Dedifferentiated Primary Parosteal Osteosarcoma of the Temporal Bone in a 19-Year-Old Patient: A Case Report.

Osteosarcoma is the most common primary malignant tumor affecting the bone but is a rare occurrence in the head and neck region. Complete surgical resection with wide surgical margins is currently the main treatment strategy for osteosarcoma but can be hard to achieve due to the complex anatomy of the head and neck. We report the first case of primary high-grade dedifferentiated parosteal osteosarcoma arising from the temporal bone in published literature. The 19-year-old patient presented with a left retroauricular lesion measuring 3 cm in diameter. Radiographic imaging and biopsy suggested the diagnosis of intermediate-grade chondrosarcoma, but definitive histopathology confirmed a diagnosis of dedifferentiated parosteal osteosarcoma. The tumor was resected with wide margins, removing the underlying temporal bone, periosteum and overlying soft tissue through a lateral temporal bone resection. The middle ear was reconstructed with cartilage grafting, and the dura of the posterior and middle cranial fossa was covered using temporal fascia grafts and local transpositional flaps. The patient is recurrence free 10 months after treatment. This report was assembled following CARE [The CARE guidelines (for Case Reports)] guidelines and describes clinical, histological, and radiological manifestations of our patient's rare clinical entity and may provide more data in treating patients with osteosarcoma affecting the anatomically complex head-and-neck region.

CORRELATION OF EXPRESSION OF TGF- ß AND MMP2 BETWEEN PROSTATIC ADENOCARCINOMA AND ADJACENT UNAFFECTED PARENCHYMA.

In prostate adenocarcinoma, both tumorous stroma and epithelium have important role in tumor progression. Transforming growth factor beta (TGF- ß) is a promotor in advanced stages of prostate cancer. Matrix Metalloproteinase 2 (MMP2), the endopeptidase that degrades extracellular matrix is considered to be overexpressed in prostatic carcinoma related to its growth and aggressiveness. Therefore, the aim was to analyze the expression of proteins TGF- ß and MMP2 between both epithelium and stroma of prostatic adenocarcinoma and adjacent unaffected parenchyma. The intensity of TGF- ß and MMP2 expression in epithelium, tumorous stroma and adjacent unaffected parenchyma was analyzed in 62 specimens of prostatic adenocarcinoma by microarray-based immunohistochemistry. TGF- ß was more expressed in tumorous than in prostate stroma (p =0.000), while no statistical significance in case of MMP2 (p = 0.097) was found. MMP2 was more expressed in tumorous than in prostate epithelium (p =0.000), while no statistical significance in case of TGF- ß (p = 0.096) was observed. The study results indicate that both tumorous stroma and epithelium have a role in tumor progression and support potential role of TGF- ß and MMP2 in prostatic adenocarcinoma progression.

Mixed Type Haemangioma of the Inferior Turbinate: A Rare Cause of Epistaxis.

Haemangiomas of the nasal cavity are rare benign tumours which usually arise in the Kiesselbach triangle of the septum. Mostly they are seen in young population with peak age 20 years. Epistaxis is the most common symptom in these patients. We present a case of a 62-year-old woman with recurrent epistaxis. On examination she had had an obstruction of both nasal cavities. Computed tomography imaging demonstrated a well-defined tumour originating from the posterior tip of the right inferior turbinate, passing into the nasopharynx. The tumour was managed via endoscopic endonasal approach. The histological analysis revealed a tumour tissue with the appearance of a cavernous haemangioma as well as capillary haemangioma. A focus of intravascular endothelial papillary hyperplasia was also observed. In patients with endonasal benign tumours choice of surgical approach depends on the exact location of the tumour and suspected pathology. The transnasal endoscopic approach and bipolar cautery resection enable adequate exposure and visualization of the tumour, control of bleeding and complete removal of the tumour.

PATHOLOGICAL CHANGES OF RENAL ARTERIES IN PATIENTS WITH RENAL CELL CARCINOMA.

