right lobe of #Liver removed for three foci of metastatic co | Figure 1

JLpath

Description

right lobe of #Liver removed for three foci of metastatic colon cancer. First pic shows anterior aspect of the liver (the slices in it were done in Pathology to help preserve the tissue better in Formalin). The area inked blue was done by us in order to help the Pathologist determine whether this tumor is invading into the capsule or the liver. The blue ink can be seen under the microscope and act as a guide for the docs. 2nd pic shows the underside where this lobe was removed from the rest of the liver. The ragged, cauterized area is the resection margin and will be inked as well to make sure there's no tumor cells left in the patient. 3rd and 4th pics show 2 of the 3 #Metastases with arrows pointing to the tumors.

Additional Cases

interesting and sad case. This is a 27 yo male who was diagnosed 3 years ago with mixed germ cell testicular cancer. These tumors are made up of 2 or more different components such as: #Seminoma, #Embryonal-carcinoma, #Teratoma, testicular #Choriocarcinoma, and #Yolk-sac-tumor. Prognosis of these tumors typically depends on the most malignant component of the tumor. In this case, the patient's tumor has metastasized to the liver. The first pic is just the outside of the lobe of liver removed and the 2nd pic shows the cut surfaces of the tumor. There was tumor present in almost every slice of the liver. Blue arrows show the solid aspect of the mass (multiple separate areas) and the yellow points to a multiloculated cystic aspect of the same mass. Interesting aspect to this case -- the patient previously had a debulking surgery to remove portions of small and large bowel which were involved by this tumor but they were only involved by malignant #Teratoma on final path. The other aspects of the mixed germ cell tumor which were originally present within the testicular tumor were nowhere to be found. This is likely due to the fact that the other components (unsure exactly which in this case) responded quite well to chemo/radiation and the teratomatous part of it did not all, which apparently is not an uncommon occurrence.

#Bladder and #Prostate-gland removed for bladder cancer. Orange arrow points to the prostate (inked blue) and the blue arrow points to the papillary, friable bladder tumor. As you can see, the bladder shows quite a bit of tumor. Probes are entering through the ureteral orifices. Top aspect is normal fat surrounding bladder.

total #Thyroidectomy for a concerning nodule in the right lobe. First pic is the total thyroid from the front - how it would look on someone's neck if you were staring at them. Blue arrow points to the left lobe. 2nd pic shows a section of the left lobe which was unremarkable -- this is what the cut surfaces of normal thyroid tissue looks like. 3rd pic shows the cut surfaces of the right lobe, which show a pink-white, firm mass involving almost each cut section. 4th pic shows a close up of the mass, showing it extending to the black-inked capsule. You can see how there's none of the normal red-brown thyroid tissue remaining, as it has been totally replaced by tumor. Diagnosis ended up being papillary thyroid carcinoma. Back to the first pic, the orange arrow points to a lymph node which is just above the isthmus (portion of thyroid between the 2 lobes) and is unfortunately positive for metastatic papillary thyroid carcinoma.

right arm removed for recurrent pleomorphic undifferentiated sarcoma. Arrow in 2nd pic points to area of underlying tumor and the 3rd pic is a cut cross section through the mass. You can see the tumor involves a lot of the soft tissue, possibly invading into the bone as well. Blue arrow on 3rd pic shows an area of tumor, but the overall size was measured to be about 11cm.

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