• * * * * * * • * * * * * * * * * * * * * * * * * * * * * * CALIFORK!A TUMOR TISSUE REGISTRY

LOS A.'ICllL£5 COUNTY - t!NIVERS ITY Of S01.J7HERN CALIFORN!A

PROTOCOL

For

MONTHLY STUDY SLIDES

APRIL 1979

POPLITEAL TUMORS

* • * * A * * * * * * * * * * * * * * * * * * * * * * * * ~

COU'l'R!BUTOR: E . R. J e.nnings , tr.. D. APRIL 1979 - CASE UO . 1 Long Beacb ~ Caliiornia

ACC . NO. 23082 TISSUE FROM: Popliteal space

CL!l'IZCP.L .I>BSTRACT:

Histor;r : The patient va.~ a 46 yo;ar old male who was admi tted to a local hospi t al in December 1978 complaining of P·" in in the ;oack of his right kn"e of one u..cnth r ~ dtJ.ration . A p:lysical eY.e.mination i n NV'~tentber l9T7 reve~...led a "Bs.ker 1 s cyst" posteri or to t he right knee. One month pri0r to admission the t1.l!nor began to sw:ell , beca11:te eryt hrematous and painful.

Ph,ys i cal e:.:a.mine.tion: The -patient t,..ras noted to have restricted mot ion of his right knee due a large mass 'Nhich. ha.O. "dissected into the subutaneous tissue . u

Laboratory studies: Cheu~stry profile , CBC, T4, and urinalysis were wi~hi~ ncrm~l limdts .

RadloP,raphs: A right l e s venogram sho~ed displacement of other-wise normal venous archi tecture by a popliteal sof t . tissue mass. A right; l eg erte~iogram showed e moder ately vascular popliteal ~$s witb a lobul~ted appee.:raJ1ce.

SlJRGE:n::

A large soft tissue mass was removed f rom the right popliteal space on December 6 , 1978.

GROSS PATHOLOGY:

T'ne specimen was a l arge rnr-ss w-hich consisted of' a large l obulated and several smal ler cvoid. tan b2·o;m 11odule~ . Soft and firm areas were noted. CD section pe.rts -of t:::.e t u.'tiDr ~·rere dark brot-.-n and other areas ;.;ere -oright yellow in col('):r . The l argest portion of t he specimen measur ed 1 4 )( 6 x 3 . 5 ems .

FOLLC~-UP:

~1:ien l ast seen i n Janua::. .. ~r 1979 the patient was doing ~ell .

COliTRl'SllTOl< : S. K. Ab:.tl-Haj, M. D. f.,FRI!, 19 79 - C.\SE 2

Ventura, Cal ifnmia ACC. NO. 15147

TISSUE FROM: Left knee

CLINICAL ABS !!\ACT:

History: This t"'ency year old married "'bite woman presenced "'ith a tender mass over the inner aspect of her lef t leg, just below th~ knee in July 1966. The mase had increasil1gly gre~m i n size fo r 6 months. The pncient had only an occasional twi3ge of pain in the lacer3l aspect of her knee ~~d had no problems vi th wal~ing, bu= was concerned vi th the l~p end soreness.

Physical ex:uoin~ was within nomal limits except for s;:elling ond tenderness over the medial aspect of the left leg, just below the knee. There was full range of ~tion through a stable knee joint.

Laboratory studies: Non-contributory .

~diog~aph: A chest film showed no abnormalities . Radiologic vie"s of the left tibia showed a destructive leGion in the metaphysis in the medial aspect of the tib(3.

SIJRGERY:

On July 5, 1966 excision and curettage of the oeteolytic lesion was carried out and the defect was filled with bene chips from the posterior left ilium. A gritty, grey-white and pink lobula t ed mass was curetted out. Portions of the •~U~as «as adulixed with bro,'tl-red soft tissue.

GROSS PATHOLOGY:

Th~ specimen "'as composed of two types of tissue. The firs t portion conei9ted of nodular or l obulated fragments of grey-whi t e to tan gritty soft tissue with bl otchy areas of bro~m-red discoloration, marginated on one side by wedge-shaped plaques of thickened cortical bone. The largcs! piece mea.sured 2 x 1.5 x 1.5 =· and 3 x 2 1< l.5 =· The second par1: of the tumor consist~d of nume~ous irregular fragments of spongy, brown-red henor-1\agic bone aggregating to approximately 9 graJlls.

POUOW UP

1\lo years later the lesion recun:ed. An en bloc res~ction was pe~foJ:med and the defecr was repaired ~ith bone graft and bone chips . In 1969 a follow­up film of t he tibia showed cotnple t e restitution of the integrity of the bone ~ithout any detect~ble defects . ~~en last seen on March 15, 1979 the patient was still ssyoptomatic.

COifl'RIBU'l'OR: James E. Ks.hl e1·, J.l. D. .A.PRIL 1979 - CASE NO . 3 Los Ang;,les , Cl'..lifarnia

.ACC . !10. 8T6'7 TISSUE FRml: Popli t ee.l space

CLI!UCAL ABSTRACT:

History: In Jar:uary 1955 t his yatient developed a "fullness" behind the lef~ knee ~nich preve~ted full e r.oension. £he ~oticed a progress~ve incr ease in size and hardnese i:l the mass . Three ;;eeks prior to hospitalization in June of 1956 it became painfu.l a.'ld va...'l"!!l to palpation . Exploration of nass vas perto~ed and a v"r7 vascular tur.or was fo~d be~vee~ muscles or lover thi gh posoeriorly. The mass was biopsied only a s a complete resection cc l:lld not be performed.

