Pathwork Diagnostics

Initial presentation:
An 86 year old woman presents with a lump in her right clavicular area. Relevant history includes prior bilateral breast cancer, a history of smoking, and a brother who died of colon cancer. She has no other symptoms, but has a suspicious skin nodule in her lower right quadrant. A PET/CT scan revealed activity in the retroperitoneum, left common iliac chain adenopathy, and nodular soft tissue along the left pelvic and adnexal regions.

Work up:

Initial treatment:
1 cycle of carboplatin and paclitaxel, with no response

Pathwork® Tissue of Origin Test ordered.

Results - Tissue of Origin Test:
Interpretation from Pathwork Diagnostics’ pathologist: “The Tissue of Origin Test suggests a BLADDER ORIGIN in this case with HIGH CONFIDENCE. The Tissue of Origin Test has effectively ruled out a derivation from the 10 tissue types with scores ranging from 0.4 to 4.4, as Similarity Scores below 5 indicate a greater than 99% probability of that tissue type not being the correct tissue of origin. Colorectal, and Breast, with Similarity Scores of 13.6 and 11.1, are also unlikely to be the origin, but have not been explicitly ruled out.”

Post Tissue of Origin Test treatment:

• Based on the Tissue of Origin Test, the patient was treated with 4 cycles of gemcitabine and radiation to the skin nodule. The patient experienced toxicity from the gemicitabine and it was stopped, but she did have a partial remission.

“Bladder cancer was an unexpected finding. With the new information, we were able to offer the patient targeted therapy that slowed the disease’s progress.”
-- Dr. Maen Hussein, Leesburg, FL