RENAL-CELL CARCINOMA METASTASES TO THE SKIN - A NOT SO RARE CASE

Objective To describe the clinical, histological, immunohistochemical and behavioural patterns of the metastases of renal cell carcinoma to the skin. Patients and methods In a retrospective review of 132 cases of renal cell carcinoma submitted for examination to the Anticancer Institute ‘St Savas’ nine patients with metastatic disease to the skin were discovered. Clinical data and follow-up information were collected and correlated to tumour behaviour and patient survival, Immunohistochemical studies with epithelial membrane antigen (EMA), vimentin, keratin and carcino-embryonic antigen (CEA) were performed. Results In six of the nine patients the skin metastasis was the first evidence of a tumour, Histology of the skin nodule led to identification of the primary site, Histological proof of the renal origin of the tumour was obtained using the above immunohistochemical studies. All patients died from their disease within 3 years of presenting with the skin metastases. Conclusion Metastases to the skin from a renal cell carcinoma as first evidence of the disease may not be as rare as the literature describes. Definite proof of the origin of the tumour requires specialized immunohistochemical techniques

c-FLIP expression in colorectal carcinomas: association with Fas/FasL expression and prognostic implications

Aims: Disruption of apoptotic cell death has been implicated in tumour aggressiveness in colonic carcinogenesis. The Fas-Fas ligand (FasL) system is involved in the execution of apoptosis induced by the immune system. c-FLIP protein constitutes an inhibitor of Fas and other (TRAIL) death receptor-mediated apoptosis. The aim of this study was to investigate the simultaneous expression of Fas, FasL and c-FLIP in relation to standard clinicopathological parameters and patients’ outcome in colorectal cancer. Methods and results: Levels of Fas, FasL and c-FLIP protein expression were quantified immunohistochemically in paraffin-embedded tissues from 90 patients. Immunopositivity was detected for Fas, Fast, and c-FLIP in 71%, 35.5% and 68.8% of cases, respectively. Concurrent expression of Fas/FasL was seen in 28 samples (31%), of which 24 (85.7%) also displayed c-FLIP positivity (P = 0.04). c-FLIP overexpression (> 10%) tended to prevail marginally in higher stage tumours (P = 0.09). Additionally, FasL and c-FLIP adversely affected survival on both univariate (P = 0.001 and P = 0.0024, respectively) and multivariate analysis [hazard ratio (HR) 3.491, P = 0.005 and HR 2.960, P = 0.036, respectively]. Conclusions: The frequent expression and coexpression of Fas, FasL and c-FLIP in colorectal carcinoma implicates c-FLIP as an inhibitor of the Fas-FasL-induced death pathway in these tumours. Moreover, c-FLIP conveys independent prognostic information in the presence of classical prognosticators

An Integrated Study of the Mesolithic Skeleton in Theopetra Cave, Greece: From the Skeleton Analysis to 3D Face Reconstruction

Skeletal evidence dating back to the Mesolithic period is scarce and should be studied under a multidisciplinary perspective. The primary objective of the study was to carefully assess the skeleton of a young woman from this era, named “Avgi,” to compile its bioarchaeological profile, analyze its paleopathology and dental pathology, and deploy a 3D reconstruction and modeling method in order to reveal her face. Both demographic and pathological information were drawn from macroscopically observing the bones, long bone X-rays, skull CT and X-rays, 3D modeling and printing of the skull, and panoramic dental X-rays. The Manchester method was used for the 3D facial reconstruction. On analysis, we determined that Avgi was a female adolescent, aged around 17–19 years at death, and likely suffering from iron deficiency anemia and Class III dental malocclusion. Notably, Harris lines and a hair-on-end pattern were identified in the long bones and skull radiographs, respectively. Various less significant skeletal lesions reflected potential minor pathologies. Our findings suggest that multidisciplinary collaborative approaches should be followed in the modern study of lesser-known past eras. Multiple scientific perspectives, as well as social structures, geographical aspects, settlements, population movements, and social networks should all be taken into account when assessing lifestyle characteristics and paleopathological signs in skeletal remains. © 2022 by the authors. Licensee MDPI, Basel, Switzerland