Phvsical exa:nination : A har:l. oval tumor, a pproximately 10 =· in dia.'!leter, vas pa.l.pa-:ed just above the poplitesl space .

Radicgra~h : X-ray demonstrated a so~ t issue Ue$ S in the poplite~l area without abnor:ne.lity in the femur or perioste\:J!I .

Si.iRGE?.Y :

An aJuputat.ion •,;as carried o ut thro>.:gh the upper 1/3 of the thi gh on June 2'7, 1956.

GROSS PAT'"t!OI.OCY :

The tumor mass measur ed 12 x 7 x 7 ems . a:1d wa2 in ti".e fibrous tiss ue, cet,..een muscle bellies, vascular sheaths , and perios teum. It separated easily from muscles, periosteum, femoral artery and nerve; however, the fe:noral vein was firmly attached by tumor thrct!bi which solicil,y filled al: the tributa!'Y vei ns . The ad·.rem.itia of the veins was not infil tl·ated. The tumor was s=rounded by a thick fibrous pseudo- capeule and ;:as very fir~ and brigh~ pink in color with small yello.., areas of necrosis and t i ny, grit ty, calcific foci.

l'CLWii- UP :

Pulmonax-j ~easteses were noted i n January of 19 58. The patient expired later t hat y ear wit hout benef it of en autopsy.

CO~"'::R!Bl.;"l''R: Ro"arci J . Go:nes, M. D. A?RIL 1979 - CASE NO . -Glendale, California

ACC . 110. 10560

'!'ISSUE FROH: Knee

CLTII!CAL ABSTRACT:

History: Yr-is 40 year old wtite oale patie~t first noticed a pain~ess lW!lp in th~ poster:..or a.spec-: of the le~ bee in trld-1959 . '!ne ca.! a }:e.:. gradually increased in size.

SiJRGERY:

A subutarteous noduJ.e WI.\!! noted to lie b eneath the s ki n and "over t :-,e fa.scia ." There was no communic a.tior, •,;ibh tlJe joint or a;;tachment to t he capsule. The aass t<pp"ared to 'be encapsulated and wa s r emoYed intac;: ~;ith DO difficulty .

GROSS PICHOLOGY:

The gross spec~JDen va..~ oval. , measu:-ing 3 =s. in <iie•,eter in ~en;;tt end J . 8 em. in di aneter . The l!lS.£S had e thin capsule ettd :fibrofe:cty t~ssue ""lit.3 on its e xternti sur~aee . After fixation tbe cut surfaces -,.;ere snoo't~ ,

:fine , and white with pale yeJ.l o·• areas ..

FOLLOH- UP:

The pat i ent i~ lost ~o ~ollo~-up .

CONTRIBUTOR : Jack Gordon, M. D. APRIL 1979 - CJ\SE NO . 5 Los ~~-scles, Califo=nia

ACC. NO . 19580

TISSUE FROH: Knee

CLINIC~L ABSTRAC7:

liistorv: This 62 year old female presented to her physkizn in early 1972 ~ith complai~ts of a cass located in her left kne~ which had been present for three months .

Patient had a past history of a pap!llary adenoc~rcinoo~ of the left ~hyroid in 1970 for which she had received a bilateral total thyroidectoQy.

Phvsical examina tion: A soft tissue mass was noted to be located anterior to the left tioia.

_Chest: radiograph on ad:niS$ion was nornlill.

SURGERY:

The t umor wa~ locall y rese c ted . The tumor did not involve tho bone and was locat~d near the knee capsule.

\BOSS PATHOLOGY:

A yello~ tan and oval tu~or with a thin fibrous capsule, ceasuring 6. 8 x 4.i x 2.~ ems, was received . On section, the t~r ~ppeared to be :o=a:ly calcified with a few •mall shiny are11s of "mucoid degeneration . "

FOLLO\~ UP:

The p~tienr hils been caref.ullr follo,.,ed in the out pat i ent clinic anc was last seen in P.arch 1979 with no evidence of recurrence or m"tastases .

CON1'RIBlJ1'0R : 1.411ll.am H. Ke r n, !1. D. t.P \HL l. 9 79 - CAS'i: NO . f. Los An~P-les, california

ACC. NO. 17303

TISSUE fROM : Lef t knee

CLI!IlCAL ABSTR.<\CT:

Bistorv: This 19 year old rna~e was admitted to ~he hospital on Januery 31, 1968 with a history of having had a l ump on the a:: t:et'ioJ: rnedisl aS?C>Ct

of the l eft tibia, 4 ye~rs ' duration. D~ring the pas• 6 months ~he lesion had g~~ to 4 ti~es i:s c~iginal size . It w~s esse~~ially painl~ss ~~less b"mpea .

Phy$ical exa:rination sho~Jed a raised 3 :! 2 Cl'll. anterior s~al!ing of tt:e dd left tibia a:-.d no ther a'::>nc r.nall.t ies were nDted.

P~dio~raPh revealed a sharply de1i~itcd 7 co. tu~or arising fro~ the outer cortical layer at the junction nf the ~orile e~d lower thir~s c: tha t ibia.

SURCERt : (February 1, 1968)

A l arge fi rm t umor was found beneath the tibial periosteum. A c.ircu.~ ferential i"d.sion was msae io the perioste~m and the ~ntire tumor was excised in ta= t .