Renal cell carcinoma is the ninth most common cancer in the world. It may have a varied microscopic appear- ance, and the most common histopathological type is clear cell carcinoma. The most common pathological changes of renal arteries are atherosclerosis and fibromuscular dysplasia (FMD). During histopathological evaluation of a kidney specimen containing carcinoma, the renal vein is routinely analyzed, while the renal artery is usually given little attention. Our stud- ies have shown that pathological changes of renal arteries are significantly more frequent in the group of patients with renal cell carcinoma compared with the control group and the group of patients with non-tumor kidney diseases. These relations led us to the conclusion that the onset of renal artery changes is not prior to the carcinoma or non-tumor diseases and that they are formed simultaneously or as a consequence. Further studies should be aimed at determining the incidence of these changes in a larger number of samples and the detection of their possible correlation with renal cell carcinoma.

Clinico-pathological features of patients with melanoma and positive sentinel lymph node biopsy: a single institution experience.

Sentinel lymph node biopsy (SLNB) is an established method for the assessment of tumor aggressiveness in patients with primary cutaneous melanoma (PCM). To improve the criteria for the selection of SLNB candidates, the aim of our study was to determine clinico-pathohistological parameters that can serve as predictors of metastatic progression. We retrospectively evaluated all available clinico-pathohistological parameters in 844 patients with PCM diagnosed between January 1, 2005 and December 31, 2010. SLNB was conducted in 484 (57.3%) patients, 122 (14.5%) of whom had a positive node. The association between predictors and SLNB outcomes (positive SLNB and metastatic development) was tested using logistic regression analysis. The main predictors of positive SLNB were Breslow thickness (adjusted odds ratio (AOR)=1.22; 95% confidence interval (CI)=1.11-1.33), Clark levels (AOR=1.78; 95% CI=1.31-2.40), ulceration (AOR=3.1; 95% CI=1.65-5.81), microsatellitosis, gender, and tumor localization. The predictors of metastatic spread were Breslow thickness (AOR=1,69; 95% CI=1.51-1.89), Clark level (AOR=3.59; 95% CI=2.79-4.62), nodular type of melanoma (AOR=8.21; 95% CI=1.70-39.53), ulceration, mitotic rate, microsatellitosis, gender, and tumor localization. It seems that these parameters should be taken into consideration when selecting patients for SLNB since tumor thickness is not a sufficient predictor of SLNB outcome, particularly in case of very thin lesions.

Surgical treatment for nasal polyposis: predictors of outcome.

Nasal polyps recur in approximately one-third of patients after surgical treatment. It would be beneficial to be able to predict the patients in whom we might expect recurrence and to predict the clinical outcome after surgery. The study included 30 patients operated for nasal polyps. Removed polyps were analyzed by immunohistochemical analysis for IL-5, IgE, vascular endothelial growth factor and eosinophilic infiltration. These parameters together with preoperative CT score were used as independent variables, and subjective score improvement after 2 years was used as a dependent variable in multiple linear regression analysis. Furthermore, the patients were divided into two groups: low and high polyp tissue immunoreactivity. The Chi-squared test was used to determine whether polyp immunoreactivity influences polyp recurrence and subjective score. Preoperative CT score had a slightly positive correlation with subjective score after 2 years. High eosinophil infiltration significantly predicted a higher risk for polyp recurrence. High IL-5 positivity was related to greater risk for polyp recurrence than low IL-5 reactivity but not significantly. IgE and VEGF reactivity in polyp specimens did not have any effect on polyp recurrence. High eosinophilic infiltration in polyps can predict worse outcome after surgical treatment of chronic rhinosinusitis with nasal polyposis. IgE and VEGF do not have prognostic significance to polyp recurrence after surgery. The preoperative extent of disease measured by CT score had a slightly positive correlation with worse outcome after surgery.

Pathological characteristics and clinical perspectives of papillary thyroid cancer: study of 714 patients.

Papillary thyroid cancer belongs to most commonly diagnosed well-differentiated malignant tumor of the thyroid gland, with only minority of cases being more aggressive, recurring locoregionally and developing distant metastatic foci. The aim of this study was to determine the clinical relationship between parameters of age, gender, size of primary tumor, intraglandular dissemination and regional metastatic spread and evaluate the importance of each parameter; analyze other major aggressive factors (tumor border, thyroid capsule invasion, perivascular, perilymphatic spread) on prevalence and extent of intraglandular dissemination and relation to metastatic spread in neck. This study is a retrospective analysis of clinical and pathological data from 714 patients with papillary thyroid cancer, presented and operated at the Department of ENT/Head and Neck surgery, Sisters of Charity University Hospital, Zagreb, in the period from 1980 to 2008. All patients were operated upon with total thyroidectomy and some type of neck lymphonode dissection (paratracheal or lateral). In results, we found 46.9% tumors were aggressive; 34.7% tumors were multicentric, with foci in the contralateral lobe nearly twice as often as in the ipsilateral lobe; 27.8% were regionally metastatic, with equal distribution between paratracheal and lateral regions. In conclusion, we revealed contralateral lobe multicentricity and male gender as independent risk factors for regional metastatic dissemination. Nodular goiter has been identified as a protective parameter.

