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  57 Year Old Male with Large Prostatic Mass

 
Case History:
  This 57 year old man presented to his urologist with increasing urinary retention over two months, and recent onset of abdominal pain. Rectal exam revealed an enlarged, firm prostate. His Prostate Specific Antigen level was 6.4 ng/ml (normal = 0-4 ng/ml). A biopsy was performed and a diagnosis was made. The slide is from the prostatectomy specimen.

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Pre-discussion Questions: (you must answer all questions)
 
1. The best diagnosis in this case is:

 
A. High Grade Prostatic Adenocarcinoma
 
B. Leiomyosarcoma
 
C. Malignant Fibrous Histiocytoma
 
D. Pseudosarcomatous Fibromyxoid Tumor
 
E. Rhabdomyosarcoma
 
2. This entity TYPICALLY shows which of the following cytogenetic abnormalities:

 
A. der(16)t(1;16)
 
B. Extra copies of chromosomes 2, 8, and/or 13
 
C. t(1;13)(p36;q14) (PAX7 to FKHR fusion)
 
D. t(2;13)(q35;q14) (PAX3 to FKHR fusion)
 
E. t(X;18)(p11;q11)
 
3. The most common malignant stromal tumor of the prostate in ADULTS is:

 
A. Leiomyosarcoma
 
B. Malignant Fibrous Histiocytoma
 
C. Neurogenic Sarcoma
 
D. Rhabdomyosarcoma
 
E. Stromal Sarcoma, NOS

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