Leiomyoma of the tunica albuginea, a case report of a rare tumour of the testis and review of the literature

BACKGROUND: Leiomyomas are benign tumours that originate from smooth muscles. They are often seen in the uterus, but also in the renal pelvis, bladder, spermatic cord, epididymis, prostate, scrotum or the glans penis. Leiomyomas of the tunica albuginea are extremely rare. CASE PRESENTATION: A 59-year-old white male has noted an asymptomatic tumour on the right side of his scrotal sac for several years. This tumour has increased slowly and caused local scrotal pain. An inguinal incision was performed, in which the hypoplastic testis, the epididymis and the tumour could be easily mobilized. Macroscopically the tumour showed a solid round nonencapsulated whorling cut surface. Histologically the diagnosis of a leiomyoma was made. CONCLUSION: We report here a very interesting and rare case of a leiomyoma of the tunica albuginea. Leiomyomas can be a possible differential diagnosis in this area. VIRTUAL SLIDES: http://www.diagnosticpathology.diagnomx.eu/vs/258509537853759

Targeted therapy in renal cell carcinoma: moving from molecular agents to specific immunotherapy

Non-specific immunotherapy has been for a long time a standard treatment option for patients with metastatic renal cell carcinoma but was redeemed by specific targeted molecular therapies, namely the VEGF and mTOR inhibitors. After moving treatment for mRCC to specific molecular agents with a well-defined mode of action, immunotherapy still needs this further development to increase its accuracy. Nowadays, an evolution from a rather non-specific cytokine treatment to sophisticated targeted approaches in specific immunotherapy led to a re-launch of immunotherapy in clinical studies. Recent steps in the development of immunotherapy strategies are discussed in this review with a special focus on peptide vaccination which aims at a tumor targeting by specific T lymphocytes. In addition, different combinatory strategies with immunomodulating agents like cyclophosphamide or sunitinib are outlined, and the effects of immune checkpoint modulators as anti-CTLA-4 or PD-1 antibodies are discussed

Increased expression of CYP17A1 indicates an effective targeting of the androgen receptor axis in castration resistant prostate cancer (CRPC)

Recent breakthrough therapies targeting androgen receptor signalling in castration resistant prostate cancer (CRPC) involve multifunctional androgen receptor (AR) blockade and exhaustive androgen deprivation. Nevertheless, limitations to an enduring effectiveness of new drugs are anticipated in resistance mechanisms occurring under such treatments. In this study we used CRPC cell models VCaP and LNCaP as well as AR-negative PC-3- and non-neoplastic epithelial BPH-1-cells treated with 5, 10 or 25 μmol/L abiraterone hydrolyzed from abiraterone acetate (AA). The origin of CYP17A1 up-regulation under AA treatment was investigated in CRPC cell models by qRT-PCR and western-blot procedures. AA treatments of AR positive CRPC cell models led to decreased expression of androgen regulated genes such as PSA. In these cells diminished expression of androgen regulated genes was accompanied by an up-regulation of CYP17A1 expression within short-term treatments. No such effects became evident in AR-negative PC-3 cells. AR directed siRNA (siAR) used in VCaP cells significantly reduced mRNA expression and AR protein abundance. Such interference with AR signalling in the absence of abiraterone acetate also caused a marked up-regulation of CYP17A1 expression. Down-regulation of androgen regulated genes occurs in spite of an elevated expression of CYP17A1, the very target enzyme for this drug. CYP17A1 up-regulation already takes place within such short treatments with AA and does not require adaptation events over several cell cycles. CYP17A1 is also up-regulated in the absence of AA when AR signalling is physically eliminated by siAR. These results reveal an immediate counter-regulation of CYP17A1 expression whenever AR-signalling is inhibited adequately but not a persisting adaptation yielding drug resistance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/2193-1801-3-574) contains supplementary material, which is available to authorized users

Expression of Olig2, Nestin, NogoA and AQP4 have no impact on overall survival in IDH- wildtype glioblastoma

Despite many years of research efforts and clinical trials the prognosis of patients diagnosed with glioblastoma remains very poor. The oligodendrocyte transcription factor 2 (Olig2) was identified as a marker for glioma stem cells, which are believed to be responsible for glioma recurrence and therapy resistance. In this retrospective analysis we assessed the prognos- tic value of oligodendroglial and glioma stem cell markers in 113 IDH-wildtype glioblasto- mas. Immunohistochemical staining for Olig2, NogoA, AQP4 and Nestin was performed in combination with sequencing of IDH1 and IDH2 as well as promotor methylation analysis of the MGMT gene. Even though differences in overall survival according to Olig2 expression were observed, univariate and multivariate survival analysis did not reveal a firm significant prognostic impact of Olig2, NogoA, AQP4 or Nestin expression. Additionally, no differences in the expression of these markers depending on clinical status, age or gender were found. The established independent prognostic factors age = 70 and methylated MGMT gene promoter were significant in the multivariate analysis. In conclusion expression of oligodendroglial and glioma stem cell markers do not have an inde- pendent prognostic effect in IDH-wildtype glioblastoma.German Research Foundation/[]/DGF/AlemaniaPublication Fund of Hannover Medical School/[]/MHH/AlemaniaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigaciones Psicológicas (IIP)UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Centro de Investigación en Neurociencias (CIN

Psychiatrischer Konsiliardienst in einem Haus der Maximalversorgung am speziellen Beispiel des Universitätsklinikums Aachen

In Germany there has recently been some work done in the field of consultant psychiatry, but only within those hospitals which offer limited services. The Aachen University Hospital is illustrative of the specific situation in which a hospital provides the entire range of services including 30 clinics and 19 medical-theory institutes under one roof. In a similar way the study undertaken in the Lübeck University Hospital (Arolt et al.,1995) this thesis examines amongst other things, the frequency and reasons for the use of each department, as well as the diagnoses and recommendations of the advising doctors. 7364 sessions over the space of five years have been drawn on (1996- 2000). A significant result of this study is the observation that the majority of patients visited clinics offering inner medicine, dermatology and surgery. The main reasons for these visits were to enquire after the possibility of psychiatric causes for these illnesses with the possibility of specific therapy and further monitoring. The majority of diagnoses belonged to three groups, namely: abnormal psychology brought about through the use of psychotropic substances, organic disorders and affective disorders. The vast majority of recommendations, beyond continuing therapy, was the use of psychopharmacology

Psychiatrischer Konsiliardienst in einem Haus der Maximalversorgung am speziellen Beispiel des Universitätsklinikums Aachen

In Germany there has recently been some work done in the field of consultant psychiatry, but only within those hospitals which offer limited services. The Aachen University Hospital is illustrative of the specific situation in which a hospital provides the entire range of services including 30 clinics and 19 medical-theory institutes under one roof. In a similar way the study undertaken in the Lübeck University Hospital (Arolt et al.,1995) this thesis examines amongst other things, the frequency and reasons for the use of each department, as well as the diagnoses and recommendations of the advising doctors. 7364 sessions over the space of five years have been drawn on (1996- 2000). A significant result of this study is the observation that the majority of patients visited clinics offering inner medicine, dermatology and surgery. The main reasons for these visits were to enquire after the possibility of psychiatric causes for these illnesses with the possibility of specific therapy and further monitoring. The majority of diagnoses belonged to three groups, namely: abnormal psychology brought about through the use of psychotropic substances, organic disorders and affective disorders. The vast majority of recommendations, beyond continuing therapy, was the use of psychopharmacology