Correlation of vascular endothelial growth factor and hypoxia-inducible factor-1α expression with pathological renal artery changes in patients with renal cell carcinoma.

OBJECTIVE: The aim of this study was to correlate the expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) with pathological renal artery changes in patients with renal cell carcinoma (RCC). A further aim was to correlate intratumoral microvessel density (MVD) with VEGF and HIF-1α expression and prognostic factors for RCC, including tumour necrosis. MATERIAL AND METHODS: Formalin-fixed and paraffin-embedded tissue blocks from 150 patients with RCC and 50 patients with non-tumorous kidney diseases were analysed. The control group consisted of specimens from both renal arteries obtained from 25 decedents at routine autopsy (50 cases in total). Immunohistochemistry was performed using primary antibodies to VEGF, HIF-1α and CD31. RESULTS: Pathological renal artery changes were more common in patients with RCC and non-tumorous kidney diseases than in the control group. MVD was higher in the RCCs of patients with pathological renal artery changes. Tumours with higher HIF-1α expression had higher MVD; however, VEGF expression was not associated with MVD. A significant association was also found between MVD and the extent of tumour necrosis, in that less necrotic tumours had higher MVD. No association between renal artery changes and VEGF and HIF-1α expression was established. CONCLUSION: Considering the results of this study, the evaluation of renal artery changes in forthcoming research on RCC would be helpful for several reasons: to estimate their incidence in a larger number of patients, to clarify their connection with RCC and to reveal their relationship with MVD in RCC.

Intensity and distribution of immunohistochemical expression of galectin-3 in thyroid neoplasms.

The aim of the study was to assess the intensity and distribution of galectin-3 expression in benign and malignant thyroid neoplasms by immunohistochemical method. Immunohistochemical expression of galectin-3 was analyzed in surgical thyroid specimens from 82 patients with histopathologic diagnosis of follicular adenoma (n = 32), Hürthle cell adenoma (n = 10) and papillary carcinoma (n = 40). Results of intracytoplasmatic and intranuclear expression of galectin-3 were scored using a semi-quantitative scale for intensity. Intracytoplasmatic expression ofgalectin-3 was positive in 18 (43%) benign neoplasms and in all 40 malignant neoplasms. The accuracy, sensitivity and specificity of intracytoplasmatic expression of galectin-3 as a malignant marker in thyroid neoplasms were 78.1%, 100% and 57.1%, respectively. Intracytoplasmatic expression of galectin-3 was positive in 10 (31%) cases of follicular adenoma and 8 (80%) cases of Hürthle cell adenoma. The accuracy, sensitivity and specificity of intranuclear expression of galectin-3 as a malignant marker in thyroid neoplasms were 84.1%, 100% and 69%, respectively. There was no strong intensity of either intracytoplasmatic or intranuclear expression ofgalectin-3 in benign thyroid neoplasms, and no weak intensity of either intracytoplasmatic or intranuclear expression of galectin-3 in malignant neoplasms. There was no statistically significant difference between intracytoplasmatic and intranuclear expression of galectin-3 in benign thyroid neoplasms. The results of our study indicate that the immunohistochemical expression of galectin-3 is a highly sensitive marker of malignancy, with low specificity in differentiating malignant from benign thyroid neoplasms. The analysis of intensity and distribution ofgalectin-3 expression could improve the specificity of the method.

Giant congenital nevus with plexiform neurofibroma and malignant peripheral nerve sheath tumor.

A female patient with a giant congenital nevus associated with plexiform neurinoma and malignant peripheral nerve sheath tumor (MPNST) on head and neck is presented. We theoretically discuss possibilities of mutual origin all three entities, including the Boland theory of neurochristopaty. The clinical, surgical, and histologic aspects of the disease are discussed. Only one similar case in written literature was described.

Prognostic value of Helicobacter pylori sinonasal colonization for efficacy of endoscopic sinus surgery.

