ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 as a quality metric, as recommendations for adjuvant therapy may depend on differentiation between pT2/pT3. Secondary reviews of pT2 ccRCCs by urologic pathologists may assist in optimizing risk stratification and patient management. Funding: Kidney Cancer Research Network of Canada ( https:// www.kcrnc.ca/ ), Canadian Kidney Cancer Information System (CKCis) ( https://www.kcrnc.ca/ckcis/ ) E-PS-24-011 Clear cell carcinoma of the urinary bladder of Müllerian type - a case report G. Stanc*, N. Novkovic, M. Papadopoulos, M. Papazian, C. Vala- vanis, E. Souka *Pathology Department Metaxa Cancer Hospital, Greece Background & objectives: Müllerian neoplasms of the urinary sys- tem are rare and are subdivided into Clear Cell Carcinoma (CCC) and Endometrioid Carcinoma. These neoplasms have been associated with endometriosis and Müllerian duct remnants. Methods: A female 65 years old was referred to our hospital for haematuria. A transurethral resection of bladder tumour (TURBT) was performed. On gross examination the specimen from the uri- nary bladder had no uncommon aspects. Results: On histological examination a high grade invasive ade- nocarcinoma was observed showing a predominant solid growth with rare tubulocystic or papillary patterns. The neoplastic cells displayed abundant clear cytoplasm and hobnail morphology. The carcinoma invaded lamina propria and submucosa while the mus- cularis propria was free from invasion in our specimen. The immunohistochemistry was positive for CK7, CA125, AMACR, Napsin A, PAX-8 and negative for ER, PgR, GATA-3, p63, CK20, CDX2, PSAP. In correlation with the clinical information a diagnosis of CCC of Müllerian type was made. Conclusion: Müllerian type CCC of the lower urinary tract is rare, it has a higher incidence in elderly females and requires radical treatment with variable outcomes. Prompt diagnosis and multidisciplinary approach are indispensable for management. Due to its rarity and lack of long-term follow-up, the prognosis of this entity remains unclear. E-PS-24-012 Extramammary Pagets disease: a case report G. Crilly*, N. Shah *University Hospital Waterford, Ireland Background & objectives: Extramammary Paget’s disease (EMPD) is a rare intraepithelial carcinoma arising in areas rich in glands, including the vulva, scrotum, penis, perineum and axilla. EMPD typically presents in older adults (>80) as an erythematous, itchy lesion, often initially diagnosed as eczema. Methods: We present the case of an 80 year old gentleman present- ing with an 18 month history of an erythematous, non-pruritic rash of the penile shaft. Past medical history was significant for diabetes mellitus, ischaemic heart disease and radiotherapy-treated prostate cancer 8 years previous. Results: An excision biopsy of the rash showed a population of nested atypical cells infiltrating into the epidermis. These cells had pleomorphic nuclei, prominent nucleoli and mitotic activity. Underlying adnexal structures were involved but there was no evidence of dermal invasion. We performed a number of immunohistochemical stains to further characterize this lesion. The cells were positive for AE1/AE3, CK7, EMA, BerEP4, GATA3 and CEA. Focal positivity was noted for CK20 and GCDFF15. PAX8 was weakly positive. The cells were negative for CK5/6, p63, CDX2 and melanocytic markers. This gentleman was diagnosed with a primary extra-mammary Pagets disease of the penis. Conclusion: EMPD is a rare carcinoma which requires a high index of suspicion, particularly in the elderly and those with failed medical management. The most common area affected are the vulva (65%) and perineum (20%) while the penis and scrotum account for 14% of EMPD cases. Patients are often initially treated with topi- cal steroids and ointments without improvement. A median time to diagnosis of 2 years has been reported. Surgical resection is the treatment of choice for EMPD. E-PS-24-013 Sarcomatoid carcinoma of the urinary bladder arising from squamous cell carcinoma. A case review G. Galanopoulos*, L. Karelis, E. Souka, M. Terzi, M. Papadopou- los, O. Tzaida *Pathology Department Metaxa Cancer Hospital, Greece Background & objectives: Bladder cancer is the 10th most common malignancy worldwide with a male to female ratio of 4:1. The majority (95%) of cases consists of urothelial carcinoma. We present a rare case of sarcomatoid carcinoma of the urinary bladder. Methods: A 77 year-old male patient was admitted for scheduled radical cystoprostatectomy due to previously diagnosed muscle invasive (T2) squamous cell carcinoma of the urinary bladder on TURBT chips. Gross examination of the bladder specimen revealed a whitish exophytic friable tumour, measuring 9X4cm, along with areas of ulceration. Results: Histopathological examination revealed two distinct and in close proximity malignant cell populations; a squamous cell carci- noma component mostly regarding the exophytic tumour and a high- grade malignant spindle cell tumour infiltrating large portion of the muscle wall and partially invading the pervesical fat. The latter also showed areas of osseous differentiation. In situ urothelial carcinoma was also present in the superficial epithelium. Prostate, bilateral semi- nal vesicles, vas deferens, and ureteric margins were free of tumour. On immunohistochemical analysis, spindle cells were positive for Vimentin, SMA and negative for CK5/6, GATA 3, CK7, p40. The aforementioned results established the diagnosis of sarcomatoid carcinoma. Conclusion: Bladder sarcomatoid carcinoma is a rare malig- nant type and is estimated to account for 0.1%–0.3% of all blad- der tumours. Less than 100 case reports have been published in the literature. It is characterized by the presence of an epithelial urothelial and a sarcomatous population. For most cases the epi- thelial component is urothelial carcinoma, however, squamous cell and small cell carcinoma components have also frequently been reported. Due to aggressive nature of disease, it is usually diag- nosed at advanced stage. E-PS-24-014 In situ urothelial carcinoma of the urinary bladder with paget- oid extension into prostatic urethra and prostatic duct epithe- lium - a case report C. Valavanis*, N. Novkovic, G. Stanc, M. Papadopoulos, M. Papa- zian, E. Souka *Molecular Pathology Unit Metaxa Cancer Hospital, Greece Background & objectives: Urothelial cell carcinoma of urinary bladder is characterized by multifocal development throughout the S352