GROSS !'ATHOLGGY:

Tne Specimen consiated of a segment of bone and an addition~lly received small fragments of fatty ti~su~. 1be s egment of l vng bone measured 7. 5 x 2. 8 ccs . in diameter. Cent~ally, there was a hard, s~oth. slightly l obulated, elongated cortical lesion that proj ected abovo the perioste~l surface for 1 . 0 em. and measured 5. 8 ems . in length . It wns extensi·~ely calcif ied and was of bony consistency. The lesion appeared to be completely excised, the m.u:gins of resection bc!ng grossly free of neoplastic change. Fibr<>ua . apparent l;• periost eal t issue, ana small port i ons of muscle were attached to the outer surface. The second portion o:' t ho specimen c:onsisced of approximat ely l gram of Slll3ll piece of yello..-ish g::a:; f atty and bon;• tissue.

FOLLOW-UP:

.The tUl!lor recurred within a year at the p:roxiCM.l surgical mn rgin. A ae~ond operati on was performed ~nd tha t~or ~as agaL• er.c:ised along "ith approxicately 4/5 of the c:ircu~ference of the tibia throug~out most of its length. A fibular' graft was done. As of February 1977, the patient w~s well and had no furth er t reatment.

COO':Ril!lr.OR: It•Jing X. Rei::lgo:d, M. D. Lono 3each, Califo:-nia

ACC. !10. 1511~

TISSUE FROM: L~ft knee

Cll!I!CAL ".BS:1'.ACt:

His torv : Tilis 59 yea• old male present~d in ~id-1966 ~i th complaints of of n painless slo~ growing mass, wh~ch had been present in the left kn¢e. for about cne year. The pati en t had hacl no disabilities f r om che mass .

SURGERY:

The ll'.ass " as removed en bloc in July 1966.

GROSS PAtHOLOGY:

The specimen consist!ld of a soft , nonencnpsulated, solid mass measuring 7 x S. 5 x 2 .5 CIIIS. 'fh« s u-;;face:l we:-e glistening , mois t , grayish-white and soft. Bands of foirly t hick fibrous cissue traversed th e s olid tuoor . On sectioning, focal pinpoi nt yel!o~ areas were noted to be dis tribu ced through the tlllllOr.

f'OLLOW-t'l':

The patient was seen i n the outpatient cl:lnic in Februa ry of 1972 at which tir:le he was free of tumor and ne t as tasis . Howev.,r, at that t!ae the patient was par~plegic and sphasic se~cndary to essential hypertension.

COliTR!llUTOR : Sidnf!}' Zui>er , ~!. D. George Scharf, M. D. Pho(llnix, Arizona

TISSUE FROM: Knee

APRIL 1979 - CASE ~0 . 8

ACC. NO. l35U

. His tory : This 15 year old ~;bite fonutte '•r.:ts firs t see n by a l ocul ortho­pedic surgeon in mid 1964 ~ith complaints of ?ein in the r ight knee, espe­cial:y along the l ateral a:ld t»OSte~ior &ides . 'Ihe pai:l ~..;as so severe ch!.t it kept d:e pat:ient a~.;ake at r.ight 2nd fo-rced her to wal~ ""·ich a l iop . The patient had previously visited a. chiroprac tor for tre:ttment , however , her symptoms had continued. The knee wa~ st•ollen . 'l:ile joi.nt. was aspi:ro.ted ar.d an iJjection of cortisone was given .

·r.,e patient ~as ad~i:ted for a biops y on July 1 , 1954. Surgical approach •.res through che anterior aspec:c o~ r.be tibi;:; . A cystic area t hat ext ended im:o t he poplit:aal fo ssa w<H; encountered and th i s area was curetted . The surgeon not~d that t he cyst wr.s empty and nc a bnorntal t issue ',;:.ts encoun­tered. The patient ,;as released from the hos!'ita l ; ho'Aever, following consultstio~ she was re-a~~it ted to the hospitul for su~gical procedure in sn effort to save t he knee .

SURGERY:

A resection of th<! r emaining portions of the lesion was performed by a posterior medial incisi on. At t his t iOie a gTay whita soft n>ater ial .,;as encountered filling this previously cystic a rea. Adjacent ca-rtilaginous sur faces were noted to be partiall y ~roded and bio~sies were also taken froo chis area.

GROSS PATHOLOGY:

The s pecimen consisted of ewe parts . 1~e firs t portion was a fr~goent of bone, oe,suring 3 x 3 x 1 em. with a layer o ( fib rous tiss ue. on the outer surface . . Sections showed an e.xpansile gray anc r~d lesion that thinned t~e cc~t~x and reFlaced trabeculae. The second portion measured 3 ~ 2 x 2 co. and consis t ed o f fim fle shy red 3nd brown tissue.

FOL!.0'.-1- UP :

Tne patient is well and there is no evidence of r ecurrence.

CON'J:RlllUTOR.: Robert. F. Hufner, rt . D. APRIL 1 9}9 - CASE NO . 9 Long B~3Ch, Califo~nia

ACCZSSION NO. 18769

TISSU!:! FP.OH: Right knee

CLINICAL ABSTRACT:

This 12 year old whi:e Eecale presented co her pbysician ..-ith a small lump in the medial aspect of her right knee, which had been present for at least three months.

SURGERY :

The mass was biopsied in July of 1970. The mass ~as felt to b~ in the soft tissue and not related t o the joint structures.

