Giacomo Perugia

Epithelioid Sarcoma of the Penis : Clinicopathologic Study of a Tumor with Myogenic Features and Review of the Literature Concerning this Unusual Location

Soft tissue tumors of the penis are uncommon. We report here the clinicopathologic features of a penile epithelioid sarcoma (ES), review the literature concerning this unusual location and focalize our attention on its differentiation. The 34-year-old patient was admitted for abrupt urinary retention due to the growth of a firm and painful plaque on the left side of the shaft, three years previously clinically diagnosed as Peyronies disease. Magnetic nuclear resonance revealed an infiltrating lesion of both corpora cavernosa. Histology of bioptic fragments showed a nodular malignant spindle and epithelioid cell tumor with focal necrosis and relatively high mitotic rate. Based on the immunohistochemical data (cytokeratin+, vimentin+, EMA+, CD34+, and S100-), the diagnosis of ES was strongly considered. Penectomy was undertaken and the diagnosis confirmed by both light and ultrastructural microscopy. The 22 month follow-up was free of recurrences and metastases. Although not dissimilar from the 10 previously described ES of the penis in terms of natural history and histology, the tumor reported here showed myogenic features as revealed by both immunohistochemistry (immunoreactivity for muscle specific actin) and ultrastructure (intercellular junctions, discontinuous basal lamina, pinocytotic vesicles and thin filaments with intercalated dense bodies). Although previously observed in ES of other sites, this feature has never been established in ES of the penis.

Analysis of STAT3 post-translational modifications (PTMs) in human prostate cancer with different Gleason Score

Prostate Cancer (PCa) is a complex and heterogeneous disease. The androgen receptor (AR) and the signal transducer and activator of transcription 3 (STAT3) could be effective targets for PCa therapy. STAT3, a cytoplasmatic latent transcription factor, is a hub protein for several oncogenic signalling pathways and up-regulates the expression of numerous genes involved in tumor cell proliferation, angiogenesis, metastasis and cell survival. STAT3 activity can be modulated by several Post-Translational Modifications (PTMs) which reflect particular cell conditions and may be implicated in PCa development and progression. The aim of this work was to analyze STAT3 PTMs at different tumor stages and their relationship with STAT3 cellular functions. For this purpose, sixty-five prostatectomy, Formalin-fixed paraffin-embedded (FFPE) specimens, classified with different Gleason Scores, were subjected to immunoblotting, immunofluorescence staining and RT-PCR analysis. All experiments were carried out in matched non-neoplastic and neoplastic tissues. Data obtained showed different STAT3 PTMs profiles among the analyzed tumor grades which correlate with differences in the amount and distribution of specific STAT3 interactors as well as the expression of STAT3 target genes. These results highlight the importance of PTMs as an additional biomarker for the exactly evaluation of the PCa stage and the optimal treatment of this disease.

MP97-06 INGUINAL HERNIA AFTER RADICAL PROSTATECTOMY: INCIDENCE AND RISKS FACTORS

exerted by the pneumoperitoneum. The aim of this study is to compare outcomes of RARP with preventive ligation versus delayed ligation of the DVC in a phase III randomized controlled trial. METHODS: After IRB approval, a prospective randomized controlled trail is recruiting patients submitted to RARP at our institution since February 2015. Exclusion criteria are: congenital or acquired coagulation disorders and salvage radical prostatectomy. After obtaining an informed consent, patients are randomized into treatment arms on a 1:1 ratio. RARP is performed according to the Patel technique, by 2 experienced robotic surgeons, with PL (1-0 Monocryl CT-1, after the opening of endopelvic fascia and before bladder neck dissection) or DL (3-0 Monocryl UR-6, once the prostatectomy is completed). Patients0 characteristics and data are recorded in a prospective maintained database. The primary endpoint is estimated blood loss (EBL) during prostatectomy (considering significant a difference of 30 ml or higher). Secondary endpoints are: transfusion rate, positive surgical margins (PSMs) in general and apical PSMs in particular and 1-month PSA and continence (defined as the use of 0 pad or 1 security pad per day). Pearson0s chi-square test was applied to all variables, with a chi-square probability of 0.05 or less considered statistically significant. RESULTS: Overall, 154 patients were randomized from February 2015 to August 2016 (86 patients with PL and 68 with DL). The two groups had comparable preoperative features and no statistically significant differences were found in term of primary and secondary endpoints with the exception of the rate of apical PSMs, higher in the PL group (table 1). CONCLUSIONS: A DL of the DVC is associated to a greater blood loss, even without any clinical significance, and seems to be protective on the risk of apical PSMs, with no detrimental effects on perioperative course and functional outcomes.

Neoadjuvant Chemotherapy in Neuroendocrine Bladder Cancer: A Case Report.

Patient: Male, 71 Final Diagnosis: Neuroendocrine cancer bladder Symptoms: Dysuria • haematuria Medication: — Clinical Procedure: Transurethral resection of the bladder tumor Specialty: Oncology Objective: Rare disease Background: Small cell carcinoma of the urinary bladder is a rare and aggressive form of bladder cancer that mainly presents at an advanced stage. As a result of its rarity, it has been described in many case reports and reviews but few retrospective and prospective trials, showing there is no standard therapeutic approach. In the literature the best therapeutic strategy for limited disease is the multimodality treatment and most authors have extrapolated treatment algorithms from the therapy recommendations of small cell lung cancer. Case Report: A 71-year-old male patient was referred to our hospital with gross hematuria and dysuria. Imaging and cystoscopy revealed a vegetative lesion of the bladder wall. A transurethral resection of the bladder was performed. Pathological examination revealed a pT2 high-grade urothelial carcinoma with widespread neuroendocrine differentiation. Multimodal treatment with neoadjuvant platinum-based chemotherapy was performed. A CT scan performed after chemotherapy demonstrated a radiological complete response. The patient underwent radical cystectomy and lymphadenectomy. The histopathological finding of bladder and node specimen confirmed a pathological complete response. A post-surgery CT scan showed no evidence of local or systemic disease. Six months after surgery, the patient is still alive and disease-free. Conclusions: A standard treatment strategy of small cell cancer of the urinary bladder is not yet well established, but a multimodal treatment of this disease is the best option compared to surgical therapy alone. The authors confirm the use of neoadjuvant chemotherapy in limited disease of small cell carcinoma of the urinary bladder.

Myxoid Liposarcoma of the Spermatic Cord

The myxoid liposarcoma, a rare form of spermatic cord liposarcoma, is a neoplasia of adult men which arise from adipose tissue, with a slow and subdolous growth, showing good prognosis and low incidence of local or distant recurrence. The case came at our attention is the sixteenth described in literature. Orchifunicolectomy is the gold standard therapy, although in some cases in which this kind of surgery is not radical, adjuvant inguinal or retroperithoneal and pelvic nodes radiotherapy should be taken in consideration.