Perce the permissive pathologist: a cautionary tale of one who misdiagnosed a pseudosarcoma, killed the patient and was found out.
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.
Allen
P W
PW
Histopathology Department, Queen Elizabeth Hospital, Woodville, South Australia.
Allen
L J
LJ
D003951:Diagnostic Errors; D005208:Fasciitis / Q000473:pathology; D005350:Fibroma / Q000473:pathology; D006104:Granuloma, Plasma Cell / Q000473:pathology*; D006801:Humans; D010340:Pathology, Surgical; D012509:Sarcoma / Q000473:pathology*