GROSS PA'IJIOLOG"l:

The specimen consisted of a fair ly firm and co!l'pressible soft tissue mass, measuring 2. 4 x 1. 7 x l . 6 em. Adheren t fat ~as present excern&lly. Hemi­section revealed •:a solid glistening gn~y appe aJ:.,nce . Small cleft-like. spaces were noted on section.

FOLLOW..UP:

Current follo~-up not avaiiebie.

CONTRI BUTOR: John Tnh, H. l). A?::tiL 197.:.> -· CASE NO . 10

Glendale, Califor.n:'...a ACC. NO. 23177

TISSUE FROM: Knee erea

CLINICAL ABSTRACT :

His torv : Th i s· 24 year old \o.Thite female -saw a physic ian in December 1978 because of a painful r1-ght knee . Conse!'V3t ive tr.entment brought no relief. ln February 19i9 she was referred_ [ o a.T\ orthopedic surgecn.

?hysical exe...rnina.tion r evealed only a p.ainful right knee.

Laboratory s tudi es t.;er e noncot'l. tribiJto r y .

Radiograph revealed' an oval lytic lesion loca t ed at t he p-roximal portioll of the rigtt tibia .

At operetion , the. lesion --.•as noted t.o be a large cyst with so~te granula­t i on tissue pres·:lltt in tbe proximal por t ion of the righ t tibia .

GROS~ PATHOLOGY:

'The specimen consisted o£ sevet·zl portions of tissue ll.~i th a var:ied morpho­logy, . Po r tio r. s of th.: tissue resembled large blood cysts, ranging up to 1 . 5 em. in .Qi aute t e r . Oth2r pot·tions of the tis sue wQr e s oft reddish- pink i n color) ag·gregat i ng to 1 x l x 2 em.. A third pon:ion of t he t issue vJas rubbery tan color and aggregated to 2 x J. x 0. 3 em.

CC~'TRlBI.iTC:\: Ric:harti J . Dor ger, M. D. Al'?.IL 1979 - CAS'£ NO. ll Oakland , C~lifornia

ACC . NO. 230.39

TISSUE FROM : Lef t poplitcct.l fossa

CLINLC~L ABS~RACT :

!list orv : This 14 year old r.tale not ed n ruzss i n t he lef t pc;>li t ed fos s .-. app ro:;; imn~ely four months pr ior t o e.~im1~is1on . The mos s slm,•ly inc1:e.ased i n si ze causing oc:cas icna l pai!l when walk;tng .

Phys!cal examination r·~ve~l~d only dilation of the skin ve ssels ove z.·­lying the area .

I..aboratory s tudies ;.1ers; nonc:ontributory .

Radio~ravh : ~' arthrogr~ and xray of the knee were no~al . TechnetiUD bone scan and ches~ tomograrr~ we re norcal .

A biopsy of t he ~~ss was done en September 14 , 1976. r.~e pare!lts re fc~cc t o allow a~putation .

<

Sl~GERY: (Sept ember 15, 19 7S)

'n1e mass was totally excised. At surgery t he t u;no ;: itself appea red to ar i se fror.~ the pos t erior capsul e of t he knee and extended 6 - 8 inches dis t ally al ong t he t i bi a l shaft but did not involve the tib i al pe riosteum. l~e t umor i nw1dad the l a t e ral half of t h e soleu!l muscle and lay benea th t he i.ateral head of the gastroc:ncmius musc l e. The per oneal n~rve and art ery as ~ell as t he posterior t ibial artery , ne rve a nd vein \ICro:> adjacen t to t he tu:11:>r .

GROSS PATI!OLOCY:

The ~~~r c:onsis t ed of a 150 ~· egg-shaped ~ass, measuring 10 x 5 x 6 ems. i n grea t es t dimensions. The external aspect ~as bossel~ted and appeared co be thinly and i rregul a r ly encapsula t ed . On sec tion the t~or was pale and tan-o-range in color with t>tJltipl e fibrous trabeculae dividing it i nto irregula r lobules . S:uall <1r eas of hemor rhage , necrosis , and c ys t.ic degene rat i on ..-ere present .

FOLLOW-UP :

In No vember a nd Deceaber o f 197S, he was treated ~itn Cytoxan; Actinomycin and Vincr is t i ne . Wo rk- up for metastat ic tumor was negaci ve . As of Mar ch 1979 he showed no evidence of recurrence or met as tases .

CON1"-IilUTOJ:\.: \·leld<.>n K. !lulled<, M. D. Pa~adena t California

TISSUE ~'ROi{ : Right knee

CLINI~~ ABSTRACT:

Ristory: rn ts 79 ye~~ old b!ack female ~ith s••elling in the r ight knee , one ye<n: ' s dur3.tion. complained of. pain confined to the right kllee and progressive circumscribed sw;,lling of that knee . the knee was within normal limits .

SURGERY:

ACC. ~;Q , 2115o

coreplaint of pain and At that t i~e the patient it l.<.'aS associated Hith The range o f motion o!

An encapsula1:ed, firm , soft tissue mass was teased frotn t he cap~ule of the right knee joint and traced into the area pos terior to the infra?atella r tendon. A second capsular incision was made adjacent to the infrapat e llar tencon and using blunt dissection a :nultilobulated fatty structu~e •.;as de­livered from th'! space posteri.or to the infrapatellar tendon. lt did not appear to c~r.e~d ~nco the intrasynovial space. The mass was then dissected from the joint capsule. The specimen measured approxin>ately (> x 4 ems.

