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Primary Pulmonary Angiosarcoma Associated with Multiple Synchronous Neoplasms
0022-534 7/88/1394-0877$2.00/0 Vol. 139, April Printed in U.S.A.
THE JOURNAL OF UROLOGY
Copyright© 1988 by The Williams & Wilkins Co.
ABSTRACTS nephrectomy the tumor was confined to the kidney with no apparent head extension. However, the patient died of widespread renal cell carcinoma 9 months later. Although it is extremely rare, renal cell carcinoma should be considered in the differential diagnosis of cases of the jugular foramen syndrome. N. J. 2 figures, 6 references
ONCOLOGY AND CHEMOTHERAPY Inactive Renin: A Tumor Marker in Nephroblastoma R. CARACHI, G. B. M. LINDOP AND B. J. LECKIE, Department of Surgical Paediatrics, Royal Hospital for Sick Children, Glasgow; Department of Pathology, University of Glasgow, and MRC, Blood Pressure Unit, Western Infirmary, Glasgow, Scotland
J. Ped. Surg., 22: 278-280 (Mar.) 1987 Although most patients with neuroblastoma are not hypertensive, recent studies of nephroblastoma have shown that these tumors contain immunoreactive renin. A prospective study of 8 patients with nephroblastoma was designed to measure renin activity preoperatively and postoperatively. Of 8 patients 7 had above normal levels of total renin. This increase was owing to inactive renin (prorenin) rather than active renin. Postoperatively, in 6 patients the levels had returned to normal and 1 patient was lost to followup. The authors suggest that the close relationship of renin-containing cells to vessels in nephroblastoma raises the possibility that angiotensin 2 is a growth factor for vessels. They also suggest that plasma levels of inactive renin could be a useful biological marker. R. K. 3 figures, 2 tables, 9 references Editorial comment. The idea that prorenin might serve as a tumor marker in nephroblastoma and possibly other abdominal tumors is intriguing. However, in the only patient in this small series with stage 3 disease who had a postoperative measurement the renin levels returned to normal. Perhaps this is an effect of chemotherapy but if that response is common it will limit the usefulness of this marker. Clearly, however, more patient studies are needed. The idea is intriguing. L. R. K.
Metastatic Renal Cell Carcinoma Simulating Glomus Jugulare Tumor M.A. BOILEAU, J.C. GROTTA, A. BORIT, C. VAN DER LINDEN, A. NATH, P. OSTROW AND D. KOPANIKY, Department of Surgery, Divisions of Urology and Neurosurgery, and Departments of Neurology, and Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston, Texas J. Surg. Oncol., 35: 201-203 (July) 1987 A case of disseminated renal cell carcinoma simulating a gl.omus jugulare tumor is reported. The patient presented with difficulty in swallowing and chewing. Radiological imaging, including cerebral arteriography and computerized tomography of the head, revealed a vascular mass in the left jugular fossa. The tumor was supplied by ascending pharyngeal and posterior articular branches of the external carotid artery and muscular branches of the left vertebral artery. A chest x-ray and radionuclide bone survey were negative for metastatic tumor. After embolization by selective angioinfarction the tumor was resected. Light microscopic study was interpreted as chemodectoma of the glomus jugulare. However, electron microscopic examination revealed an epithelial tumor. In search of a possible primary tumor an excretory urogram revealed a large mass in the upper pole of the left kidney. At left radical
Primary Pulmonary Angiosarcoma Associated With Multiple Synchronous Neoplasms R. A. OTT, J. EUGENE, J. KOLLIN, R. J. KANAS, D. E. CONSTON AND J. C. H. CHI, Departments of Surgery, Medicine, Pathology and Radiological Sciences, VA Medical Center, Long Beach and University of California, Irvine, California
J. Surg. Oncol., 35: 269-276 (Aug.) 1987 A 60-year-old man had primary pulmonary angiosarcoma associated with multiple synchronous neoplasms. The patient presented with shortness of breath and pleural effusion. Right pneumonectomy was done for uncontrollable hemorrhage and he died 68 days postoperatively. Autopsy revealed residual angiosarcoma involving the right thoracic wall and mediastinum. Additional autopsy findings demonstrated 4 other different neoplasms, including poorly differentiated adenocarcinoma of the prostate, mucin-secreting carinoid of the ileum, stage B adenocarcinoma of the rectum and leiomyoblastoma of the stomach. The adenocarcinomas of the rectum and prostate were different primaries as shown by immunoperoxidase using antisera to carcinoembryonic antigen and prostate specific antigen. The authors discuss the natural history of primary angiosarcoma of the lungs and they document the role of multiple synchronous neoplasms. N. J. 9 figures, 18 references
NB Rat Bladder Cancer Model: Evaluation of the Subrenal Capsular Assay System J. R. DRAGO AND J. A. NESBITT, Department of Surgery, Division of Urology, College of Medicine, Ohio State University, Columbus, Ohio J. Surg. Oncol., 36: 5-7 (Sept.) 1987 The subrenal capsular assay system in a Noble rat bladder cancer model is evaluated. The authors have used this bladder cancer model since 1978. They previously studied a number of chemotherapeutic agents in subcutaneously implanted tumors and they also characterized the Noble rat tumor. This bladder carcinoma is a transitional cell tumor that has arisen spontaneously in the bladder of an aged female rat. The tumor invades the muscle of the bladder and it has undergone 8 tumor transplant generations with a doubling time of 4.3 days. The tumor also metastasizes to the lungs. The authors used a well documented system known as a subrenal capsular assay system to evaluate the efficacy of cyclophosphamide, doxorubicin, cis-platinum and methotrexate. The technique of the subrenal capsular assay system is well described in the literature. Briefly, this is a 6-day subrenal assay system in which 1 mm. 3 fragments of tumor tissue are implanted under the renal capsule of the Noble rat. The rat
877
THE JOURNAL OF UROLOGY
Copyright© 1988 by The Williams & Wilkins Co.