Compared with rhinologic patients without chronic rhinosinusitis (CRS), a higher prevalence of sinonasal Helicobacter pylori (HP) in patients with CRS was found. This study investigated if HP sinonasal colonization has a prognostic value for efficacy of functional endoscopic sinus surgery (FESS). Nasal polyps of 40 patients with CRS, undergoing FESS, were analyzed for presence of HP using immunohistochemistry (IHC). Patients were categorized as to whether the IHC was positive (HP+ group) or negative (HP- group). HP+ group and HP- group were compared according to the nasal polyp eosinophil density, and to the improvement (difference between pre- and post-operative scores) of the subjective symptom scores, and the nasal endoscopic scores. Nasal polyps in 28 (70%) patients were positive for HP. There were no significant differences between HP+ group and HP- group comparing the eosinophils, and the improvement of the single symptom and the total symptom scores. HP+ group had significantly greater improvement of the nasal endoscopic scores (F[1.38] = 6.212; P = 0.017). There is no influence of sinonasal HP on tissue eosinophilia and on CRS symptoms. There is a prognostic value for endonasal findings: CRS patients with HP have statistically significant greater improvement of the postoperative endoscopic scores.

Periacinar retraction clefting and d2-40 expression in prostatic adenocarcinoma.

Retraction clefting is known to appear in various types of tumors, but it has only recently been recognized as a specific histological phenomenon. Previously, it was considered merely a laboratory procedure artifact, but lately, there have been some assumptions that peritumoral retractions actually represent lymphatic spaces. In our study, we analyzed neoplastic glands in 52 specimens of prostatic adenocarcinoma. Immunohistochemical analysis was performed using D2-40 antibody, to highlight lymphatic endothelium and thereby differentiate actual lymph vessels or lymphovascular invasion from periacinar retractions. Our results showed that the number of lymph vessels was significantly lower in tumorous tissue compared to adjacent normal prostatic tissue. On the other hand, the number of lymph vessels in tumorous tissue was significantly higher than the number of lymph vessels mimicking periacinar retractions. Overall, the number of lymph vessels mimicking periacinar clefts was particularly low. These results are in accordance with our previous studies, which had shown that periacinar clefting appears due to lack of basal cells and stromal changes around tumorous acini. Also, these results support our hypothesis that retractions do not represent lymph vessels but should be considered a distinct entity, which is proven to be helpful both as diagnostic and predictive factor.

Papillary thyroid microcarcinoma: clinical and pathological study of 321 cases.

The primary aim of the study was to investigate microcarcinoma characteristics of aggressivity, multicentricity and metastasis. Though its features are not significantly different from those of other papillary carcinomas, the optimal therapeutic approach continues to be an issue of controversy, most notably appropriate surgical approach and indications for neck dissection. The study is retrospective analysis of 321 microcarcinoma cases, operated upon with total thyroidectomy, with or without neck dissection. These cases were compared to larger papillary cancers. We found that 35.1% tumors were aggressive; 25.2% were multicentric, with foci in the contralateral lobe nearly twice as often as in the ipsilateral lobe; and 18.2% were metastatic. In comparison to groups of < or = 2 cm and < or = 3 cm, microcarcinomas were less aggressive, multicentric and metastatic. Male gender and age < 45 were unfavorable parameters. Multivariate analysis revealed contralateral lobe multicentricity and male gender as risk factors for metastasis. Although microcarcinoma demonstrated better characteristics than larger tumors, this subgroup behaves aggressively and should be approached cautiously.

[Carcinosarcoma of the sigmoid colon with micropapillary pattern: a case report]. / Karcinosarkom sigmoidnoga debelog crijeva s mikropapilarnom slikom: prikaz bolesnice.

Carcinosarcomas are very rare malignant tumors showing both mesenchymal and epithelial differentiation. They most commonly occur in the head and neck region. Few cases were described in the colon associated with very aggressive course. Micropapillary variant is also very rare in the colon and associated with poor prognosis. We report an unusual case of carcinosarcoma of the colon with micropapillary features and psammomatous calcification in an 83-year-old female patient. Tumor was located in the sygmoid colon and measured up to 3.8 cm in the largest diameter. Microscopically it was composed of glandular structures and micropapillary formations with psammomatous calcifications and solid areas built up of spindle cells with focal areas of cartilaginous differentiation. Glandular and micropapillary components immunohistochemically showed positive staining for cytokeratin and EMA while mesenchymal areas were positive for vimentin. The tumor was spreading through the whole thickness of the wall into adjacent fat tissue. Metastases in regional lymph nodes were composed entirely of glandular component. To the best of our knowledge, this is the first case of carcinosarcoma of the colon showing micropapillary features and psammomatous calcification.