GROSS PA'Il!OLOGY:

The spec~n consisted of 47 gr~s of f2tty connec~ive tissue which was multilobul a ted and ~easurcd 6 x 6 x 3 ems . The m3ss had a pale thin translu­cent capsule attached to multiple fotty pale yello~J lobules which averaged 2-3 cm:l. in diameti!r. One t!Ulr!\in of the 1:Ullior was fibro:.ts and multiple sections revealed no foci of necrosis hemorrhage or mucoid ~aterial .

S·"·iJDY GF.OllP CASES

For

APRIL 1979

CP.SE NO. 1 - !ICC. NO. 23082

l/.IS Al!GELES: Pigmente!i villonodul er s ynovi t is with xanthomat \ilu o trlllls forma.­t ion - 13

C;:)iiTRAL V~: Pigoent e d vill onodula r synovitis - ll; benign xanthoma - l

SAJITA BARB..t...'q;\ : Pigrr.ented villonodular syn<r~it:!. s - 4

1/ZST SAil F<:R!IAIIDO: Pibl!!ente d villonodula.r synovi t is - 15

lf.P.R'l'!rJEZ : ?ig~:~ented n : l or.od·..Uar synovitis - 8

IA'!G llEhCH : Pigmented villonodula.r synon t is - 8

OA."<ktND: Xll.nthoma.tous va.riant o f nodul.ar synovi t is - 13

fiii.N BERNARDINO: Pi gment ed v illonodular synovitis - 11

SAN li'RhN~: Pigoent ed villonodular synovi tis - 23

SEP.'Z'J'T..E : Pig:nented \'illonodular synov:\ tis - 7

FRESt;o : Vill onodul.nr synovitis - 6; hi bcrr.oml!. - 3

SACRAM!!lll'O : Y.a:~thooatous synovitis - 3

RE'!O: Yhnthoma - 13

OHIO : Pi €'lltmte6. -.rillonodul a r synovitis - 3

Fi.I;E DIAGNOSIS : Pigmented viHonodular s yttovi t i s , p opliteal spo.~e 1713 -1:951~

CASE l~O. 2 - ACC. !10. 15147 APR:O. 1979

LOS A1HiELJ;;S: Chondroid ostecblastoma - 1 ; b enign juve!lile metaphyseal uncol:l!rl tted 1,;,sion - 11; chondr o·olastoma - 1

CENT?~ VALUTl : ~nondroblastoms - 2; fibrous dys~las~a - 4; osteoie osteo~a- 2 ; giant os"teoid osteoma - 1; giant cell tumor - 2; chondromyxoid fib ro:ma - 1

SAlil'P. B.!>RBARA : ~ncndro:ey::ofibroma - 2 ; chondroblas-.oma - 1 ; chondr cna - 1

HE:ST SAN FERNANDO: Cnondroblastcr:ie. - 9; osteob1as-tom.a - 3; fibrous dyo:ple.sia. - 3

M.\RTTIILZ : Non-cssit'yin;; !'ibrotr.a - 1; :fibrous dy~lasia - 2 ; l o;;-grade osteo­genic sarcoma - 4; chor.ci.roblastone.- l

LOJlG BEI\.Cli: Osteobla.storna - 7 ; fibrous dysplasia - 1

OA.~iD : Os-.eoblastoma - 10; a'ypical chondromyxoi d !ibro~a - 3

SAJI E>"~'l•!ARDTilO : Chond:"obla.stcma - ~; giant cell t un:or - 4; aneuryem.al bone cyst - 2; osteosarcoma - 1

SAN Flta.J<CISCO : l~ature chondl'olll<f-xOid fibr oma - 2 ; fibrous d,_vsple.si a - 12; osteoblastome. - 3

SEP.TXLV: Fibrous dysp:asia - 1

FRESNO : Chondro~xoid f ibroma. - 4; fibrous dyspl asi a - 2 ; giant cell tumor - 2 ; osteoblastoma - 1

SACRA~·lENTO : Osteoble.stc::na - II

R!:liO : . Osteogenic se.rccl!:a - 1 ; chondrobl astome. - 7; chondr o;myxcfibro:.e. - 5

~: Bcnig~ gi~t cell t~~or of bone - 2; benign osteoblas~cme. - 1

FILE DIAG!IOSIS : Chondrobla&tc:o.a, knee 1 707- 9230

eASE UO. 3 - ACC. NO. 8767 l1PRIL 1979

LOS .t<tiGELES: Alveolar soft 11an s arco;r;e - 14

CB!l'l'fu\L VALLEY : Alveolar soft part s<>.rcoma - 8; rhabdo~roserc<:>ma - 1; large cell s arcoma of tendon oheath - 1; l!l.!ll i gne.nt gzoanul er cel l m.y o-:)lastoma - 1

SANTA EAREA-"IlA: Alveolar soft part s arcoma - I<

.WEST SMf FERNMIDO: Alveolar soft part sarcoma - 15

l&..RTI!!EZ: .Uveole.r s oft p e.::-t sarcoma - 8

LONG BE.'l.CH: Al v~ lar soft part se.rcoma B

OAJ(L.4ND: JUveolar sort pan sarcoma - 13

SAN BEPJU!.ilDINO: Alveolar go:f't pen-t sarcoma (malignant gr83lular cell. t llll!or) -ll

SAN FRANcrsco: Al veolal:' soft parl sarcoma - 23

SEATTLE: Alveolar so.ft part sarcoma - 7

FRESNO: Alveolar soft part sarcomrt - 8; e.J.veolar rhabdomyosarcoma - 1

§SiRAHENTO: Alveol ar s 01't part sal:'coma - l!

