Stereotactic radiosurgery for brain metastasis from renal cell carcinoma

The PRESAGE database is a collaborative resource for structural genomics. It provides a database of proteins to which researchers add annotations indicating current experimental status, structural predictions and suggestions. The database is intended to enhance communication among structural genomics researchers and aid dissemination of their results. The PRESAGE database may be accessed at http://presage.stanford.edu/     

Spontaneous regression of renal cell carcinoma: a pitfall in diagnosis of renal lesions

Lobar atrophy is a rare morphologic change of the liver. We describe a 73-year-old woman with mild liver dysfunction and history of Sj?gren's syndrome who had right hepatic lobar atrophy. Serum biochemistry levels were as follows: albumin, 4.5 g/dl; total bilirubin, 1.0 mg/dl; alanine aminotransferase, 25 international units/l; aspartate aminotransferase, 27 international units/l; alkaline phosphatase, 333 international units/l; and gamma-glutamyl transpeptidase, 332 international units/l. Serological data were as follows: rheumatoid factor, 27.9; anti-nuclear antibody, 1:640; and antismooth muscle antibody, 1:80. Viral markers for hepatitis B were all negative. Anti-hepatitis C virus (anti-c-100) was negative. Portal hypertension developed thereafter, and the patient died of hepatic failure at age 76. Postmortem examination revealed autoimmune hepatitis with moderate fibrosis, portal vein thrombus, and complete obstruction of the right hepatic duct due to hepatolithiasis. Terminal hepatic failure resulted from combination of decreased hepatic volume due to the right lobar atrophy, exacerbation of autoimmune hepatitis in the remnant left hepatic lobe, decreased portal venous blood flow due to thrombosis, portal hypertension, and cholangitis with hepatolithiasis. This is the first reported case of hepatic lobar atrophy due to autoimmune hepatitis. From a clinical standpoint, patients with hepatic lobar atrophy, even if asymptomatic, should be followed up with careful attention to progression of liver diseases, portal hypertension, and biliary complications.     

Spontaneous regression of pulmonary metastases from transitional cell carcinoma

Spontaneous regression of metastatic cancers occurs rarely and has been reported only once for pulmonary metastases from transitional cell carcinoma. Two cases of spontaneous complete regression of lung metastases from transitional cell carcinoma are presented. In one case, regression occurred after a course of radiation to the primary bladder cancer, but in the other patient, lung lesions disappeared without treatment to the primary or metastatic cancers. The factors that alter the tumor-host relationship to allow spontaneous regression of cancers are unknown, but observation of these phenomena may help reveal parameters that influence tumor progression in the majority of cancer patients.     

Late presentation of solitary jejunal metastasis from renal cell carcinoma

Haematogenous metastases to the small bowel are a rare occurrence, usually from malignant melanoma or bronchogenic carcinoma. There are occasional reports of other primary tumours presenting with small bowel involvement as the first evidence of metastases. We describe a case of intraluminal jejunal metastasis from a renal cell carcinoma, occurring 10 years after the original nephrectomy.     

Prognostic factors and surgical treatment of osseous metastases secondary to renal cell carcinoma

BACKGROUND: The purpose of this study was to analyze the survival of 38 cases of metastatic renal cell carcinoma with secondary osseous metastases treated at the Orthopaedic Oncology Unit of the Massachusetts General Hospital. The survival was analyzed because it seemed to be considerably longer than any reported previously in the literature. METHODS: Survival was analyzed with respect to age, gender, site of primary tumor, presence of pathologic fracture, disease free interval, initial presentation with metastasis, solitary versus multiple metastases, and axial versus appendicular metastases. RESULTS: Survival for the entire group was 90% at 6 months, 84% at 1 year, 55% at 5 years, and 39% at 10 years. Age, gender, and presence of pathologic fracture had no influence on survival. Presentation without metastases, long disease free interval between nephrectomy and first metastases, appendicular skeletal location, and solitary metastases were all correlated with longer survival. CONCLUSIONS: In the authors' view, patients with the characteristics correlated with longer survival are appropriate candidates for aggressive surgical resection of bone metastasis.     