Osteolytic skull metastasis with dural involvement from a papillary thyroid carcinoma.

Skull metastatic tumors are relatively rare medical entities and originate most often from the lungs, breast or prostate. We report a case of a 76-year-old woman who presented with a bulging, well-circumscribed mass on the right side of the forehead. Neuroimaging of the cranium detected an osteolytic lesion measuring 7 cm in the largest diameter while propagating outwards and intracranially. A thorough medical history revealed that patient had undergone surgery for invasive breast ductal carcinoma and also for a well-differentiated thyroid carcinoma 13 years ago. Considering patients medical history metastatic breast carcinoma was suspected. After a frontal craniotomy the tumour tissue was totally resected. Histological examination revealed metastatic papillary carcinoma characterized by ground-glass nuclei with intranuclear pseudo inclusion and nuclear grooves. We report clinical and neuroradiological features of this uncommon lesion and discussed the differential diagnosis of skull osteolytic lesion together with the treatment management.

C-myc expression in the microvessels of medulloblastoma.

The increased expression of c-myc is related to neoplastic transformation and angiogenesis. Therefore, the assessment of expression of c-myc in endothelial cells and neovascularization could help to determine the biological behavior of the tumor. We analyzed neovascularization and c-myc expression in 36 medulloblastoma specimens. The results were shown by determining immunohistochemical staining index (ISI), the sum of staining intensity (SI) and the percentage of positive cells (PPC) in the blood vessels endothelium of the tumor. We also performed the microvessel count (MVC) in 10 high-power fields (400X) with the most prominent vascularization and expressed it as microvessel density per mm2 (MVD). C-myc immunostaining intensity index in blood vessel endothelium is grouped into four groups, 0--no reaction, I-weak reaction (ISI = 1 or 2), II--moderate reaction (ISI = 3 or 4), III--strong reaction (ISI = 5 or 6). Statistically significant differences (p = 0.0214) have been found between groups 0 and 1 compared to groups 2 and 3. A higher percentage of positive cells has been found in male patients than in female ones (p = 0.0483). C-myc PPC 0 or 1 has on the average smaller density of blood vessels per mm2 than c-myc PPC 2 or 3, but the difference is not statistically significant. C-myc ISI 0 or 1 has, on the average, smaller density of blood vessels per mm2 than c-myc ISI 2 or 3, but the difference is not statistically significant. We concluded that c-myc staining intensity was associated with higher microvessels density.

Isolated cerebellar intraparenchymal Rosai-Dorfman disease--case report and review of literature.

BACKGROUND: Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) rarely affects intracranial structures without involvement of other sites. We herein review the tumour characteristics, differential diagnosis and treatment policy of this rare disease. METHOD: We conducted a PUBMED search using a combination of words 'Rosai-Dorfman disease', 'Central nervous system', and identified 42 cases of such a disease infecting exclusively central nervous system. Out of those cases only one case was reported to be purely intracerebellar making our case the second one in the literature. Clinical features, differential diagnosis, treatment details and follow-up were discussed. We also described the case of 41-year-old man presented with vertiginous symptoms and mild cerebellar ataxia who was diagnosed with a solitary lesion localised deep in the right cerebellar hemisphere. Immunohistological findings revealed Rosai-Dorfman disease. FINDINGS: The most common locations of the tumour were frontal and parietal region, but CNS lesions have commonly involved the skull base with a leptomeningeal component too. The median age at presentation was in the third decade, ranging from 3 to 78 years. There is a slight male predominance. The follow-up ranged from 1 month to 11 years. Recurrence was not observed in the cases where total surgical excision was performed. CONCLUSION: Though Rosai-Dorfman disease is a rarity, one should take it into a consideration when treating solitary intracerebellar lesion. Thorough preoperative evaluation is mandatory and biopsy should be done whenever feasible. Surgical treatment of this type of tumour is not always necessary, however, it is essential for postulating the right diagnosis. When total tumour removal is achieved, the outcome is generally better, with minimal risk of recurrence and with no need for further additional therapy.

Influence of CagA-positive Helicobacter pylori strains on atherosclerotic carotid disease.

