TP53 and neoplasm: In addition to mutant p53 expression, the two cases with metastases (Cases 4 and 7) had the following features (Table 1): larger tumor size, local invasion, complete carcinoma-like pattern (Fig. 2A, B), focal pseudoglandular structures (Fig. 2C), diffuse significant atypia, a large percentage of multinucleated giant tumor cells (Fig. 2D), tumor necrosis (Fig. 2E), high mitotic count (> one mitosis/50 HPF), and pathological mitosis (Fig. 2F).