Ischiogluteal bursitis mimicking soft-tissue metastasis from a renal cell carcinoma

We report a case of ischiogluteal bursitis mimicking a soft-tissue metastasis from a renal cell carcinoma. A 66-year-old woman suffered from pain over the left buttock 6 months after she was operated on for renal cell carcinoma of the left kidney. CT of the abdomen and pelvis revealed a tumor-like lesion adjacent to the left os ischii, which was suspected to be a soft-tissue metastasis. Percutaneous biopsy revealed no evidence of malignancy, but the histopathological diagnosis of chronic bursitis.     

Tumor angiogenesis and metastasis: correlation in invasive renal cell carcinoma

BACKGROUND: Experience suggests that tumor growth is dependent on angiogenesis. The intensity of angiogenesis in human cancer is reported to be predictive of the probability of metastasis in many types of cancer. The aims of this study were 1) to determine the relationship of microvessel density (MVD) in renal cell carcinoma to pathologic stage, and 2) to evaluate the role of MVD in metastasis. METHODS: Paraffin-embedded tumor specimens were reviewed from 34 unselected patients with RCC who had undergone surgery from 1986 to 1990 at Taichung Veterans General Hospital. The pathology findings and clinical records were reviewed to note relationships between pathologic stage and whether or not metastasis had occurred. Specimens were studied from 16 cases (eight Stage I cancers, five Stage II and three Stage III) without metastasis and from 18 cases (two Stage I, six Stage II, six Stage III and four Stage IV) in which metastasis later developed. Microvessels were highlighted by immunostaining endothelial cells for factor VIII-related antigen. Microvessels were counted in a x-400 field (0.1885 mm2/field) in the most active areas of neovascularization. RESULTS: The 16 patients without metastasis have survived for between 65 and 136 months (mean, 94.5 months), up to the present time. Of the 18 patients with metastasis, 15 died and three survived, with mean survivals of 42.8 months (range, 12-99 months). Mean overall MVD was 99.6 vessels; mean MVD was 98.5, 96.2, 109.3 and 90.0 in Stages I, II, III and IV tumors, respectively. Mean MVD was 99.3 in patients without metastasis and 99.9 in patients with metastasis. CONCLUSIONS: MVD does not correlate with pathologic stage and is of no prognostic significance in renal cell carcinoma.     

Penile metastasis secondary to cecum carcinoma: a case report

To date, only around 300 cases of metastasis to the penis have been reported and the primary cancer has been generally found in genitourinary structures. However, exceptional cases in which the primary site has been situated in organs like esophagus, pancreas, stomach have been published. We report an uncommon case in which the primary tumor was located in the cecum. To our knowledge, this is the first case of penile metastasis in which the responsible tumor was located in the cecum and in which the mode of metastasis was not direct invasion. As the tumor was restricted to the colon wall without invasion to neighbouring structures, and because colon cancer follows mainly the lymph-vascular route to its dissemination, this route is the most likely mode of the spread. By magnetic resonance imaging (MRI) on penile shaft, multiple nodules were clearly visualized. Nevertheless, as in most cases, in spite of the availability of advanced and precise diagnostic methods, the information was of little value for the patient. His survival was short.     

Spontaneous pneumothorax complicating lung metastasis from lingual carcinoma

Cervical cancer is the fourth cancer in women. It is the first malignancy for which mass population screening has been demonstrated to significantly reduce the mortality due to this disease. In Belgium, the mortality associated to cervical cancer decreased from 6 to 4 per 100,000 women-years from 1955-1959 to 1985-1989. European recommendations regarding cervical cancer screening are to perform a cervical smear each three years in women aged 25 to 65 years. In Belgium, while the Flemish region has decided to organize the cervical cancer screening according to the European recommendations, the screening in the French part of the country is essentially opportunistic. In this short review, the cost/benefit of the organized screening versus the opportunistic screening is discussed.     

