Circulating Prostate Cells Found in Men with Benign Prostate Disease Are P504S Negative: Clinical Implications.

Introduction. Developments in immunological and quantitative real-time PCR-based analysis have enabled the detection, enumeration, and characterization of circulating tumor cells (CTCs). It is assumed that the detection of CTCs is associated with cancer, based on the finding that CTCs can be detected in all major cancer and not in healthy subjects or those with benign disease. Methods and Patients. Consecutive men, with suspicion of prostate cancer, had blood samples taken before prostate biopsy; mononuclear cells were obtained using differential gel centrifugation and CPCs detecting using anti-PSA immunocytochemistry. Positive samples underwent further classification with anti-P504S. Results. 329 men underwent prostate biopsy; of these men 83 underwent a second biopsy and 44 a third one. Of those with a biopsy negative for cancer, 19/226 (8.4%) had CPCs PSA (+) P504S (-) detected at first biopsy, 6/74 (8.1%) at second biopsy, and 5/33 (15.2%) at third biopsy. Men with cancer-positive biopsies did not have PSA (+) P504S (-) CPCs detected. These benign cells were associated with chronic prostatitis. Conclusions. Patients with chronic prostatitis may have circulating prostate cells detected in blood, which do not express the enzyme P504S and should be thought of as benign in nature.

Secondary circulating prostate cells predict biochemical failure in prostate cancer patients after radical prostatectomy and without evidence of disease.

INTRODUCTION: Although 90% of prostate cancer is considered to be localized, 20%-30% of patients will experience biochemical failure (BF), defined as serum PSA >0.2 ng/mL, after radical prostatectomy (RP). The presence of circulating prostate cells (CPCs) in men without evidence of BF may be useful to predict patients at risk for BF. We describe the frequency of CPCs detected after RP, relation with clinicopathological parameters, and association with biochemical failure. METHODS AND PATIENTS: Serial blood samples were taken during followup after RP, mononuclear cells were obtained by differential gel centrifugation, and CPCs identified using standard immunocytochemistry using anti-PSA monoclonal antibodies. Age, pathological stage (organ confined, nonorgan confined), pathological grade, margin status (positive, negative), extracapsular extension, perineural, vascular, and lymphatic infiltration (positive, negative) were compared with the presence/absence of CPCs and with and without biochemical failure. Kaplan Meier methods were used to compare the unadjusted biochemical failure free survival of patients with and without CPCs. RESULTS: 114 men participated, and secondary CPCs were detected more frequently in patients with positive margins, extracapsular extension, and vascular and lymphatic infiltration and were associated with biochemical failure independent of these clinicopathological variables, and with a shorter time to BF. CONCLUSIONS: Secondary CPCs are an independent risk factor associated with increased BF in men with a PSA <0.2 ng/mL after radical prostatectomy, but do not determine if the recurrence is due to local or systemic disease. These results warrant larger studies to confirm the findings.

Acquired melanonychia in chilean patients with essential thrombocythemia treated with hydroxyurea: a report of 7 clinical cases and review of the literature.

Longitudinal melanonychia has been associated with a range of drugs, especially chemotherapeutic agents. We report 7 cases of melanonychia associated with the use of hydroxycarbamide for essential thrombocythemia. Of a patient population of 27, 7 (26%) developed melanonychia over a period of 2-7 years, and was not dose dependent. The high incidence of melanonychia in Chilean patients may be in part due to their Hispanic descent or to the high levels of UV radiation found in Santiago.

Oligodendroglioma bifrontal gigante / Giant bifrontal oligodendroglioma

Se da a conocer y se revisa la literatura en un caso de "Oligodendroglioma Bifrontal Gigante" de un enfermo de 34 años, que se habría expresado clínicamente por un episodio convulsivo generalizado. Las radiografías del cráneo mostraron calcificaciones irregulares que nos permitieron efectuar un diagnóstico pre-operatório de presunción. Las arteriografías carotídeas muestran el cacácter bilobulado del tumor. El estudio histopatológico mostró las características del Oligodendroglioma. La resección radical del tumor produjo la mejoría del enfermo, que recibió además radioterapia. El paciente se encuentra actualmente, dos años después de la operación, asintomático y sin indicios de recidiva ni de metastasis

Ectasia de la arteria basilar e hidrocefalia / Ectasia of the basilar artery and hydrocephalus

Se presenta un caso de Hidrocefalia Obstructiva, ocasionada por Ectasia de la Arteria Basilar (E. A. B.), diagnosticada por Tomografía Computada del Encéfalo (T.C.E.) en un paciente adulto con un cuadro demencial. Se hace énfasis en los benefícios del tratamiento con derivativa del L.C.R., que produce un mejor pronóstico con remisión importante de los síntomas demenciales, que, al igual que en los cuadros de demencia producidos por Hidrocefalia Comunicante con presión normal del L.C.R., son tratados quirúrgicamente, con resultados positivos y alentadores