Osteoclasts Are Active in Bone Forming Metastases of Prostate Cancer Patients

BACKGROUND: Bone forming metastases are a common and disabling consequence of prostate cancer (CaP). The potential role of osteoclast activity in CaP bone metastases is not completely explained. In this study, we investigated ex vivo whether the osteolytic activity is present and how it is ruled in CaP patients with bone forming metastases. METHODOLOGY: Forty-six patients affected by newly diagnosed CaP and healthy controls were enrolled. At diagnosis, 37 patients had a primary tumour only, while 9 had primary tumour and concomitant bone forming metastases. In all patients there was no evidence of metastasis to other non-bone sites. For all patients and controls we collected blood and urinary samples. We evaluated patients' bone homeostasis; we made peripheral blood mononuclear cell (PBMC) cultures to detect in vitro osteoclastogenesis; we dosed serum expression of molecules involved in cancer induced osteoclatogenesis, such as RANKL, OPG, TNF-alpha, DKK-1 and IL-7. By Real-Time PCR, we quantified DKK-1 and IL-7 gene expression on micro-dissected tumour and healthy tissue sections. PRINCIPAL FINDINGS: CaP bone metastatic patients showed bone metabolism disruption with increased bone resorption and formation compared to non-bone metastatic patients and healthy controls. The CaP PBMC cultures showed an enhanced osteoclastogenesis in bone metastatic patients, due to an increase of RANKL/OPG ratio. We detected increased DKK-1 serum levels and tissue gene expression in patients compared to controls. IL-7 resulted high in patients' sera, but its tissue gene expression was comparable in patients and controls. CONCLUSIONS: We demonstrated ex vivo that osteoclastogenesis is an active mechanism in tumour nesting of bone forming metastatic cancer and that serum DKK-1 levels are increased in CaP patients, suggesting to deeply investigate its role as tumour marker

SOCIOECONOMIC-STATUS AND SURVIVAL FROM SOFT-TISSUE SARCOMAS - A POPULATION-BASED STUDY IN NORTHERN ITALY

BACKGROUND AND PURPOSE: Differential prognosis among cancer patients according to socioeconomic status (SES) has been reported. We analyzed survival from soft tissue sarcomas (STS) according to different SES indicators. METHODS: We followed up all the adult patients with a new diagnosis of STS occurring between 1.1.1981 and 31.12.1983 in an area of Northern Italy (N = 86). RESULTS: The overall three-year survival rate was 57 percent. After adjustment for confounders, both low education and blue collar jobs were negatively associated with survival. CONCLUSIONS: The results suggest that patients of low SES have a poorer prognosis for STS

Ectopic pleural thymoma mimicking a giant solitary fibrous tumour of the pleura

Abstract: Thymoma is the commonest tumour of the anterior mediastinum in adults. Ectopic thymoma sometimes occurs, usually affecting the neck, mediastinal compartments, the lung and, very rarely, the pleura. We describe the case of a giant right-sided pleural thymoma (14 x 13 x 8 cm), preoperatively suspected to be a solitary fibrous tumour; a complete surgical resection was achieved and a postoperative diagnosis of type AB Masaoka stage II B tumour was attained