Date of Presentation:12/23/2020

Attending pathologist: Anil Parwani, MD, PhD

Presented by: Taylor MacDonald, MSIV

Prepared by: Taylor MacDonald, MSIV



A male in his 70s presented with gross hematuria to ER. CT evaluation of the pelvis revealed a bladder mass and prostatic urethra lesion. Cystourethroscopy and TURBT revealed a bladder tumor which extended to the prostatic urethra.

Patient has a history of colon cancer which he underwent partial sigmoid colectomy and adjuvant pelvic chemoradiation in 2008.

No evidence of recurrence for the last 12 years.


Multiple pieces of gray-tan tissue with yellow calculi received from posterior superficial bladder tumor measuring 1.5 x 1.4 x 0.8cm in aggregate. Prostatic lesion light tan tissue fragments received measuring 1.0 x 0.6 x 0.4 cm in aggregate. Posterior deep bladder tumor pieces also received measuring 0.7 x 0.5 x 0.4 cm. Finally, four pieces of light tan tissue measuring 0.2 – 0.4 cm in greatest dimension received labeled small satellite tumors.

No gross images since this case is coming from an outside hospital originally.

What is the most likely diagnosis?

  1. Epithelioid hemangioendothelioma
  2. High grade invasive urothelial carcinoma, sarcomatoid features
  3. Epithelioid angiosarcoma
  4. Metastatic colorectal carcinoma
  5. Metastatic melanoma
Epithelioid angiosarcoma