Jacinto J. Regalado

Molecular predictors of clinical outcome in patients with head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) involves the upper aerodigestive tract and can destroy the structure and function of organs involved in voice, speech, taste, smell and hearing, as well as vital structures necessary for survival. HNSCC has long been a treatment challenge because of the high rate of recurrences and of advanced disease at the time of diagnosis. Molecular identification of tissue biomarkers in diagnostic biopsy specimens may not only identify patients at risk for developing HNSCC but may also select patients that may benefit from more aggressive treatment modalities. Several biomarkers studied to date such as the proteins p53, cyclin D1, p16, Cox‐2 enzyme, epidermal growth factor and vascular endothelial growth factor receptors, matrix metalloproteinases and the Fhit marker for genomic instability could be manipulated for the therapeutic benefit of these patients. This review presents the most updated information on molecular biomarkers with the greatest prognostic potential in HNSCC and discusses some factors that contribute to the controversy concerning their prognostic importance.

Bilateral hyperplastic nephromegaly, nephroblastomatosis, and renal dysplasia in a newborn: A variety of universal nephroblastomatosis

A preterm boy was born at 34 weeks. Prenatal ultrasonography showed oligohydramnios, fetal ascites, large kidneys, and small thorax. He died 21 h after birth of respiratory insufficiency. Autopsy revealed Potters-like facies, hypoplastic lungs, ascites, and bilateral nephromegaly (renal weight almost 10 times normal). The kidneys were finely nodular externally, solid, and cerebriform on cut section. Histologically, they showed a diffusely distorted architecture of jumbled lobules, hyperplasia of cortical-type tissue with inconspicuous proximal tubules, relative hypoplasia of medullary tissue, tubulointerstitial dysplasia, and perilobar nephrogenic rests. The renal features represent a variety of the universal or panlobar (also called pancortical or infantile) type of nephroblastomatosis. To our knowledge, this is only the third such case reported. In the brain, each lateral ventricle contained a yellow gelatinous mass. Histologically, the masses consisted of a pseudomyxoid matrix with delicate fibers and focal adipocyte clusters, all confined within choroid plexus. We consider these lesions fibrolipomatous hamartomas.

A novel epidermal nevus syndrome with congenital cylindromatous turban tumor

Background:  Epidermal nevi (in the broad sense of epithelial nevi) may give rise to benign or malignant skin tumors. They may also be associated with anomalies of other organ systems in an epidermal nevus syndrome.

Multinodular hyperplastic pannephric nephroblastomatosis with tubular differentiation: A new morphologic variant

We report a case of bilateral nephromegaly detected prenatally with oligohydramnios. Delivered at 35 weeks, this black male infant rapidly developed renal failure, requiring dialysis. He lived 3 1/2 months. The kidneys were three times normal size and diffusely multinodular, with hypoplastic calyces, no corticomedullary demarcation, and no pyramids. Histologically, they revealed hyperplastic embryonal rests composed of tubules and ducts with prominent branching. The nodular rests were intermixed with areas of mature parenchyma, which showed prominent oxalosis. By flow cytometry, rests were diploid, with an S-phase fraction of 25.9%. The proliferation of embryonal collecting system analogs is attributed to excessively rapid and prolonged branching of the ureteric bud, dating from the fourth gestational month or earlier. This unique case may represent a new morphologic variant of universal nephroblastomatosis.