Sarcomatoid differentiation in renal cell carcinoma: prognostic implications

INTRODUCTION: Renal cell carcinoma with sarcomatoid differentiation is a tumor with aggressive behavior that is poorly responsive to immunotherapy. The objective of this study is to report our experience in the treatment of 15 patients with this tumor. MATERIALS AND METHODS: We retrospectively analyzed 15 consecutive cases of renal cell carcinoma with sarcomatoid differentiation diagnosed between 1991 and 2003. The clinical presentation and the pathological stage were assessed, as were the tumor's pathological features, use of adjuvant immunotherapy and survival. The study's primary end-point was to assess survival of these individuals. RESULTS: The sample included 8 women and 7 men with mean age of 63 years (44 - 80); follow-up ranged from 1 to 100 months (mean 34). Upon presentation, 87% were symptomatic and 4 individuals had metastatic disease. Mean tumor size was 9.5 cm (4 - 24) with the following pathological stages: 7% pT1, 7% pT2, 33% pT3, and 53% pT4. The pathological features showed high-grade tumors with tumoral necrosis in 87% of the lesions and 80% of intratumoral microvascular invasion. Disease-free and cancer-specific survival rates were 40 and 46% respectively, with 2 cases responding to adjuvant immunotherapy. CONCLUSIONS: Patients with sarcomatoid tumors of the kidney have a low life expectancy, and sometimes surgical resection associated with immunotherapy can lead to a long-lasting therapeutic response

Characterization of the occupied shells by the hermit crab Clibanarius vittatus (Decapoda, Diogenidae) at Baixio Mirim tideflat, Guaratuba Bay, southern Brazil

A characterization of the occupied shells by the hermit crab Clibanarius vittatus was carried out. Hermit crabs were collected in the intertidal zone, during the low spring tide monthly from April 2005 to March 2006. They were sexed and their cephalothoracic shield length (CL) was measured. Shells were identified, dried, weighed and the aperture length (AL) and width (AW) were measured. 1187 crabs were collected (949 males, 216 females and 22 intersexes), which occupied 12 species of gastropod shells. Stramonita haemastoma, Olivancillaria urceus and Dorsanum moniliferum made up 96.55% of the total shell species. Male hermit crabs attained significantly larger sizes than females; therefore, males occupied a wider spectrum of shells in size and weight. A stronger correlation ratio was obtained between CL and AW of S. haemastoma. Last whorl with a rounded shape and a spacious inner area is a common feature of all shell species most frequently occupied by this hermit crab where it occurs. The successful establishment of C. vittatus at Baixio Mirim is mainly due to the appropriately shaped and wide range of size of S. haemastoma shells that were most often occupied by the hermit crabs of the studied population.<br>A caracterização das conchas ocupadas pelo ermitão Clibanarius vittatus (Bosc, 1802) foi realizada. Os ermitões foram coletados de abril/2005 a março/2006, na zona intertidal, durante a maré baixa de sizígia. Os ermitões tiveram o sexo reconhecido e foram medidos no comprimento do escudo ce-falotorácico. As conchas foram identificadas, pesadas depois de secas e edidas no copriento e na largura da abertura. Foram coletados 1187 ermitões (949 machos, 216 fêmeas e 22 intersexos) que ocuparam 12 espécies de conchas de gastrópodes. Stramonita haemastoma, Olivancillaria urceus e Dorsanum moniliferum perfizeram 96,55% do total das conchas ocupadas. Ermitões machos atingiram tamanhos significativamente maiores do que as fêmeas; entretanto ocuparam um maior espectro de conchas em tamanho e peso. Fortes índices de correlação foram obtidos para a relação entre o escudo cefalotorácico dos ermitões e a largura da abertura de S. haemastoma. A última espira espaçosa e de formato globoso é um aspecto comum das conchas mais frequentemente ocupadas pelo presente ermitão em todos os locais de sua ocorrência. O sucesso no estabelecimento de C. vittaus no Baixio Mirim é devido principalmente ao formato e à amplitude de tamanhos das conchas de S. haemastoma, as quais são mais frequentemente ocupadas pelos ermitões da população estudada