ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 *Pathology Department, Sahloul University Hospital of Sousse, Tunisia Background & objectives: Papillary renal cell carcinoma (PRCC) is the second most common type of renal carcinoma(RC), representing approximately 18.5% of RC. Metastatic PRCC involving temporal bone is extremely rare. We aim to analyse the clinico-pathological features of inhabituel metastatic sites of PRCC. Methods: We present a case of PRCC revealed by a temporal bone metastasis whose clinical and radiological appearances were mis- leading in a 34 year old woman, without pathological past history. This case was diagnosed in our institution in 2022. Results: Patient was referred to neurosurgery department for a rapidly evolving mass of the fronto-temporal region. The magnetic resonance imaging concluted to an osteosarcoma. Thus, patient underwent neurosurgery which revealed an haemorrhagic tumour appearing to be of muscular origin. Grossly, specimen consisted of a whitish fribale lesion measuring 4cm. Histologically, the tumour was composed of papillae formed by delicate fibrovascular cores, lined by a single layer of tumour cells with abundant eosinophilic cytoplasm and enlarged hyper- chromatic nuclei with prominent nucleoli. Tumour cells expressed CD10, P504-S and focally CK7, TTF1 ans CK20 were negative evocating renal metastasis. Abdominal-ultrasound was performed showing a renal mass. Therefore, patient was referred to urologic department. Conclusion: Lung metastasis and bone metastasis are the most most metastatic sites of PRCC. Metastatic PRCC involving the fronto-temporal bone is a rare condition and misdiagnosis is not uncommon. Clinical history information of the metastasis, morpho- logical characteristics and combined immunohistochemistry are the key to identify the renaal origin of a metastatic PRCC. E-PS-24-042 Unusual presentation of ureteriris cystica associated with malignancy È. Iglesias Martínez*, M.M. Buda, N. Santiago Quispe, A. Sifre Ruiz, A.P. Martínez Aracil, A.I. Ruiz de Angulo Otxaran, V. Moreno Nieto, M.A. Viguri Diaz, M.J. De Diego Rivas *Araba University Hospital, Spain Background & objectives: Ureteritis cystica is a rare urological dis- ease and is usually seen as incidental finding. Its aetiology is not clearly known, but it is associated with chronic urothelial irritation caused by nephrolithiasis and urinary tract infections. Methods: We present the case of 86-year-old who complained of haematuria. Abdominal ultrasonography revealed a right-sided renal mass with extension into the renal vein and inferior vena cava. Nephroureterectomy and thrombectomy was performed. On the gross examination, two different lesions was observed: a multycistic-yellow polypoid mass protruding into the ureter lumen, and a solid tumour mass in the kidney. Results: Postoperative histopathological examination revealed clear cell renal carcinoma, G1 according to WHO/ISUP (sized 11,5 cm). The renal vein thrombus was composed of the same carcinoma cell and the perirenal fat and margin of the ureter were negative (pT3N0M0). Microscopic lymphovascular invasion was observed near the right renal hilum. The ureteral lesion was composed of multiple dilated urothelial cysts, known as van Brunn nests, embedded below their mucosal lining, and filled with macrophages and eosinophilic and amorphous material content. The final diagnosis was polyoid ureteritis cystica (sized: 1,4 cm). Conclusion: Ureteritis cystica is a benign and indolent lesion char- acterized by the formation of single or multiple cysts in the ureteral lumen. It is usually associated with inflammation/infectious dis- eases. Although, in this case, it was is shown as a polypoid mass associated with a renal carcinoma. E-PS-24-043 Encrusted cystitis and pyelitis: study of 2 cases S. Moussa*, O. Belkacem, A. Loghmari, W. Majdoub, S. Mestiri, M. Ben Othmane, S. Hmissa *Pathology department, Sahloul University Hospital of Sousse, Tunisia Background & objectives: Encrusted urinary tract infections (EI) are an uncommon disorders characterized by the calcification of the urothelial wall. EI is usually due to Corynebacterium-urealyticum, a Gram-positive-bacillus, which has a major urease activity. We aim to analyse clinico-pathological aspects of the EI. Methods: Two cases of encrusted cystitis and pyelitis of 2 males aged 57 and 62 years old, respectively, without pathological past history, were diagnosed between 2014 and 2020 in our institution. The patients were referred to the urology department for a management of urosepsis. Results: Physical examination showed systemic manifestation includ- ing fever and pelvic pain. Urologic symptoms consisted of dysuria in two patients and macroscopic haematuria in one patient. Blood analysis showed a neutrophilic leukocytosis. Urinalysis revealed alkaline urine with pyuria and haematuria. CT-scan showed in all cases a calcified thickening of the urothelial wall and moderate bilateral and unilateral hydronephrosis, respectively. Thus, the diagnosis of urosepsis caused by perforated urinary EI was suspected. Bacterial culture results were positive to Corynebacterium-urealyticum in all cases. Adjusted antibio- therapy was undertaken in all cases. Histological examination showed chronic cystitis comprising calcic deposits. The evolution was fatal in one patient due to septic shock and uneventful in another patient. Conclusion: Encrusted cystitis and pyelitis is a rare entity characterized by a poor prognosis in case of delayed diagnosis and inappropriate treatment. Bladder perforation and urosepsis are a serious complications that can be fatal as described in our case. E-PS-24-044 Ductal adenocarcinoma of the prostate presenting as penile metastasis J. Boavida*, T. André Sousa Oliveira, L. Correia *Department of Pathology - Hospital de Santa Maria, CHULN; Faculdade de Medicina da Universidade de Lisboa, Portugal Background & objectives: In spite of its rich vascularization, penile metastasis are extremely rare and are commonly from the prostate and bladder. Herein we present a case of ductal adenocarcinoma of the prostate presenting as a penile metastasis in a 83-year old patient. Methods: A 83-year old patient with a history of chronic ure- thral catheterization post-urethroplasty and a diagnosis of pros- tate acinar adenocarcinoma(2019), for which he received com- bined hormonal-radiation therapy, presented with an exofitic lesion of the glans (13 mm) and general stiffness of the penis. After imagiologic evaluation documenting the presence of S360