Long-term survival in an adolescent with widely metastatic renal cell carcinoma with rhabdoid features.

Renal cell carcinoma is rarely seen in children and adolescents. Patients with widespread disease at diagnosis have a particularly poor survival rate. Currently, all known chemotherapy has been ineffective in improving the median survival in patients with advanced disease. A 13-year-old black boy with stage IV renal cell carcinoma with rhabdoid features is a long-term disease-free survivor after aggressive multiagent chemotherapy. After the initial evaluation and histologic diagnosis of renal cell carcinoma, the patient received three courses of an aggressive chemotherapy regimen consisting of vincristine, doxorubicin, cyclophosphamide with mesna uroprotection, granulocyte colony-stimulating factor and erythropoietin (Epogen). After an almost complete response, a radical nephrectomy was performed and results demonstrated a solitary small nodule with viable tumor. After surgery, he received floxuridine infusion for 14 days by circadian schedule at 28-day intervals for a total of 1 year. The patient is well and free of disease 5 years after initial presentation. The dramatic response to treatment and long-term disease-free survival of this patient suggest this chemotherapeutic approach warrants additional investigation.

Urachal adenocarcinoma.

Primary adenocarcinoma of the bladder is a rare neoplasm comprising less than 2% of all bladder tumors. Approximately one-third of primary bladder adenocarcinoma arise in the urachal remnant. Differentiation from vesical adenocarcinoma preoperatively is essential because the surgical approach differs. We herein present a case of urachal adenocarcinoma whose radiographic work-up permitted the correct preoperative diagnosis.

Pathologist review of the peripheral smear. A mandatory quality assurance activity?

Peripheral smear review (PSR) might be viewed as another undesired and burdensome consequence of today's often oppressive regulatory climate. At The New York Hospital-Cornell Medical Center, specific criteria have been formulated that reflect disorders likely to be present in the patient population; thus, a productive quality assurance activity has been established and a positive learning experience has been created. In addition, interactions with clinical colleagues have been enhanced and patient care has been improved.

Benign schwannoma of the retroperitoneal space: case report.

We report a case of retroperitoneal benign schwannoma involving the left femoral and obturator nerves. The difficulties of diagnosis are discussed and the potential complications of tumor removal are described.