Citotoxin-associated gene-A (CagA)-positive Helicobacter pylori strains have been associated with occurrence and destabilization of coronary atherosclerotic plaques. However, data on the relationship between CagA-positive H. pylori infection and carotid artery instability are lacking. Thus, the role of CagA antigen in patients with symptomatic and asymptomatic carotid atherosclerotic plaques was investigated. A total of 64 patients with advanced carotid artery stenosis, including 33 patients with symptomatic and 31 patients with asymptomatic internal carotid artery stenosis, verified by duplex ultrasound, all undergoing carotid endarterectomy, were studied. The control group consisted of 65 subjects without a history or presence of vascular diseases. Serology for H. pylori and CagA antigen was assessed in all participants. Specimens of atherosclerotic plaques obtained from all patients during carotid endarterectomy were analyzed immunohistochemically using anti-CagA monoclonal antibodies. The ultrasonographic plaque characteristics were also estimated. CagA antibody titers were significantly higher in symptomatic patients (8.8; range, 5.8-32.7) compared to asymptomatic patients (4.7; range, 2.1-8.8; P = 0.005) and the control group (5.0; range 2.2-7.9; P < 0.001). There was significant difference in echolucency (≥ 25% soft material) between the symptomatic and asymptomatic groups (P = 0.034) by ultrasonographic evaluation. Positive immunoreactivity between monoclonal CagA antibodies and antigens within atherosclerotic specimens was significantly higher among symptomatic patients compared to asymptomatic patients (97.0 vs. 74.2%; P = 0.009). H. pylori may play a role in the pathogenesis of the atherosclerotic process due to autoimmune mechanisms and even contribute to destabilization of carotid atherosclerotic plaques.

Xanthogranuloma of the sellar region in a patient with sarcoidosis.

Xanthogranuloma of the sellar region is a very rare brain tumor with favorable prognosis and without reported relapses of purely xanthogranulomatous lesion after complete resection. A case is presented of a 40-year-old male diagnosed with and treated for sarcoidosis, complaining of headache, photophobia and loss of libido. Physical examination revealed generally scarce hairiness, while laboratory investigations showed panhypopituitarism. Expansive sellar and suprasellar mass compressing the floor of the third ventricle and optical chiasm was confirmed by cranial multi-slice computerized tomography (MSCT). Complete resection of the tumor mass using trans-sphenoidal approach was performed. Histopathologic analysis revealed cholesterol clefts, sparse lymphoplasmacellular infiltrates, macrophages, siderophages and foreign body giant cells around cholesterol clefts confirming the diagnosis of xanthogranuloma of the sellar region. Since preoperative diagnosis of xanthogranuloma is very difficult, therapeutic algorithm does not differ from other expansive lesions of the sellar region, but pituitary involvement should always be considered in patient with sarcoidosis since therapeutic management is non-surgical. Follow up MSCT imaging after 6 months revealed a solid, contrast-enhanced mass at the posterior base of the sella.

Immunohistochemical expression of tumor antigens MAGE-A3/4 and NY-ESO-1 in renal oncocytoma and chromophobe renal cell carcinoma.

The distinction between renal oncocytoma (RO) and chromophobe renal cell carcinoma (ChRCC), especially the eosinophilic variant, can often be difficult. Our study has documented for the first time the expression of MAGE-A3/4 and NY-ESO-1 cancer testis antigens (CTAs) in these tumors. A total of 35 patients (17 ROs and 18 ChRCCs) were included in the study. Two antibodies were used for immunohistochemical staining: 57B recognizing multiple MAGE-A and D8.38 recognizing NY-ESO-1 CTAs. Fifteen (88.2%) samples of RO stained positively for both MAGE-A3/4 and NY-ESO-1 antigens. Regarding ChRCC, seven (38.9%) stained positively for MAGE-A3/4 and six (33.3%) for NY-ESO-1 antigens. Median MAGE-A3/4 expression was moderately positive in RO and negative in ChRCC. The difference in MAGE-A3/4 expression between two tumor groups was significant (P=0.0013). Median NY-ESO-1 expression was strongly positive in RO and negative in ChRCC. The difference in NY-ESO-1 expression between two tumor groups was also significant (P=0.0008). Our study has shown that RO had a significantly higher expression of both CTAs. However, additional research is needed to clarify their potential diagnostic implications.