Split cord malformation concomitant with spinal teratoma without open spinal dysraphism.

PURPOSE: Split cord malformation (SCM) presenting concomitant with spinal teratoma without any open spinal dysraphism has rarely been reported in the literature. We aimed to make a systematic review and qualitative analysis of the literature about the topic and present the first case of SCM concomitant with spinal teratoma harboring papillary thyroid carcinoma (PTC) component. METHODS: Two big search tools (Pubmed/MEDLINE) and Scopus were used. The search strategy was compatible to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An exemplary case of ours was also presented. RESULTS: There were 30 patients (15 pediatric and 15 adult). Female and male distribution was even. Median age of the patients was 18 years (range = 0-66 years). The most common presenting symptoms were back pain and lower limb weakness. Spinal teratoma and SCM mostly presented at thoracic/thoracolumbar region in children and lumbar region in adults. Surgical outcome was better in the children compared to the adults. CONCLUSION: Thoracolumbar region is the most common location for such entity in children, whereas lumbar region for the adults. Surgical resection should be done as much as possible under neuromonitorization. The resected material should be evaluated thoroughly not to miss any malign pathology. Surgical outcome is better when it is done at an early age.

Development of a SERS based cancer diagnosis approach employing cryosectioned thyroid tissue samples on PDMS.

An efficient SERS based novel analytical approach named Cryosectioned-PDMS was developed systematically and evaluated applying on 64 thyroid biopsy samples. To utilize thyroid biopsy samples, a 20-µl volume of h-AgNPs suspension was dropped on a 5-µm thick cryosectioned biopsy specimen placed on the PDMS coated glass slide. The SERS spectra from a 10 × 10 points array acquired by mapping 22.5 µm × 22.5 µm sized area from suspended dried droplets placed on the tissue surface. The probability of correctly predicted performance for diagnosis of malignant, benign and healthy tissues was resulted in the accuracy of 100 % for the spectral bands at 667, 724, 920, 960, 1052, 1096, 1315 and 1457 cm-1 using PCA-fed LDA machine learning. The Cryosectioned-PDMS biophotonic approach with PCA-LDA predictive model demonstrated that the vibrational signatures can accurately recognize the fingerprint of cancer pathology from a healthy one with a simple and fast sample preparation methodology.

Protective effects of Tadalafil and darbepoetin against ischemia - reperfusion injury in a rat testicular torsion model.

OBJECTIVES: To evaluate protective effects of darbepoetin and tadalafil against ischemiareperfusion injury in ipsilateral and contralateral testicle. MATERIALS AND METHODS: Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/ tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion. RESULTS: There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000). CONCLUSION: The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.

Beneficial effects of Oltipraz, nuclear factor - erythroid - 2 - related factor 2 (Nrf2), on renal damage in unilateral ureteral obstruction rat model.

INTRODUCTION: We investigated whether Oltipraz (OPZ) attenuated renal fibrosis in a unilateral ureteral obstruction (UUO) rat model. MATERIALS AND METHODS: We randomly divided 32 rats into four groups, each consisting of eight animals as follows: Rats in group 1 underwent a sham operation and received no treatment. Rats in group 2 underwent a sham operation and received OPZ. Rats in group 3 underwent unilateral ureteral ligation and received no treatment. Group 4 rats were subjected to unilateral ureteral ligation plus OPZ administration. Transforming growth factor beta-1 (TGF-ß1), E-cadherin, nitric oxide (NO) and hydroxyproline levels were measured. Histopathological and immunohistochemical examinations were carried out. RESULTS: TGF-ß1, NO and E-cadherin levels in the UUO group were significantly higher than the sham group and these values were significantly different in treated groups compared to the UUO group. In rats treated with UUO + OPZ, despite the presence of mild tubular degeneration and less severe tubular necrosis, glomeruli maintained a better morphology when compared to the UUO group. Expressions of α-SMA in immunohistochemistry showed that the staining positivity decreased in the tubules of the OPZ-treated group. CONCLUSIONS: While the precise mechanism of action remains unknown, our results demonstrated that OPZ exerted a protective role in the UUO-mediated renal fibrosis rat model highlighting a promising therapeutic potency of Nrf2-activators for alleviating the detrimental effects of unilateral obstruction in kidneys.

Protective effect of hydrogen sulfide on renal injury in the experimental unilateral ureteral obstruction.

INTRODUCTION/OBJECTIVE: Ureteral obstruction is a common pathology and causes kidney fibrosis and dysfunction at late period. In this present study, we investigated the antifibrotic and antiinflammatory effects of hydrogen sulfide on kidney damage after unilateral ureteral obstruction (UUO) in rats. MATERIALS AND METHODS: 24 rats were divided into four groups. Group 1 was control, group 2 was sham, group 3 included rats with UUO and group 4 rats with UUO which were given sodium hydrogen sulfide (NaHS)-exogenous donor of hydrogen sulfide (intraperitoneally 56 µmoL/kg/day). After 14 days, rats were killed and their kidneys were taken and blood analysis was performed. Tubular necrosis, mononuclear cell infiltration and interstitial fibrosis were determined histopathologically in a part of the kidneys; nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH) levels were determined in the other part of the kidneys. Urea-creatinine levels were investigated by blood analysis. Statistical analyses were made by the Chi-square test and one-way analysis of variance (ANOVA). RESULTS: There was no significantly difference for urea-creatinine levels among groups. Pathologically, there was serious tubular necrosis and fibrosis in group 3 and there was significantly decreasing of tubular necrosis and fibrosis in group 4 (p<0.005). Also, there was significantly increase of NO and MDA levels and decrease of GSH levels in group 3 compared to other groups (p<0.005). CONCLUSIONS: hydrogen sulfide prevents kidney damage with antioxidant and antiinflammatory effect.

