A.P. McLaughlin

Prostatic Carcinoma: Incidence and Location of Unsuspected Lymphatic Metastases

Prospective pathologic staging by pelvic lymphadenectomy in 60 patients with clinically localized carcinoma of the prostate disclosed a high incidence (35 per cent) of clinically silent and unsuspected lymph node metastases. When present, metastatic disease was frequently bilateral (57 per cent) and most commonly involved the obturator-hypogastric lymph nodes (87 per cent). Micrometastases alone were found in 5 patients and the potential significance of this finding on survival is discussed. Although the presence or absence of metastases could not be accurately predicted by histologic analysis of biopsy or prostatectomy specimens, the finding of undifferentiated tumor, marked anaplasia and penetration through the capsule correlated positively with nodal metastases. Pelvic lymphadenectomy is a safe and important diagnostic tool in the accurate staging of these patients. Its widespread use is advocated in patients with clinical stage B1, B2 and C tumors prior to definitive therapy. Based on the prospective data generated in this study lymphatic metastasis appears to be an early event in the spread of prostatic cancer.

Familial Transitional Cell Carcinoma of the Bladder

AbstractTransitional cell carcinoma of the bladder was found in 6 family members from 2 generations. The possibility that the tumors in this family were mediated by an autosomal dominant gene is raised. No common carcinogenic exposure was present and studies of tryptophan metabolism and immunologic competence were negative.

Agenesis of penis: Embryology and management

The embryology and other developmental anomalies of agenesis of the penis have been presented together with two cases. We think that patients who fit into this category should be raised as females. Our suggested therapy will enable the patient to function psychologically and sexually as a female.

Amyloidosis of the Lower Genitourinary Tract

Three patients with amyloidosis of the lower genitourinary tract are described. In the cases of primary localized amyloidosis of the urethra and primary systemic amyloidosis involving the prostate the clinical presentation mimicked cancer of the respective sites. In the case of secondary localized amyloidosis of the seminal vesicles chronic perineal pain suggested seminal vesiculitis.

Xanthogranulomatous pyelonephritis unusual clinical presentations

Abstract The association of xanthogranulomatous pyelonephritis with renal-cell carcinoma and the loss of a kidney homograft because of this disorder suggest that in certain cases altered immunologic competence might be an etiologic factor in this disease. This entity may develop acutely over a four-month period and can occur during the first year of life. It is not necessarily associated with non-function of the involved kidney during excretory urography. Xanthogranulomatous pyelonephritis may be a segmental renal disease and may also occur bilaterally. Subtotal nephrectomy is the treatment of choice in these instances. Studies of calcium and phosphorus excretion in patients with this disease should be implemented in an effort to clarify the pathophysiologic aspects of the disease.

Urogenital anomalies and congenital rubella syndrome.

Abstract Eight patients with congenital rubella syndrome and associated genitourinary anomalies are reported and the English language literature reviewed. This association appears most prevalent in male patients. Although hypospadias and cryptorchidism are the most common anomalies in the literature, 50 per cent of the patients in this series had vesicoureteral reflux. It is suggested that genitourinary anomalies may be present in 20 per cent of children with the congenital rubella syndrome.

Spontaneous tumor regression Experimental aspects

Abstract C57/BL mice were immunized against methylcholanthrene sarcoma and were challenged with second-tumor isografts injected into cortical bone to test the hypothesis that bone is an unusually privileged site where metastases are protected from immunologic destruction in the sensitized host. Results indicate that structural characteristics of bone do not protect metastatic tumor cells from destruction by immune lymphocytes. An alternative explanation for the failure of osseous metastases from renal cell cancer to regress may involve modification of surface antigens. Also, a review of important aspects and principles of tumor immunology is given.

The fate of methylcholanthrene tumor cells in bone: Analysis of immune factors in host resistance

SPONTANEOUS REGRESSION has been reported for a variety of neoplasms. In the 130 cases documented by Everson, neuroblastoma and renal cell carcinoma were the most common cancers to demonstrate spontaneous regression [ 11. This phenomenon seldom involves skeletal metastases from these neoplasms [2] suggesting that bone may be a relatively privileged site where metastatic cells are protected from immunologic surveillance. Current evidence suggests immunity against malignancy is predominantly a cellular mechanism involving tumor cell destruction by immune lymphocytes [3]. Lysis of tumor cells requires close lymphocyte approximation as well as a high lymphocyte-tumor target cell ratio [4, 51. We wondered if anatomical and structural factors in bone protected metastatic cells from immunologic attack by preventing optimal lymphocyte-tumor cell interaction, In this work, a highly immunogenic methylcholanthrene (MCA) induced fibrosarcoma was used to immunize C57/BL female mice. Once resistance against this tumor was established the animals were rechallenged by tumor isografts injected directly into bone to determine if bone was