Background: Telepathology refers to the practice of pathologists from different locations who communicate to arrive at a diagnosis. As of 2016, the estimated pathologist-to-patient ratio is only 1:167,000. The limited number of pathologists available and the bulk of biopsy specimens to be diagnosed is entirely disproportionate thus emphasizing the need for telepathology. However, comprehensive imaging software, high-end communication systems, fast and stable internet connection are all expensive. Thus, it is only practical to utilize free voice and video calling applications like Google Meet®. Objective: The objective of this study was to determine the efficiency of a mobile video sharing application (Google Meet®) in real-time field image transmission for telepathology specifically identifying how many concordant and discordant diagnoses were done and to determine the acceptance rate of the pathologists in terms of quality of images, quality of voice communication, confidence in diagnosis, and Turn-Around Time (TAT). Methodology: A total of 171 benign and malignant cases with released outright histopathology results from January 2023-December 2023 were chosen as samples. Results: The highest concordant diagnoses (100%) were made with malignant gastro-intestinal tract excision, benign and malignant female genital tract, benign and malignant male genital tract, malignant lymphoid neoplasm, polyp, pap smear, and ditzels. The lower concordant diagnoses (80%) were from benign breast excision, malignant head and neck excision, and benign lymphoid neoplasm. The shortest Turn-Around Time (TAT) was observed among ditzels with an average of 2 minutes per slide. Longer Turn-Around Time (TAT) was observed among more difficult cases such as malignant cases of the head and neck, soft tissue, and fine-needle aspiration biopsy or smears. More than 90% of the diagnoses made by the pathologists are concordant with the official result. Conclusion The overall acceptance rate of application of dynamic telepathology is high with a good to average rating in terms of image and audio quality.
Pathologists ; Telepathology ; Communication

Introduction: Primary ovarian pregnancy is a rare ectopic gestation (<1% of ectopic pregnancies), usually presenting with first-trimester rupture. Progression to term with live birth is exceedingly rare and requires pathologic confirmation to exclude secondary implantation. Case Presentation: A 32-year-old multigravida underwent exploratory laparotomy for suspected ectopic pregnancy at term. A placenta-bearing mass involving the right ovary was identified, with a grossly normal ipsilateral fallopian tube. Right oophorectomy was performed, delivering a live female infant weighing 3,060 grams with Apgar scores of 8 and 9. Gross examination showed a large hemorrhagic placenta-like mass replacing the ovary with peripheral residual ovarian tissue. Histology revealed mature chorionic villi with syncytial knots, stromal fibrosis, calcifications, and abundant intervillous blood, directly implanted within ovarian stroma containing luteinized cells and corpus albicans remnants, with no tubal or endometrial tissue identified. Discussion: Advanced primary ovarian pregnancy is extremely rare and may mimic secondary abdominal or tubal implantation. Diagnosis relies on the Spiegelberg criteria, including an intact ipsilateral fallopian tube, ovarian location of the gestation, attachment through the ovarian ligament, and histologic demonstration of chorionic villi within ovarian stroma, confirming true ovarian implantation. Conclusion Clinical, gross, and microscopic findings fulfill the Spiegelberg criteria, confirming primary ovarian pregnancy. This rare term pregnancy highlights the crucial role of surgical pathology in establishing the definitive diagnosis and excluding secondary implantation.
Female ; Pregnancy ; Ovary ; Pregnancy, Ovarian

Renal cell carcinoma (RCC) is notorious for its propensity to metastasize even after a prolonged period of remission following nephrectomy. The metastatic spread can occur months or even years after initial treatment, which necessitates a heightened level of clinical awareness and vigilance in patients with a history of renal malignancy, particularly who present with new or unexplained nasal symptoms. Although RCC most commonly metastasize to the lungs, bones and liver, its involvement in the nasal cavity is exceedingly rare, posing significant diagnostic challenges due to the non-specific nature of symptoms. We describe a case of metastatic renal cell clear cell carcinoma presenting with recurrent epistaxis and unilateral nasal obstruction. Immunohistochemistry studies play a crucial role in confirming the diagnosis and ruling out potential differential diagnoses, along with a comprehensive clinical history of the patient.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Clear Cell Renal Cell Carcinoma ; Carcinoma, Renal Cell ; Metastasis ; Neoplasm Metastasis ; Nasal Cavity ; Epistaxis