Prostate Cancer Detected by Choroidal Tumor and Complete Response to Hormonal Therapy: Case Report and Literature Review of 24 Patients With Choroidal Metastasis From Prostate Cancer

Metastatic choroidal tumors derived from prostate cancer are rare. In this study, we report a patient who manifested a choroidal tumor as the initial presenting sign of prostate cancer and review 23 patients with choroidal metastasis of prostate cancer in the literature to answer a clinical question how the choroidal metastases would respond to hormonal therapy. A 73-year-old man presented with a choroidal tumor in the right eye. He was in good health and had no previous history except for current hemodialysis in 3 years due to chronic renal failure as a sequel to glomerulonephritis. With the diagnosis of a probable metastatic tumor, positron emission tomography was performed to disclose high-uptake sites in multiple bones, lymph nodes, and the prostate, together with multiple nodular lesions in bilateral lungs on computed tomography (CT) scan. Serum prostate-specific antigen (PSA) was elevated to 541 ng/mL, which supported prostate cancer as the primary site. He had degarelix injection, and the choroidal tumor resolved rapidly and became flat degeneration in a month. Prostate biopsy showed poorly differentiated adenocarcinoma, and he underwent surgical castration. He had no medication until 3 years later when he showed gradual increase of serum PSA up to 6.05 ng/mL and multiple bony metastases on CT scan. Bicalutamide, switched to enzalutamide and then to abiraterone, led to the undetectable level of serum PSA until the last visit with no relapse of the choroidal metastasis, 6.8 years after the initial visit. In the literature review of 24 patients with choroidal metastasis of prostate cancer, including this patient, 8 patients presented a choroidal tumor as the initial sign and the choroidal lesions mostly showed complete response to hormonal therapy. Among 13 patients who were frequently in the course of hormonal therapy, choroidal metastases showed complete or partial response to external beam radiation to the eye in 11 patients and episcleral plaque radiotherapy in 2 patients. In conclusion, metastatic choroidal tumors of prostate cancer would show good response to hormonal therapy when the therapy has not been initiated. Hormone-resistant choroidal metastases in the therapeutic course of prostate cancer could be managed successfully by external beam radiation to the eye

Identifying High Energy Neutrino Transients by Neutrino Multiplet-Triggered Followups

Transient sources such as supernovae (SNe) and tidal disruption events are candidates of high energy neutrino sources. However, SNe commonly occur in the universe and a chance coincidence of their detection with a neutrino signal cannot be avoided, which may lead to a challenge of claiming their association with neutrino emission. In order to overcome this difficulty, we propose a search for $\sim10-100$ TeV neutrino multiple events within a timescale of $\sim 30$ days coming from the same direction, called neutrino multiplets. We show that demanding multiplet detection by a $\sim 1$ km$^3$ neutrino telescope limits distances of detectable neutrino sources, which enables us to identify source counterparts by multiwavelength observations owing to the substantially reduced rate of the chance coincidence detection of transients. We apply our results by constructing a feasible strategy for optical followup observations and demonstrate that wide-field optical telescopes with a $\gtrsim4$ m dish should be capable of identifying a transient associated with a neutrino multiplet. We also present the resultant sensitivity of multiplet neutrino detection as a function of the released energy of neutrinos and burst rate density. A model of neutrino transient sources with an emission energy greater than ${\rm a~few}\times 10^{51}$erg and a burst rate rarer than ${\rm a~few}\times 10^{-8}\ {\rm Mpc}^{-3}\ {\rm yr}^{-1}$ is constrained by the null detection of multiplets by a $\sim 1$km$^3$ scale neutrino telescope. This already disfavors the canonical high-luminosity gamma ray bursts and jetted tidal disruption events as major sources in the TeV-energy neutrino sky.Comment: The version accepted for publication in Ap

Breast spindle cell carcinoma

Spindle cell carcinoma (SpCC) of the breast is quite a rare modality classified to the metaplastic carcinoma of the breast. Regarding its biological behavior and the prognosis of the patients with this rare tumor, it has been remaining controversial. We herein report an 88 year-old woman who had a huge bleeding tumor on the right breast. She was a high-aged woman with low activities of daily life, even with some suspicion of distant organ metastasis. While the tumor proved to drastically bleed due to the tumor disintegration, a right simple mastectomy was performed. According to the histopathologic examinations, sarcomatoid spindle cells with severe atypia were observed. By an immunohistochemical examination, the tumor had proved to express neither estrogen receptor, progesterone receptor nor HER2 receptor. Moreover an immunohistochemical expression of AE1/3 and CAM5.2, defining an epithelial neoplasm were observed in addition to an expression of vimentin. From these findings, this bleeding tumor was diagnosed as spindle cell carcinoma of the breast

Nephrin is an important component of the barrier system in the testis.

Nephrin, a gene product of the congenital nephrotic syndrome of the Finnish type (NPHS1), is a 1242-residue putative transmembrane protein of the immunoglobulin family of cell adhesion molecules. The expression of this gene is localized in rat and human glomerular epithelial cells. Here we report the expression of nephrin in various tissues other than the kidneys in mice. The expression of nephrin mRNA in various tissues of mice, including the kidneys, testes, spleen, thymus and brain, were first investigated by the RT-PCR method, and it was shown that a high level of nephrin mRNA could be detected in the testes of mice 1-6 weeks old. In situ hybridization revealed the expression of the nephrin gene in the Sertoli cells. Additionally, immunofluorescent staining studies indicated that nephrin was colocalized with anchoring protein ZO-1 in the mouse testis. From these results, it is inferred that nephrin is an important component of the barrier system in testes.</p

A Study of Japanese Management and its Analyses

修士論文要