ABSTRACTS nephrectomy the tumor was confined to the kidney with no apparent head extension. However, the patient died of widespread renal cell carcinoma 9 months later. Although it is extremely rare, renal cell carcinoma should be considered in the differential diagnosis of cases of the jugular foramen syndrome. N. J. 2 figures, 6 references
ONCOLOGY AND CHEMOTHERAPY Inactive Renin: A Tumor Marker in Nephroblastoma R. CARACHI, G. B. M. LINDOP AND B. J. LECKIE, Department of Surgical Paediatrics, Royal Hospital for Sick Children, Glasgow; Department of Pathology, University of Glasgow, and MRC, Blood Pressure Unit, Western Infirmary, Glasgow, Scotland
J. Ped. Surg., 22: 278-280 (Mar.) 1987 Although most patients with neuroblastoma are not hypertensive, recent studies of nephroblastoma have shown that these tumors contain immunoreactive renin. A prospective study of 8 patients with nephroblastoma was designed to measure renin activity preoperatively and postoperatively. Of 8 patients 7 had above normal levels of total renin. This increase was owing to inactive renin (prorenin) rather than active renin. Postoperatively, in 6 patients the levels had returned to normal and 1 patient was lost to followup. The authors suggest that the close relationship of renin-containing cells to vessels in nephroblastoma raises the possibility that angiotensin 2 is a growth factor for vessels. They also suggest that plasma levels of inactive renin could be a useful biological marker. R. K. 3 figures, 2 tables, 9 references Editorial comment. The idea that prorenin might serve as a tumor marker in nephroblastoma and possibly other abdominal tumors is intriguing. However, in the only patient in this small series with stage 3 disease who had a postoperative measurement the renin levels returned to normal. Perhaps this is an effect of chemotherapy but if that response is common it will limit the usefulness of this marker. Clearly, however, more patient studies are needed. The idea is intriguing. L. R. K.
Metastatic Renal Cell Carcinoma Simulating Glomus Jugulare Tumor M.A. BOILEAU, J.C. GROTTA, A. BORIT, C. VAN DER LINDEN, A. NATH, P. OSTROW AND D. KOPANIKY, Department of Surgery, Divisions of Urology and Neurosurgery, and Departments of Neurology, and Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston, Texas J. Surg. Oncol., 35: 201-203 (July) 1987 A case of disseminated renal cell carcinoma simulating a gl.omus jugulare tumor is reported. The patient presented with difficulty in swallowing and chewing. Radiological imaging, including cerebral arteriography and computerized tomography of the head, revealed a vascular mass in the left jugular fossa. The tumor was supplied by ascending pharyngeal and posterior articular branches of the external carotid artery and muscular branches of the left vertebral artery. A chest x-ray and radionuclide bone survey were negative for metastatic tumor. After embolization by selective angioinfarction the tumor was resected. Light microscopic study was interpreted as chemodectoma of the glomus jugulare. However, electron microscopic examination revealed an epithelial tumor. In search of a possible primary tumor an excretory urogram revealed a large mass in the upper pole of the left kidney. At left radical
Primary Pulmonary Angiosarcoma Associated With Multiple Synchronous Neoplasms R. A. OTT, J. EUGENE, J. KOLLIN, R. J. KANAS, D. E. CONSTON AND J. C. H. CHI, Departments of Surgery, Medicine, Pathology and Radiological Sciences, VA Medical Center, Long Beach and University of California, Irvine, California
J. Surg. Oncol., 35: 269-276 (Aug.) 1987 A 60-year-old man had primary pulmonary angiosarcoma associated with multiple synchronous neoplasms. The patient presented with shortness of breath and pleural effusion. Right pneumonectomy was done for uncontrollable hemorrhage and he died 68 days postoperatively. Autopsy revealed residual angiosarcoma involving the right thoracic wall and mediastinum. Additional autopsy findings demonstrated 4 other different neoplasms, including poorly differentiated adenocarcinoma of the prostate, mucin-secreting carinoid of the ileum, stage B adenocarcinoma of the rectum and leiomyoblastoma of the stomach. The adenocarcinomas of the rectum and prostate were different primaries as shown by immunoperoxidase using antisera to carcinoembryonic antigen and prostate specific antigen. The authors discuss the natural history of primary angiosarcoma of the lungs and they document the role of multiple synchronous neoplasms. N. J. 9 figures, 18 references
NB Rat Bladder Cancer Model: Evaluation of the Subrenal Capsular Assay System J. R. DRAGO AND J. A. NESBITT, Department of Surgery, Division of Urology, College of Medicine, Ohio State University, Columbus, Ohio J. Surg. Oncol., 36: 5-7 (Sept.) 1987 The subrenal capsular assay system in a Noble rat bladder cancer model is evaluated. The authors have used this bladder cancer model since 1978. They previously studied a number of chemotherapeutic agents in subcutaneously implanted tumors and they also characterized the Noble rat tumor. This bladder carcinoma is a transitional cell tumor that has arisen spontaneously in the bladder of an aged female rat. The tumor invades the muscle of the bladder and it has undergone 8 tumor transplant generations with a doubling time of 4.3 days. The tumor also metastasizes to the lungs. The authors used a well documented system known as a subrenal capsular assay system to evaluate the efficacy of cyclophosphamide, doxorubicin, cis-platinum and methotrexate. The technique of the subrenal capsular assay system is well described in the literature. Briefly, this is a 6-day subrenal assay system in which 1 mm. 3 fragments of tumor tissue are implanted under the renal capsule of the Noble rat. The rat
877