Ayten Someren

Ectomesenchymoma: A malignant tumor of migratory neural crest (ectomesenchyme) remnants showing ganglionic, schwannian, melanocytic and rhabdomyoblastic differentiation

A case is reported in which a tumor containing elements of mature and immature ganglioneuroma, Schwannoma, clusters of apparently benign melanocytes and embryonal rhabdomyosarcoma presented as a right‐sided facial mass in a six‐month‐old child. Different elements of the tumor were intimately intermingled without distinct borders. Embryogenesis of the tumor, which is thought to arise from remnants of migratory neural crest cells (ectomesenchyme), showing multidirectional phenotypic expression is discussed. It was felt that the lesion contributed additional evidence in support of pluripotentiality of the migratory neural crest derivatives, and their susceptibility to mutagenic and oncogenic influences.

Odontogenic adenomatoid tumor (adenoameloblastoma): Survey of 111 cases

Abstract As other studies have suggested, the odontogenic adenomatoid tumor is predominately a tumor of young persons under the age of 20 years. There is a marked female preference (7:4), as well as a marked maxillary preference (4.5:2.5). Fully 76 per cent of these lesions occur in the anterior regions of the jaws, and 74 per cent are associated with an unerupted tooth—most commonly a cuspid (68 per cent). It has been shown that the odontogenic adenomatoid tumor has, on occasion, an inductive effect upon the connective tissue and cannot continue to be considered a pure epithelial tumor. A significant number of cases with long-term follow-up has been presented which, in our opinion, offers sufficient support for the widely held concept that the odontogenic adenomatoid tumor is a benign lesion that does not recur after conservative removal.

The ultrastructure of the adenomatoid odontogenic tumor.

An adenomatoid odontogenic tumor (AOT) which occurred in the maxilla of an 8-year-old boy was studied by the light and electron microscopy. The tumor was found to contain cells resembling preameloblasts, the stratum intermedium, and the stellate reticulum, suggesting its origin from the enamel organ, in agreement with previous reports. Characteristic ductlike structures are thought to be formed as a result of secretory activity of the tumor cells, rather than degeneration. Duct-lining cells ultrastructurally similar to preameloblasts were found to contain electron-dense granules. These granules are believed to play a role in secretion by tumor cells, a concept not previously considered. The results of previous ultrastructural studies of the AOT are reviewed and summarized.

Special Feature: Hemolytic-Uremic Syndrome Following “Crack” Cocaine Inhalation

The authors present a patient who experienced cocaine-related thrombotic microangiopathy and patchy renal cortical necrosis, associated with the clinical syndrome of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure, characteristics of the Hemolytic-Uremic syndrome. The proposed pathogenetic mechanisms include: (1) cocaine-induced vasoconstriction and endothelial damage and (2) procoagulant effects of cocaine.

Suture granuloma simulating bladder neoplasm.

A large suture granuloma rarely may occur long after surgery using nonabsorbable suture. We report a case in which such a lesion simulated a bladder wall neoplasm.

Polypoid spindle-cell carcinoma (pleomorphic carcinoma)

Abstract A case of spindle-cell carcinoma (pleomorphic carcinoma), a rare polypoid tumor of the tongue, is reported. The characteristic clinical, gross, and microscopic features of this peculiar lesion and its common sites of location are presented. Origin and pathogenesis of the sarcoma-like elements of the lesion are discussed and the literature on the subject is reviewed. Sites of apparent transition between the spindle-cell elements of the tumor and the overlying epithelium were observed in light microscopic sections, and the electron micrographs of the spindle-cell portion of the lesion demonstrated the presence of tonofilaments and desmosomes in many tumor cells. These findings support the concept that this group of lesions are pleomorphic variants of squamous-cell carcinoma with predominantly spindle-cell pattern. Current evidence in the literature also suggests that metaplastic transformation of the tumor cells into mesenchymal elements may take place in some of these lesions, and that “metaplastic carcinoma” may probably be a more proper designation for them.

Normothermic Renal Artery Perfusion: A Comparison of Perfusates

Hypothermia and preservative perfusates have been used to decrease ischemic renal injury. This study was performed to identify the preservative function of perfusates independent of the effects of hypothermia. Rats underwent 45 minutes of renal ischemia. Rectal and renal parenchyma temperatures were monitored and maintained within 1° C of normal. Perfusates were University of Wisconsin solution (UW), Euro-Collins solution, normal saline solution, and Ringers lactate solution. A nonperfused ischemic control and a nonischemic control group were also evaluated. Parameters evaluated included serum creatinine and blood urea nitrogen levels, renal ischemic injury grade, renal weight, and gross appearance of the injured kidney. Rats treated with UW solution were found to have a significantly lower creatinine, blood urea nitrogen, and injury grade than the other three perfused groups. The external gross appearance of the UW-treated kidneys was normal, whereas that of the other groups demonstrated moderate to severe injury. Although the mean right/left renal weight difference of the UW-treated group was lower than that of the other three groups, this was not statistically significant. Under normothermic conditions in rats, UW solution affords significant renal protection from ischemia. Euro-Collins, normal saline, and Ringers lactate solutions display no significant protective effect.