Barrett McCormick

MP72-16 CREATION OF A RENAL MEDULLARY CARCINOMA MOUSE MODEL: FEASIBILITY AND PRELIMINARY RESULTS AFTER TREATMENT WITH ANTI-NEOPLASTIC AGENTS

cell carcinoma (RCC) grown on chicken embryo chorioallantoic membranes (CAM-PDX) as a model of early metastatic disease. METHODS: Clinical grade MV-NIS was grown at Mayo Clinic facilities. Patient tumor cores were obtained from multiple independent sites of the primary tumor at the time of radical nephrectomy. Sectioned tumor fragments were implanted on chicken embryo chorioallantoic membranes and allowed to become vascularized over approximately seven days. In vivo infectivity studies were performed with measles virus expressing green fluorescent protein (MV-GFP), allowing real-time serial visualization of infection using fluorescent stereoscopy. Direct virus inoculation and intravascular administration were utilized. Volumetric Doppler US quantified xenograft vascularity as a measure of treatment response. RESULTS: MV-GFP achieved robust infection of patientderived RCC tumors grown in the CAM model of early metastatic disease, as visualized by fluorescent stereoscopy. The kinetics and distribution of infection varied markedly between direct and intravenous administration, with direct inoculation achieving infection within 24 hours and resulting in near complete infection and xenograft destruction within four days. Intravenous administration achieved infection restricted by neovascularization of the xenograft with delayed kinetics and limited distribution compared to direct administration. Volumetric Doppler ultrasound quantified the vascularization index (percent xenograft volume composed of vasculature), correlating MV infection with decreased xenograft vascularity. CONCLUSIONS: Our data show robust infection and destruction by oncolytic MV of patient-derived RCC xenografts grown in vivo on chicken embryo chorioallantoic membranes. Xenograft destruction was correlated with loss of vascularity as measured by volumetric Doppler ultrasound. Infection was more rapid and widespread after direct inoculation compared to intravenous administration. These data highlight the potential of oncolytic virotherapy as a therapeutic strategy against metastatic RCC. Importantly, the CAM-PDX model allows for rapid and high-throughput analysis of disease response to therapy by individual patient tumors, making in-vivo directed patient-specific treatment approaches a viable option for future oncolytic virotherapy trials.

Understanding the Pathophysiology of Penile Cancer and Its Preneoplastic Lesions

Squamous cell carcinoma of the penis is a rare malignancy that can develop anywhere on the penis. The epidemiology, risk factors, and pathophysiology of penile carcinoma are described here. Human papillomavirus has been proven to play a pivotal role in a significant subset of cases and is discussed in detail. Penile intraepithelial neoplasia refers to the penile preneoplastic lesions. These lesions demonstrate variable risk to progression to invasive cancer and are reviewed in completeness.

Surgical Complications of Presurgical Systemic Therapy for Renal Cell Carcinoma: A Systematic Review

Background: Locally advanced and metastatic renal cell carcinoma (RCC) is associated with poor survival outcomes. The integration of presurgical systemic therapy with targeted molecular agents prior to surgical resection of RCC tumors has been utilized to improve on these outcomes. These agents may be associated with an increased risk of perioperative complications due to their action on angiogenesis and cell proliferation. Objective: To examine the evidence for the incidence and severity of perioperative complications following presurgical targeted therapy for locally advanced or metastatic RCC. Methods: We performed a systematic review of retrospective studies, prospective clinical trials, and meta-analyses using key search terms in PubMed and Medline. Studies were screened for eligibility and data were extracted by the authors. A qualitative analysis was performed and the complications for available targeted agents was reported. Results: Retrospective analyses and small prospective trials indicate varying complication rates and types based on presurgical therapies. While some studies indicate a possible increase in wound-related complications, other studies did not show similar results. Additional unique complications reported include an increase in surgical adhesions. There was not any significant difference in overall or bleeding complications. Conclusions: Overall, these studies demonstrate an acceptable level of surgical complications that should not discourage the clinician considering presurgical therapy. The results of pending trials looking at presurgical therapies will provide further information.

Rare urologic tumors

Purpose of review Management of genitourinary malignancy is likely to encompass a large portion of most of the urologists practice. The challenge for the modern urologist is not only in understanding the management of commonly seen genitourinary malignancies, but also in recognizing unusual variants and their differences in management. This is evermore important as new technologies have refined the ability to identify rare entities. This review presents a brief overview of the various genitourinary malignancy subtypes seen within urology. Recent findings All major organ subtypes are highlighted along with an overview of the current understanding of their associated malignancies. An update on the current state management paradigms as well as future directions is also outlined. Summary After reading this review, the urologist should have a deeper understanding of the breadth of disorders in genitourinary oncology and a clearer approach to the management of these problems. Additionally, ongoing avenues for research are highlighted.

From Tucking to Twisting; A Case of Self-induced Testicular Torsion in a Cross Dressing Male.

A self-induced, non-traumatic testicular torsion is a rare entity that to our knowledge has not been reported in the literature. We report the case of a 28-year-old male who caused a self-induced testicular torsion during acts associated with cross dressing. Differential diagnosis of the acute scrotum in an adult should always include testicular torsion, as outcomes in this population are worse than in younger populations. Additional unusual causes of testicular torsion are reviewed.

Impact of Global HPV Vaccination for Male Genital Disease

The human papillomavirus (HPV) is a double stranded DNA virus with numerous known implications in human pathology, particularly in its potential to contribute to the development of penile cancer in men. Since the advent of the HPV vaccine, data has shown significant effects on the prevalence of HPV and penile cancer in the population.

A Rare Case of a Renal Cell Carcinoma Confined to the Isthmus of a Horseshoe Kidney.

Horseshoe kidney (HSK) is the most common renal anomaly. Reports of the incidence of renal cell carcinoma (RCC) in HSK are conflicting. Very few cases of isthmus-located RCC have been reported in the literature. We report a unique case of an isthmus-located RCC. Proper vascular and tumor imaging prior to surgery is key to successful tumor removal.