Document Detail

Perce the permissive pathologist: a cautionary tale of one who misdiagnosed a pseudosarcoma, killed the patient and was found out.
MedLine Citation:
PMID:  8147783     Owner:  NLM     Status:  MEDLINE    
Perce, a promising young trainee pathologist, correctly recognizes a biopsy of a benign pseudosarcoma but his diagnosis is overruled by the less well read Head of Pathology. Acting under instructions from his Chief, Perce knowingly and without protest 'signs out' this benign condition as a sarcoma. The surgeon accepts the diagnosis without question and performs radical surgery, which is complicated by postoperative haemorrhage from which the patient dies. The Coroner orders a review of the slides and the misdiagnosis is discovered. Perce's defense that he did as he was told is rejected; he is forced to quit pathology and becomes an administrator. This unfortunate tale, which is related in verse, is intended to stress the importance of such benign but uncommon pseudosarcomas as nodular fasciitis, proliferative myositis, myositis ossificans, postoperative spindle cell nodule, pseudosarcoma of the bladder and juxta-articular myxoma. The poem also implies that surgeons should not carry out radical surgery based on an uncommon pathological diagnosis without checking on the adequacy of consultation and informed review of the sections.
P W Allen; L J Allen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian and New Zealand journal of surgery     Volume:  64     ISSN:  0004-8682     ISO Abbreviation:  Aust N Z J Surg     Publication Date:  1994 Apr 
Date Detail:
Created Date:  1994-05-05     Completed Date:  1994-05-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0373115     Medline TA:  Aust N Z J Surg     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  273-4     Citation Subset:  IM    
Histopathology Department, Queen Elizabeth Hospital, Woodville, South Australia.
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MeSH Terms
Diagnostic Errors
Fasciitis / pathology
Fibroma / pathology
Granuloma, Plasma Cell / pathology*
Pathology, Surgical*
Sarcoma / pathology*

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