CK 8/18

Diagnosis: metastatic prostatic adenocarcinoma

Discussion: I called the surgeon, and was told that  the patient had no history of prostatic cancer but he will certainly investigate further.

Personal note: This case I didn't see metastatic "blastic" lesions grossly. Although I took a large section from the fracture side, the HE side only showed a small focus of tumor that was initially thought to be "lymphoid aggregate". The deeper sections revealed more tumor cells with glandular formation. The curettage specimen after a brief decalcification exhibited extensive tumor infiltrate with much better morphology. Therefore, for every pathologic fracture, I feel it would probably be more helpful to submit   some red marrow around the fracture side into a second cassette with a brief decalcification (1-2 hours) besides taking a standard section.