Retroperitoneal immature teratoma producing alpha-fetoprotein.

An alpha-fetoprotein producing retroperitoneal immature teratoma is demonstrated and the aetiology of AFP arising probably from small island of hepatoid cells or various tubular epithelial cells in the immature teratoma is discussed.

[Retroperitoneal lymphangiomyomatosis. Immunohistochemical and ultrastructural study of a case]. / Linfangiomiomatosi ad esordio retroperitoneale. Studio immunoistochimico ed ultrastrutturale di un caso.

A case of retroperitoneal lymphangiomyomatosis occurring in a 34-year-old woman is reported. Alpha-smooth muscle actin and desmin were localized in the proliferating cells. Electron microscopy showed the presence of many thin perinuclear myofilaments with dense bodies. The differential diagnosis with leiomyosarcoma has been taken into consideration.

[A case of retroperitoneal schwannoma].

A 39-year-old man, who had been pointed out to have a lower abdominal mass, was admitted to our hospital. Physical examination revealed a child-head-sized mass with smooth surface in the middle part of the lower abdomen. Computerized tomographic scan showed the non-cystic mass located in the retroperitoneal space from the level of L5 to S5. An open biopsy was performed and pathological diagnosis was benign schwannoma (Antoni A and B type). Radical operation could not be performed because of his refusal. In addition to this case, 40 cases of retroperitoneal schwannoma reported in Japan are reviewed and discussed.

Detection of AFP and HCG in metastatic testicular cancer after treatment with chemotherapy or radiation therapy.

We used an indirect immunoperoxidase technique to detect alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in tissue sections of nine metastatic germ cell tumors excised after treatment with chemotherapy or radiation therapy, and correlated the results with the serum levels of AFP and HCG. In all but 1 case yolk sac tumor (YST) was the only histologic type that reacted for AFP (AFP+) and syncytiotrophoblasts (STB) were the only histologic type that reacted for HCG (HCG+). Among 5 cases with normalization of the serum AFP before surgery, 3 were associated with YST-/AFP-, 1 with YST+/AFP+, and 1 with YST+/AFP- metastases; and among 4 cases with normalization of the serum HCG all were associated with STB-/HCG- metastases. Among 3 cases with persistent elevation of the serum AFP, 1 was associated with YST+/AFP+, 1 with YST+/AFP-, and 1 with YST-/AFP- metastases; and of 2 cases with persistent elevation of the serum HCG, 1 was associated with STB-/HCG- and 1 with STB+/HCG+ metastases. These data suggest that marker normalization in the face of persistent tumor results primarily from eradication of YST and STB, but also from treatment-induced inhibition of AFP and HCG synthesis or secretion.

Immunocytochemical and ultrastructural findings in a mature retroperitoneal teratoma.

Report is made of a mature retroperitoneal teratoma in a 32-year-old man. Investigation of the tumor revealed cells immunoreactive for ACTH, Met-enkephalin, beta-LPH, serotonin, FSH, BPP, S100, Neuron-specific-enolase. These cells were mainly present in the glandular epithelium, lining the cysts of the tumor. Ultrastructurally, neuro-secretory granules were demonstrated in the cytoplasm of the tumoral endocrine cells. At no time did the patient display endocrine symptoms.

[A case of primary retroperitoneal tumor with combined histologic features of embryonal carcinoma and yolk sac tumor].

A case of a primary retroperitoneal tumor, combining two histologic features of embryonal carcinoma and a yolk sac tumor is reported. A 31-year-old male complained of severe abdominal pain and had a laparotomy following a diagnosis of acute panperitonitis. During the operation, a large retroperitoneal tumor attached to the abdominal aorta was found, accompanied with remarkable hemorrhage and necrosis. Histologically, the tumor showed immature large cells with a solid pattern, focally forming reticular, tubular and glomeruloid structures. PAS positive hyaline bodies, multinuclear giant cells and mitoses were noted in the tumor cells. Immunohistochemically, the tumor cells in the reticular pattern were positive for alpha-fetoprotein. No abnormality was found in the testes on palpation and ultrasound sonographic examination.

Rhabdomyoma of the retroperitoneum. A report of a tumor with both adult and fetal characteristics: a study by light and electron microscopy, histochemistry, and immunochemistry.

An unusual benign tumor of skeletal muscle origin is described. The tumor was located in the left retroperitoneum of a newborn female. The tumor contained features of both an adult and fetal rhabdomyoma when studied by light and electron microscopy, immunocytochemistry, and histochemistry. This is the only report of this type of neoplasm in the literature.

Eutopic and ectopic macromolecular human placental lactogen.

Macromolecular forms of human placental lactogen have received little attention because it has been thought that such forms either compose only a small fraction of total immunoactive placental lactogen or are merely laboratory artifacts. We examined serum and placental tissue from women with normal pregnancy (first and third trimesters), serum and tissue from women with eutopic tumors (mole and choriocarcinoma), and serum from men with ectopic placental lactogen production. Samples were chromatographed on dextran gel (Sephadex G-100), and placental lactogen was measured in the fractions by radioimmunoassay. In all specimens examined, immunoactive placental lactogen was found at the void volume of the column (molecular weight greater than 150,000 daltons). This macromolecular placental lactogen comprised less than 4% of total placental lactogen in the third trimester, in mole, and in 16 of 18 first-trimester samples but was significantly higher, up to 19%, in the malignant cases. In two first-trimester placental extracts (but not in their matched sera) macromolecular placental lactogen was the dominant (greater than 45% of the total placental lactogen) immunoactive species. Authentic monomeric placental lactogen was not converted to macromolecular placental lactogen by repeated freezing and thawing. Third-trimester placental macromolecular placental lactogen was unstable; only 13% remained at the void on rechromatography. First-trimester placental macromolecular placental lactogen, on the other hand, was stable to rechromatography. The behavior of immunochemical dilutions of macromolecular placental lactogen from first-trimester placenta was similar to that of monomeric placental lactogen in the same sample. Macromolecular placental lactogen is probably not artifact, and it can comprise a large fraction of the total immunoactive placental lactogen in certain conditions.

