c-myc, c-erb-B2, nm23 and p53 expression in human endometriosis.

We studied the expression of oncogenes and tumor-suppressor genes in human endometriosis in a retrospective pilot study. Sixteen patients with histologically verified pelvic endometriosis at the university-based tertiary care referral center were studied. Immunohistochemical determination of c-myc, c-erb-B2, nm23 and p53 expression in archival, paraffin-embedded pathological samples were used from patients operated upon for pelvic endometriosis. c-myc was expressed in 8/15 cases (53.3%). nm23 was expressed in 7/16 cases (43.7%). c-erb-B2 and p53 reactivity was undetectable in the samples studied. The c-myc oncogene and nm23 are overexpressed in many cases of endometriosis, and may play a still undefined role in its pathogenesis. Immuno-histochemistry is a useful tool for the study of oncogenic activation in this disease.

Angiosarcoma of the breast and pregnancy: a new therapeutic approach.

A case of angiosarcoma of the breast managed primarily by a chemotherapeutic approach is referred. A 29-year-old patient presented complaining of a painful mass in her right breast. An incisional biopsy carried out under general anesthesia showed a moderately-differentiated angiosarcoma surrounded by fibrofatty tissue. Ruled out distant metastases, a decision was made to initiate neoadjuvant chemotherapy consisting of ifosfamide, vincristine and dactinimycin. After 2 courses of chemotherapy the tumor volume was reduced by 50% and the histologic examination of the mastectomy specimen revealed a well-differentiated angiosarcoma with widespread areas of necrosis probably produced by previous chemotherapic treatment. The patient is clinically free of disease after 24 months of follow-up. Although this is a single case report, and by no means can be considered a guideline for future treatments, we nevertheless feel that the result obtained with the chemotherapeutic approach with this patient is encouraging.

Idiopathic acute esophageal necrosis: not necessarily a terminal event.

Idiopathic acute esophageal necrosis (AEN) has been considered a rare event, usually having an ischemic origin. Primarily cases from autopsy studies have been reported. This report deals with 10 such cases which were diagnosed among some 80,000 esophago-gastroscopies performed during a 16-year period. Nine patients recovered and were discharged from the hospital. The esophageal lesions presented as a demarcated, black discoloration which usually evolved to a picture suggestive of unspecific esophagitis. Histology invariably revealed diffuse and conspicuous necrosis involving the mucosa, submucosa and, frequently, muscular layers. In 2 cases, esophageal stenosis developed and, in one case, a full-thickness necrosis made surgery with colon interposition mandatory. Hyperglycemia, hypoxia, carcinoma and ischemic phenomena were found as associated conditions. Gastroduodenal, acute ulcerative disease was present in four patients. From this experience, it is concluded that AEN is not necessarily a terminal phenomenon, notwithstanding that it is usually associated with pre-existent serious illness. Nevertheless, its etiology remains unknown.

In vitro lithotripsy with the Alexandrite laser.

The Alexandrite laser system has proven to be an effective and safe method of ureteral lithotripsy. Some authors have recently reported the risk of interspersion of fiber splinters into tissue during lithotripsy, when short pulses and high power densities are employed. In vitro lithotripsy on renal calculi artificially placed in human ureters was realized under the parameters of a manufactured model (Alexantriptor, HMT). We have observed neither interspersion of fragments nor ureteral damage. These in vitro experiments and our clinical experience confirm that Alexandrite laser lithotripsy is reliable and safe.

[An infrequent form of metastasis of carcinoma of the prostate]. / Forma infrecuente de metástasis de un carcinoma prostático.

A case of carcinoma of the prostate metastatic to breast is reported. We highlight its rarity, its relationship with estrogen treatment, and the poor prognosis of this condition which develops in the end stages of metastatic carcinoma of prostate.

[Association of 2 prostatic tumors]. / Asociación de dos tumores prostáticos.

We report on a case of primary transitional cell carcinoma of the prostate associated with focal prostatic carcinoma, incidentally discovered after TUR of the prostate. An underlying bladder tumor was discarded by randomized TUR of the bladder and serial cytologic analyses.

[Leydig cell tumor]. / Tumor de células de Leydig.

We report on a 54-year-old male patient with Leydig cell tumor of testis, an incidental finding following orchiectomy for a testicular tumor. The pathological findings met the established histologic criteria for a benign tumor. The patient required no other treatment. The results of hormonal analyses were hormonal. We discuss recently proposed histologic and hormonal criteria to distinguish the benign from the malignant form of this tumor type. The foregoing are useful in determining the therapeutic approach.

Chondroma of the tongue. Report of a case and review of the literature.

A case of chondroma of the tongue in a 53-year-old male is reported. A review of the literature is presented.

Retrospective endoscopic analysis of gastric xanthelasma in the non-operated stomach.

To investigate the significance of gastric xanthelasma, a retrospective review of 109 cases with an endoscopic diagnosis of this lesion was undertaken. A predominance in older patients was noted, with a similar distribution in antrum and fornix. In 15 cases (16.6%) they were multiple. They were occasionally associated with gastric erosions. In particular they were associated with chronic gastritis and intestinal metaplasia (48.9%). It is therefore concluded that gastric xanthelasma is not a rare lesion and that it is frequently associated with senile degenerative changes in the gastric mucosa.

Chromosomal complements in primary gonadal failure.

Twenty-nine patients underwent clinical, hormonal, endoscopic, and cytogenetic studies to determine the cause of primary amenorrhea or delayed sexual development. In 19 of them (mean age 17.6 years), the X chromosome was either missing or anomalous. In ten patients (mean age 25.5 years), the chromosomal complement was normal, 46 XX in six patients and 46 XY in four patients. Those with abnormal chromosomal complements were shorter (mean height, 141.9 cm) than patients with normal complements (158.7 cm). Somatic stigmas were observed more frequently in patients with chromosomally abnormal primary gonadal failure. In 23 patients (79.3%), the gonads were streaks, with fibrous stroma devoid of either follicles or tubules containing germ cells. In three patients the ovaries were hypoplastic, with few primordial follicles. Gonadoblastoma was present in two patients with XY and mixed XX/X/XY gonadal dysgenesis. In every patient with streak gonads and lack of germ cells, serum gonadotropin levels were elevated. Karyotype, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) assays, and eventually laparoscopy and gonadal biopsy are important in the management of patients with primary gonadal failure.