~0: He.lignant gre.nula.r cell tumor - 6; eJ.veolar sol't part sarcoma - 7

OHIO: .AJ..veola.r soft part sarco-ma - 3

FILS DIAGNOSIS : Alveolar soi't !'S.rl sarcoma, popliteal space 1713-9373

CASE NO . 4 - ACC. !10 . 10560 Jl.PRIL 1979

L.QS :'INGELE~ : Heoangioper:!.c:r~o= - 4; nod"ill.ar syno>'i t~ s (giant ceH t~mor or tendon she~th) - 6

CE!ITRAL VAIJ:i,Y: Fibrous histiocytoma, "benie,n - 4; f ibrol1s histiocytoma., maJ.ignant - 1; synovio:na. - 1 ; h eme.nsiopericytomo. - 3; cellular tumor , 1•os - 1; he!:'l0 1"Sioendot:"l" H oma - l

SFJlTA BARB!~~~-: Hemangioperi cy-;;oma - 4

\<"EST SA.~ FERl!PJ!DO : Giant cell tumor of tendclt sheath - 5; ll·:!!n:mgiop~ricy­toma - 5 ; intravascular Ln~ioma~osis - 2

~!ART!NEZ : Henmngiope:ricytoma - 1; giant cell t•JJnor of tendon sheath - 7

LOr~G :lEACH: G!.c.nt cell t'Wt.or o!' tendon ~:nesth orioi::. - 8 ,.

OAKLAND: Ucdular tenosynovitis (nbrous hist!.o~rton:a) - 13

S!>Jl BEEUliU\DINO: Fibroue histiocytoma - 11

SP.M FRA.'ICISCO: Gi=t cell tun:or ( fibroxantho:na) - 20 ; he:ne.ngiopericyte:na - 3

SEATTLE: Hecangioperictyo~a - 7

FRESNO : Fibrous histiocytoma - 7; hemangi opericytoma. - l; giant cell tu.7.or -

Sl!CRA!-1E'l!'I:O: fibrous histiocyto= - 1 ; £~am; ceil t umor tendon sheatl:. - 2; hems.ngiopericy-;;omu - 1

P.:2NO: l!eaang!oper i c:;tOir.a. - 13

OliiO: Giant cell tuao~ of te~don 3heath - 3

FILE DIAGriOSIS : tfodule.r teoosynovi tis ( gia1'Jt cell t uroot· sheetb)

c'f "tendon 1713-4953

(SNOP)

CASE UO. 5 - ACC. JlO . 1 9680 APRIL 1979

LOS JlJlGELES: Fibrosarcoma - 13

OE!ITRJU. VALLEY: Schws.nnoma , solitary - 2; leiomyosarcoma, 1m.- graee - 5; ~ibrosaJ·coma, 1o>~ grade - 3; ne=of'ibrosarco:Da - 1

SA1!Tf,. RA.Rlll>J\A : Fi brosarcome. - 4

W!ST SA:~ FEPJIA!IDO: L-eioeycse.rcoJ:>a - 5; IDtii{3tlant echwo.nr.oma - 4; fibrcsar­co:a - 5; synovial sarcoma - 1

f.!io.R'l'INEZ: Fi brosa.rcoma, lw gre.'de - 8

U:liG "~EAC!l: F:ibrosarcoma - 6; leio~eyosar~oma - 2

OAKLt.. .. TifD: Fibr osarcoma - 8; leiomyosarcoma - ~ ; c lear cell sarcoma - 1

BAil jlE!ltiARDHO: Fibrosarcoma - 10; leicn~rosar~oma - 1

SAl! F?.Arrcrsco : Fi brose.rcoma. - 23

SEA~LE: Fi "o-ro:;arco:aa, lov gre.de - 7

FRESNO: fibrosarco~a - 9

SACR4..~1'l'O : Fibrosarcoma. - h

RfliO: Fibrosarcoma - 13

Oh'IO: Ji'i brosercoma - 3

FILE DIAG!TOSIS : Fibrosarcoma. , knee 1713-8823

CAS!!l NO. 6 - ACC. NO. ~7303 APRIL 1979

LOS ANGELES : Pa.rostea.l oste~sa:rcorne - 14

CEi·lTF' ... &.L VAL1EY: Chcndromyxofibroma - 3 ; fibrous dysplasia - 2; osteobl.r..stor.:ta, beni.gn - 1; periosteal osteogenic se.rco!l'~ - ·2; osteoin!l. - 1; enc:hondroma - l ;. · periost•<.e.l chondroma - l

S.&IITA B.luU.lP.RA : Chondrosarcoma - 4

HEST SPli FEBNANDO: Chondro.myxoid fibroma - 7; J"aros teal chondroma - 1; be!'l i gn cart i lage tumor- 1; osteochondroma - 1; pnrostee.l os teose.rcoma - 1

}1Jt..i1TilfRZ: Ossif".ring :fibroma - 1 ; lort-g:rade :perios~es.l ost eogenic se:rco!lta - 8

L O!fG 3E.I.\C5 : Parostea~ osteogenic sarcoma. 8

OAKLA~D: Par osteal osteosarcoma - 13

Sill'l BERN.IL.'lDINO: Chondromyxoid fibroma 9, ·oenign , f!OS, 2

SA.ti FRIU~CISCO : Parosteal osteosarcoma - 10; chondronwxoid fib:rcna - 2

SEATTLE: Periosteal osteogenic sarcoma - 7

FP-ESNO: Osteo.::hoodroma - 2; chonecl!l';xoid fibroma - l; pa,rost eal osteogenic s arcome - 3; chondrosar coma - 3

SA~R!l.N:ENTO: Periosteal osteosarcoma - 2

REl'iO: CbOl'ldrosa.rc.oma. - 13

OHIO: Chondrcw~xoid fibroma - 2; cnondrosarccm.~ - 1

FILE DIAlliJOSIS : ~arosteal osteos~rcoma, knee 1107- 9193

Reference : U:nni, K1~is.hnan K. et 8.1 : Periosteal Osteogenic Sarcoma. Cancer 3T:2376-2385, ·1976 .