Late metastasis in thyroid gland after nephrectomy for renal clear cell carcinoma

Renal carcinoma natural history is unpredictable. Spontaneous metastases regression after nephrectomy, as well as late recurrence are suggestive of this peculiar human neoplasm. tumor metastases localized to thyroid gland are uncommon in clinical practice; and carcinoma of the kidney, breast, lung, melanoma and gastrointestinal tract tumors are responsible for the majority of them. This paper reports on a patient with metachronous thyroid gland metastases after fourteen years of renal carcinoma nephrectomy, with one year after hemithyroidectomy recurrence on cervical striated muscle followed by surgical excision. Therapeutical aspects are briefly reviewed in literature, emphasizing surgical treatment and the need of all-life follow-up, with more alert attitude toward thyroid gland after renal cell carcinoma nephrectomy.     

Generation of metastatic variants of Eker renal carcinoma cell lines for experimental investigation of renal cancer metastasis

We and others have demonstrated that a mutation in Tsc2 is the rate-limiting step for renal carcinogenesis in the Eker rat model. Although inactivation of Tsc2 results in development of renal tumors, it is not sufficient for metastatic renal cell carcinomas (RCs) in the Eker rat. To investigate the additional genetic event(s) necessary for cancer metastasis, we have established highly metastatic S-Lk9d-SLM cell lines from a non-metastatic RC cell line (Lk9dL) by co-implantation with a foreign body (gelatin sponge). Since these cell lines were remarkably different in metastatic performance (all and none, respectively) despite having the same genetic background, they should be useful experimental tools to investigate metastasis-promoting events in renal carcinogenesis.     

Metastasis of renal cell carcinoma to the contralateral renal pelvis

A young woman with syphilids resembling borderline lepromatous (BL) leprosy is being described. This is yet another addition to its already well-documented manifestations. The high prevalence of leprosy and syphilis augments the epidemiological significance of the case.     

Embolotherapy for massive upper gastrointestinal haemorrhage secondary to metastatic renal cell carcinoma: report of three cases

Three cases are reported in which angiographic embolisation therapy was effective in arresting upper gastrointestinal bleeding secondary to metastatic hypernephroma. Each patient had histologically confirmed disseminated renal cell carcinoma and presented with recurrent haematemeses with a successful outcome following palliative embolisation therapy.     

Acute myelomonocytic leukemia secondary to synchronous carcinomas of the breast and lung, and to metachronous renal cell carcinoma

We describe a patient in whom synchronous breast cancer and small-cell lung cancer, and metachronous renal cell carcinoma were diagnosed within an 11 months period. All three tumors were treated surgically, followed by administration of tamoxifen, adjuvant chemotherapy with etoposide (2.8 g/m2 total) and vindesine, and administration of interferon alpha and flutamide. The patient developed acute myelomonocytic leukemia 26 months after discontinuation of etoposide-containing chemotherapy. This pattern of multiple neoplasms fits the wider disease spectrum associated with germline mutations of the p53 gene; however, analysis of p53 exons 5-8 did not disclose any sequence abnormalities in this patient. In conclusion, clustering of four (synchronous and metachronous) malignancies may on rare occasions occur in an individual patient and in the absence of a family history of cancer; the sequence during which treatment of primary malignancies may result in treatment-related acute myelocytic leukemia is discussed.     

A case of thymic carcinoma with brain metastasis

A 43-year-old female with a thymic carcinoma spreading to the extrathorac region is reported. She had received radiation and chemotherapy, after that thymic carcinoma was extirpated. Five months later, the patient was noticed to have a right side hemiparesis, following consciousness disturbance. CT and MRI revealed a left thalamic mass with a heterogenous enhancement effect. The tumor was diminished dramatically due to radiation. Metastasis of thymic carcinoma to the central nervous system is discussed.