Keigo Okamura

Pathologic examination of renal cell cancer by means of step-sectioning

Abstract Background : Because incidental detection of small renal cell cancers (RCC) has recently become increasingly common, nephron‐sparing surgery for these cases has been more widely performed. Renal cell cancer was investigated by means of step‐sectioning in order to determine which cases were suitable for nephron‐sparing surgery and how it should be performed.

A CASE OF GROWING TERATOMA SYNDROME

A 25-year-old man with a left testicular tumor underwent a high inguinal orchiectomy. Histopathological examination of the resected specimen revealed tumors of more than one histological type, mixed forms (seminoma, immature teratoma). Further evaluation revealed no metastasis (pT1N0M0S1 Stage IS).Four months after orchiectomy, alpha-fetoprotein (AFP) was elevated.CT scan revealed retroperitoneal masses of recurrent tumor. Although the AFP returned to normal level after four courses of BEP (bleomycin, etoposide and cisplatin), the retroperitoneal lymph nodes continued to grow. He underwent excision of the retroperitoneal lymph node dissection. Histopathological examination of the resected specimen revealed mature teratoma.Few reports examined about the development mechanism of growing teratoma syndrome (GTS). We considered that the development mechanism of GTS in this case is induction of differentiation. In this case report, we discuss the development mechanism of GTS based on bibliographical consideration.

1768: Prognostic Significance of Plasma Placental Growth Factor Levels in Renal Cell Cancer: An Association with Clinical Characteristics and Vascular Endothelial Growth Factor Levels

BACKGROUND Angiogenesis plays important roles in pathogenesis in human cancer. We assessed the relationship between clinical features of renal cell cancer (RCC) and PlGF levels in relation to VEGF. MATERIALS AND METHODS Plasma PlGF and VEGF levels were measured in patients with renal cell cancer. The levels of these angiogenetic factors were analyzed in relation to clinical parameters. RESULTS PlGF and VEGF levels in patients with RCC were significantly higher than those in non-cancer controls. PlGF levels were significantly associated with histological grade and total tumor vascularity (TTV), and VEGF levels were significantly associated with T, M stage, histological grade, venous invasion and TTV. Multivariate analysis showed plasma PlGF was an independent prognostic factor. CONCLUSION These findings suggested that plasma PlGF levels were significantly associated with the clinical features of RCC, especially prognostic significance.