CASE &C . 7 - ACC. NO. 15114 A?~L 1979

L')S M<GBLES : 11)-p:oid liposarcoma. - 14

CEl!:fTHAL VALLE'l : Chondronr;xofibrome - 2; li:posiJ.rcolW). , lov grade - 2 ; rny:<oid liposarcoma, low grade - 5; ll'.yxoma. - 1; my:wfibroll\a - 1

SA:1TA BAP.Ba.R~t : Liposarcoma - 4

WEST SAri FBRliMIDO: l~"Xoid liposarcoma - 15

;,fARTllfEZ : Liposa.rcomn - 4; myxoliposarcor.a - 5

LONG JlRACH: 1<1yxo1d liposarcoma - 8

OA.!(LA!iD: }tY:coid liposarcool!. - 13

SAN llF:RKA.;o:rn<:; : Liposarcoma 8; ltlY.XOms. - 1; hemangiop.:ric:-r~oma :! ; ~:OS - 1

SAN FRANCISCO: l<1yxoid lipcsarcoma {vi th mi toee~ ) - 23

SEJ\TTLE : Liposarcoma, l ow grade - 7

FRES!IO : ~:yxoid lipose!"co:na - 9

SACRf~~TO : ~-xoid liposarcoma - 3; l i posarcoma - l

RENO: Liposarcoma - 13

OlfiO : l·trxoid liposarcooa - 3

FilE DIAG!;osrs: !·~xoid liposarcace. , k."1ee 1713-8853

CASE 110. 8 - ACC . 1l0. 13841 APRIL 1979

LOS A!IGBLES: Chondrobl asto:z:a. - 11.

C2JITP.AL VALIS"t : Gian~ cell tu:r.or, benign - 3; giant eel: tumo!", me.lignant - 1 ; siant cell tumor , NOS - 3; chondroblastoma - 3; de~e~ed - 1

SANTA BAR.BAFk Chondroblast oma - 4

T,.'EST SA!f FERNANDO: Giant cell t umor ( bone) - 2 ; chondrobl ast on:o. - 12

~lARTINEZ. : Chondr c bl astoma - 5 ; ·osteosarcoma - 2; giant c ell t 1.lrlor of bone - 2

LONG BEACH : Chondr obl astom.a - 8

OAKIJl~D : Giant cell tuner ( i~ it did not involve t he epiphysis) - 11; atypi­cal chondroblastom.a - 2

SAN BSRRA.Romo: C:;o:1droblasto:~:a - 11

SAl: FF.AMCISCO: Chondroblastc:na, atypice.J. - 21 ; non- cssii'y:.ng fibr01na - 2

SEATTLE: Chondroo l astoma - 7

FRESNO : Giant cel l tumor - 3; chondroble.storna - 5 ; chondr os e.r como. - l

SAC!',AI.!EIITO : Coondr o])J.as'i;orua - 1,

RID~O : m1ondroblastoma - 7; giant cel l t umor - 6

OlUO: Synovi al os t e-;,chondromatosis equi Yo.lent 2 ; ost eos arcoma - l

?ILB DIAGNOSIS: C"nondrobl asto=, lmce 1707-9230

CASE !lO. 9 - ACC. NO . 18769 A?RIL 19!9

LOS /illCELES : }~~ligr.ant fibrous h i stiocytoma- 14;

CENTRAL VllLI.E'!: Fibrous histiocytoma, malignant - 5 > hemengiopericytcrH - 1; hen•a.nsio<md.othe1io:ma, b enign - 1 ; :fibroma - 1 ; a.ngi ose.rco:ma - 2 ; deferred- 1

SANTA BARBARA: Epithelioid 1eior;~osaTcome. - 2; synovial Ss.!'~Or.la. - 1

WEST SAN PE?3A~: Naligne.nt fi"t-rous histiocytoma - 13

~.!.\...1lTil!EZ : ?ibr ous histiocytona, me.ligna.m: - 7; ben!gn 2; atJ'picU - 1

LCHrG .BEACH : Benign fibrouo histiocyte~ - 2; atypical giant cell tUI:lOr , t endon sheath - 2; malignant giant cell tumor - 1; nodular :fasciiti~ - 1; hemP.l"lCi oped cyt oma - 2

OAKLAND: Fibroxanthosarcoma - 11 ; pleomorphic fibrous histiocytoma - 2

SAil EER:IARDDIO: !l.alie;nant f!.brcus histiocyto::~a - 4; sar::o:na, NOS - u; fibro•.ls histioc:~ooa - l ; deferred - 2

S~Jl !'RAUCISCO : Fibr oxanthosarcorr.a (u.align:~.nt fibrous his tiecytcm&.) - 21 ; hemangioper:cytom~ - 2

SEft~TLE : Fibrous histiocy•oma - 7

FRESNO: Atypical fibrous hi3t iocy tooa - 3 ; maligns.'">t lm< gr ade !"ibrous histiocytoma - 6

SACRA.'!El!TO : Fibr ous hi stiocytorua - 4

Rr."NO : . l-la.ligmmt f i brous histiocyt~me- 7 ; synovial S?~coms - 5 ; chond.l·Olli)"-,.:o­:fi brom3. - 1

OEt!O: Heruangioperic-:yoroa - 2 ; probably benign fibrohi stiocytoma - J.

