong (pamela YoudeNethe!sole Eastern Hosnitall • PNET Ireland (Kerrv General Hospital! - PNET Iapan (Kyoto University Ho~nital) · SynoviaJ sarcoma Oatar <Hamad Medical Corooration> - S}noviai sarwma Snudj Ambia (Kin• Foltad National Guard Hospitall · PNET Saudi Ambia CMC!~l • PNET Singanore fKK Women's and Children's tlospitall • Synovial sarcoma, differential diagnosis, mesenchymal chondrosarcoma The Ne!herlands. Am<telvcen • PNET/E\ving SllrtQma United· Kingdom (Oxford Study Grounl • Poorly differentiated synovial sarcoma, shoulder

Case 10 ·Diagnosis: 'Primitive small round cdftumor most consistent with Ewi.ng's $1arcowa!PNET, $~pu.la and hu.merus

T-11:280, M-92W

Case 1 0 -References: Carpentieri DF, Qualman SJ, Bowen J, ct al. Protocol for the Examination of Specimens from l'ediatric arid Adult Patients with Osseous

and Extraosseous Ewing Sarcoma Family of Tumors, Including Peripheral Primitive Neuroectodermal Tumor and Ewing Sarcoma. Arch ofPatho./ & Lao Med 200~; 129(7):866-873.

Folpe AL, Goldblum JR, Rubin BP, ct a!. Morphologic and lmmunopbcnotypic Diversity in llwiog Family Tumors. A Study of 66 Genetically Cnfinned Cases. Am J ofSurg Patho/2005; 29(8): 102~·1033.

Bridge RS, Rajaram V. Dehner U', et al. Molecular Diagnosis of Ewing Sarcoma/Primitive Neuroectodennal Tumor in Routinely Processed Tissue. A Comparison of Two FISH Strategies and R.T·PCR in MaHgoant Round Cell Tumors. Mod l'at/w/2006; 19(1):1...'!. .

Carvajal R and Meyers P. Ewing's Sarcoma and Primitive Neuroectodermal Family of Tumors. Hematol-Onc Clin of North A mer 2005; 19(3):501-525.

Scridcli CA., De Paula Quciroz RG, Nogucint CO, et al. Which Small Blue Round Cell Tumor of Bone? How Molecular Techniques Can lle Useful. Mild & Ped Onco/2003; 40(6):387-39{).

18 CITR, October 2006 "Minutes" (Subscription A)