Virilizing mature ovarian cystic teratomas.

Three further cases of mature benign cystic teratomas of the ovary associated with virilization are added to the three previously reported in the literature. They were found in postmenopausal, obese, diabetic women aged 52, 61, and 67 years. The patients presented with hirsutism and voice changes and clitoromegaly was present in one. Testosterone and androstenedione levels were elevated but promptly regressed after removal of the tumours. Histologically, sheets of stromal luteinized cells were found peripherally at the interface between the neoplasm and ovarian tissue. Luteinization of ovarian stroma induced by an unknown factor related to diabetes mellitus is the origin of the virilization.

Human papillomavirus and bladder cancer.

Human papillomavirus (HPV) deoxyribonucleic acid (DNA) has been originally detected in urothelial carcinomas of the bladder in immunocompromized patients. Studies from the general population showed a variable incidence of high risk HPV DNA which ranged from 2.5% to 81%, with HPV 16 DNA occurring more frequently. HPV DNA was detected in both papillary and invasive cancers, although in our experience the overall incidence was low. Most HPV positive cases were of high grade and stage with significant reduced survival or increased recurrence rate after transurethral resection. These results indicate an additional prognostic value of viral infection in bladder cancer. In addition, molecular studies suggest that the HPV related oncoproteins E6 and E7 play a role in bladder carcinogenesis via inactivation and/or degradation of p53 and pRb suppressor gene-associated proteins. The purpose of this review is to provide a brief summary of what is known about HPV and bladder cancer, and to address issues germane to the translation of this information to patient management.

Sarcomatoid transitional cell carcinoma of the renal pelvis. A report of five cases with clinical, pathological, immunohistochemical and DNA ploidy analysis.

Sarcomatoid transitional cell carcinoma of the renal pelvis is a rare neoplasm with only 7 well illustrated examples reported. These tumours can assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification as sarcomas. We describe the clinic-pathologic features of five additional examples of sarcomatoid carcinoma of the renal pelvis observed in three males and two females. The age ranged from 65-to-82 years-old (mean 71.6). All these patients were treated by nephrectomy and died of disease between 6 and 20 months (mean 11.2) after the onset of symptoms. An immunohistochemical study demonstrated coexpression of keratins, epithelial membrane antigen and vimentin. The image DNA ploidy of all the tumours showed an aneuploid pattern.

Human papillomavirus infection and transitional cell carcinoma of the bladder. Immunohistochemistry and in situ hybridization.

The aim of the present research was to investigate human papillomavirus (HPV) infection by means of immunohistochemistry and in situ hybridization in 76 bladder cancer specimens. A biotinylated DNA probe that recognizes HPV 6/11, HPV 16/18 and HPV 31/33/35 was used for in situ hybridization. A polyclonal antibody recognizing HPV capsid antigen (HPVcAg) was used for immunohistochemistry. In situ hybridization and immunohistochemistry were developed by alkaline phosphatase and immunogold-silver techniques respectively. Our results showed that 25 (32.8%) out of 76 bladder carcinoma specimens reacted with HPVcAg. Twelve (15.7%) out of 76 cases were positive for HPV 16/18-DNA using non-isotopic in situ hybridization. Sixteen cases had koilocytosis. No positive signals were found for HPV 6/11 or 31/33/35-DNA probes.

Human papillomavirus DNA as a factor determining the survival of bladder cancer patients.

The natural history of transitional cell carcinoma (TCC) of the urinary bladder is somewhat variable, with a significant number of tumour recurrences that occasionally evolve towards an infiltrating disease. The aim of this study was to investigate the presence of human papillomavirus (HPV) DNA in 76 TCC specimens, and then correlate such findings with the overall patient survival. However, other classical prognostic clinical and pathological variables such as pathological grade and stage, koilocytosis, age and sex were also tested. HPV DNA was investigated by means of the highly sensitive polymerase chain reaction (PCR). DNA primers specific for HPV types 6, 11, 16 and 18 were used. Our results showed that 7 (9.21%) out of 76 such cases were reactive for HPV 16 DNA; one of them also reacted with HPV 6 DNA. The statistical analysis was done by the Kaplan-Meier method, Wilcoxon's generalised test for studying the differences in survival curves and Cox's regression analysis for independent prognostic factors. A significant P-value was found for pathological grade (P < 0.0001) and stage (P < 0.0001), HPV 16 DNA (P = 0.0418) and koliocytosis (P = 0.0140). Thus, pathological grade was the only independent factor in the bladder cancer survival. These observations may prove useful in prognostic stratification of patients with TCC of the bladder.