FILE DIAGNOSI S : tA.alignent :fibr ous hi st i ocytotl(t, knee 1 7:.3- 8833

Special Stain: AMP 11as positive before &.:;d nege.ti·Fe a..f'ter hya1uronidl!.Se treatwen~ .

CASE NO . 10 - ACC. NO. 23177 A? !l!L 1979

LOS P..NG!;L:ES: Cystic giant cell tumor - 1~

CD!T?.ft.L VALLEY : .4.net~:-ysmal bone cyst - 10; giant c-:11 tl!l!lor, malignant - 1

~IES'2 SAlf ?ERI"IA!JDO: Aneuqsmal. bone cyst - :tl;

!W.TH!EZ: Aneurysmt1.l 'bone cyst - 10

LOl-10 BEACK: Aneurysmal bone cyst - 7; giant ce.ll tumor of bone - 1

O!lKLAV.D : fl.neuryzme.l bone c:rs• - 12; telangecta"tic ostecge:Uc s~come. - 1

SJ\~'1 FRt.NCISCO: Aneu-:-ysms.l bone cyst - 23

S.EA1'"1'LE: .1\ .. tleu:rysna.! bone cya t - 7

FR2S:'IO: Aneu...-ysmaJ. bone cyst - 9

SACR~JtJ:JH'O : Aneurysmal bone cyst 4

RENO: .~neurysmal bone cys t - 13

OHIO : Aneurysmal bone c~'st - 3

CO~J:1EIIT (Dr. Roger '!:err;): '"\'t,en Je::fe used the -:e:-m ' at:eu..;•snal' he ·,as re!'er:-ing to the e;,.-pansile radiographic appearance end not tbe h istologic appearance ct the .lesion , vhich i s t r au:ns.tic in origin . A cyntic giant cell tUIJlOr is not expans~le radi ographically and has a tendency to recur . The latter , whom found in a patient prior t o epiphyseal pl ate closure , :has never been re;x>rted to extend across the plate into the epiphysis ."

F:L:i!! DDl.G:iOS!S: Gi&:t cell tu:a:or , kr.ee 1107- 9251

CASE no. 11 - ACC. NO. 23039 />.P?.!L 1979

LOS A.;IGE!LE'S: S;r.:ovial sarcoma - 10; se.rcon:a, UOS - h

CEilTRAL VALLEY: Synovial sarcoma - 11

SANTA .P..ARBARA: Chondrosarcoma - 4

KECT SAN F:?:Fillt.JlOO: Synovial sarcoma. - 6; E\;ing ' s se.:::-coma of soft tissue - 6; !:le!!:.'l.ngioperic~,.;oma - 3

WJiTIJ!EZ: Synovial sarcoma, ~onophas::.c - 10

LO::G BEACH : Synovial sarcoma - 8

OAICI.I\.l.JD: Syno,:ia.l sarcoma - 9; sarcoma, NOS - lo

SAr. BEr'.NAEDilfO : Synovial oarccma - 6; hema.ngiopcricyt<?.r.:.:J. - 2; epi t.hCllioid sarcoma - 1; deferred - 2

SPJ·1 FP.AJ.\CISCO : Synovial sarcoma - 23

SE..ld"l'LE: Sync~;ial sarcoma - 7

PRE6!10: Hel!langio"Peric:rtoma - 3; synovie.l sarcOl!\a - 6

SACRP-1®1.12,: Undifferentl.ated ·smell celJ. sarcoma - 1; synovial sarcorn:1 - 3

RENO: Synovial sarcoma - 3; oalignent sch,:annoma - 5; malignant fi hrous hi stioc:rtor.ta - 5

OHIO: E:riraosseous Ewi.ng' s sarcoma - 2; synovial sarcoma - 1

FILE l>IAG!IOSIS : Synovial sarcoma, pop:iteaJ. fossa 1713-90L3

CAS.E NO. 12 - ACC. HO. 23256

LOS ANC!LES: L.i.!>Om.a. - 14

APRIL .1979

c;-:1Dt4L Vl\LlE'l: LipCl'lla - 2; ar-&ioli;:o= - li; arboresce~l. lipo= - 5

SAl'iTP. BARBARA: Lipom~. - 4

W!'ST SAtl FZPJ!A.."'DO: Fibrolipo:ta - 15

LONG BEACH: Li;;>oma - 8

OAKLPJJD: Li porn a - 13

SAN F?JINC!SCO: Lipoma - 23

EEATTL~: Lipoma·- 7

FR~~O: Differem::iated liposarcoma - 6; lipoma - 3

SAC?J.Y"'NTO: Liposarcoma, well di:f'ferentia.ted - 1; l ipome. - 3

RE)JO : Lipoma - 13

OHIO: Lipoma - 3

nLE DIAGNOSIS : Lipome, popliteal space 1713-8850

Reference: J . !-!t. Sinai Hosp. 2h : ll12- ll20, 1957 . Plaut, Alf~ed: '''!b.e !!etched lh:.cleus c:' the Fe.c Cell" (UD!la' s Lockker:'l)