[Multicystic peritoneal mesothelioma. Ultrastructural and immunohistochemical study apropos of a case]. / Le mésothéliome multikystique péritonéal. Etude ultrastructurale et immunohistochimique à propos d'une observation.

Authors present the case of a 59 years old man in whom an intra abdominal mass was discovered fortuitly. A surgical intervention permitted to remove a retroperitoneal mass. The macroscopic features were similar to those of multicystic mesothelioma. A review of literature of the 31 cases published permits to present the characteristics of cystic mesothelioma. This entity was confound during a long time with cystic lymphangioma, from which it was distinguished in 1979 with the use of electron microscopy. Interest of studies in immunochemistry, already unpublished, is demonstrated here for Factor VIII and cytokeratin.

The isolation and sequence analysis of vasoactive intestinal peptide from a ganglioneuroblastoma.

A ganglioneuroblastoma was excised at surgery from a 1-yr-old girl with severe watery diarrhea. The tumor, weighing 1 g, was extracted in trifluoracetic acid and contained 8.3 nmol immunoreactive vasoactive intestinal peptide. The peptide was isolated by affinity chromatography and high pressure liquid chromatography and was found to be identical to porcine vasoactive intestinal peptide by amino acid analysis and microsequence analysis.

Proteins of intermediate filaments. An immunohistochemical and biochemical approach to the classification of soft tissue tumors.

The intermediate filament cytoskeleton of various types of human soft tissue tumors was analyzed by immunofluorescence microscopy with the use of specific antibodies against cytokeratins, vimentin, and desmin, as well as by one- and two-dimensional gel electrophoresis of high-salt buffer- and detergent-resistant cytoskeletal preparations. All leiomyomas as well as a leiomyosarcoma contained desmin. Leiomyomas of both gastrointestinal and uterine derivation and the retroperitoneal leiomyosarcoma showed strong reaction for desmin in the smooth muscle cells, but the latter two exhibited also vimentin staining. In embryonal rhabdomyosarcomas, desmin prevailed in the large, apparently well-differentiated rhabdomyoblasts; whereas the smaller, less differentiated tumor cells preferentially contained vimentin. Cells of malignant fibrous histiocytomas were characterized by their content of vimentin as the only intermediate filament protein present. In alveolar soft part sarcoma, a rare tumor of hitherto unknown histogenesis, vimentin and desmin co-existed within the same tumor cells, indicating, together with chemical determinations, the myogenic derivation of this neoplasm. The results show that immunologic and biochemical analysis of proteins associated with the intermediate filament cytoskeleton is a useful adjunct in the diagnosis of diverse neoplasms, particularly those with equivocal histologic features, and thus aids in the histogenetic classification of soft tissue tumors.

Qualitative and quantitative analyses of human chorionic gonadotropin and its subunits produced by malignant tumors.

Human chorionic gonadotropin (hCG) and its subunits in plasma, urine, ascites, and tumor extracts from four patients with hCG-producing tumors (undifferentiated cell carcinoma and choriocarcinoma of the bladder, malignant teratoma of the retroperitoneum, and pancreatic carcinoma) were measured by the radioimmunoassays specific to each component. While both free alpha and beta subunits as well as the whole molecule of hCG were found in all these samples, the proportion of beta subunit was much higher in these tumor extracts than in the placental extracts. Since the alpha and beta subunits are known to be translated from separate mRNAs, such increase of subunit is probably due to the predominant increase of mRNA encoding beta subunit of hCG in the hCG-producing tumors. Gel filtration of the extracts of these four tumors on Sephadex G-100 and G-150 columns demonstrated a heterogeneity of hCG, alpha, and beta subunits in these tumor extracts, and the elution profiles of plasma, urine and tumor extracts were slightly different. Lower molecular weight forms of hCG and its beta subunit were present in all urine samples. The significance of these heterogeneities remains to be elucidated.

Retroperitoneal hemangiopericytoma associated with hypoglycemia: report of a case.

A 34-year-old woman had episodes of hypoglycemic attack 8 years after a surgical resection of a retroperitoneal hemangiopericytoma. In spite of normal levels of serum IRI, insulin radioreceptor assay demonstrated high level of plasma ILA (insulin like activity). The patient underwent resection of a recurrent retroperitoneal tumor with metastatic lesions of the liver. Postoperatively, ILA level in plasma by insulin radioreceptor assay decreased, and hypoglycemic attacks disappeared. Therefore, this associated hypoglycemia was presumed to be not caused by excess glucose consumption by the tumor, not by excess secretion of IRI by the tumor, but caused by the presence of high level of ILA related to the tumor.

[Yolk sac tumor (author's transl)]. / Tumeur de la membrane vitelline.

An analysis was made from a histopathological and clinical standpoint of 6 cases of yolk sac tumor over a period of 15 years, treated in the first surgical department of the University of Hokkaido. All these cases, with the exception of one retroperitoneal tumor, were diagnosed as embryonic carcinomas before the study. AFP were examined throughout the duration of treatment and their levels reflected changes corresponding to the effects of treatment and recurrence. They were seen in the form of special fluorescence in the tumor cells using the antibody immunofluorescence method. Radiotherapy and chemotherapy may be effective, but the prognosis of these tumors is poor. Amongst the cases mentioned, only the child with a tumor of testicular origin is in good health.