Beneficial effects montelukast, cysteinyl-leukotriene receptor antagonist, on renal damage after unilateral ureteral obstruction in rats.

INTRODUCTION: Ureteral obstruction is a common pathology and caused kidney fibrosis and dysfunction at late period. In this present, we investigated the antifibrotic and antiinflammatory effects of montelukast which is cysteinyl leukotriene receptor antagonist, on kidney damage after unilateral ureteral obstruction(UUO) in rats. MATERIALS AND METHODS: 32 rats divided four groups. Group 1 was control, group 2 was sham, group 3 was rats with UUO and group 4 was rats with UUO which were given montelukast sodium (oral 10 mg/kg/day). After 14 days, rats were killed and their kidneys were taken and blood analysis was performed. Tubular necrosis, mononuclear cell infiltration and interstitial fibrosis scoring were determined histopathologically in a part of kidneys; nitric oxide(NO), malondialdehyde(MDA) and reduced glutathione(GSH) levels were determined in the other part of kidneys. Urea-creatinine levels were investigated at blood analysis. Statistical analyses were made by the Chi-square test and one-way analysis of variance (ANOVA). RESULTS: There was no difference significantly for urea-creatinine levels between groups. Pathologically, there was serious tubular necrosis and fibrosis in group 3 and there was significantly decreasing for tubular necrosis and fibrosis in group 4(p<0.005). Also, there was significantly increasing for NO and MDA levels; decreasing for GSH levels in group 3 compared the other groups(p<0.005). CONCLUSION: We can say that montelukast prevent kidney damage with antioxidant effect, independently of NO.

Protective effect of hydrogen sulfide on gentamicin-induced renal injury.

OBJECTIVE: We evaluated the potential protective effect of hydrogen sulfide (H2S) against GEN-induced nephrotoxicity in rats. MATERIALS AND METHODS: Twenty-four rats were randomly divided into four groups, each consisting of six animals as follows: (1) the rats were control, (2) intraperitoneally injected with GEN 14 consecutive days (100 mg/kg/day), (3) treated with GEN plus %0.9 saline intraperitoneally for 14 days and (4) treated with GEN plus sodium hydrogen sulfide (NaHS)-exogenous H2S donor (56 µmol/kg/day) for 14 days. After 15 days, rats were sacrificed and their kidneys were taken and blood analysis was performed. Twenty-four hours urine collections were obtained in standard metabolic cages a day before the rats were sacrificed. Tubular necrosis and interstitial fibrosis scoring were determined histopathologically in a part of kidneys; nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH) levels were determined in the other part of kidneys. Statistical analyses were made by the chi-squared test and one-way analysis of variance. RESULTS: Serum urea and creatinine levels were significantly higher in rats treated with GEN alone, than the rats in control and GEN + NaHS groups. The GSH levels in renal tissue of only GEN-treated rats were significantly lower than those in control group, and administration of NaHS to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and NaHS had significantly lower MDA and NO levels in kidney cortex tissue than those that was given GEN alone. In rats treated with GEN + NaHS, despite the presence of mild tubular degeneration and tubular necrosis are less severe, and glomeruli maintained a better morphology when compared with GEN group. DISCUSSION: We can say that H2S prevent kidney damage with antioxidant and anti-inflammatory effect.

Histopathological characteristics of nasal polyps in smokers and non-smokers.

OBJECTIVE: It is known that cigarette smoking causes squamous metaplasia in upper and lower airways. We hypothesized that in patients with nasal polyposis, nasal polyps of smokers might reveal some histopathological changes and there might be an increased neoplasia risk. Therefore, in this study, we aimed to explore the effects of smoking on nasal polyp histopathology and clinical measures. STUDY DESIGN: Retrospective chart review. SETTING: Fatih Sultan Mehmet Education and Research Hospital. MATERIAL AND METHODS: Thirty smoker and 47 non-smoker patients with nasal polyposis who underwent endoscopic sinus surgery between 2007 and 2011 were enrolled in this study to assess effect of smoking on histopathological characteristics of nasal polyps and clinical measures such as endoscopy score, computed tomography score of Lund-Mackay, Nasal Obstruction Symptom Evaluation (NOSE) Scale, presence of allergy and asthma, and blood eosinophil level. RESULTS: No statistically significant differences were found between smoker and non-smoker groups with regard to histopathological findings. Also, there were no significant correlation defined by endoscopy, computed tomography, and NOSE scores of patients between 2 groups. Smoking did not have a significant effect on the presence of allergy or asthma. But blood eosinophil levels were found to be significantly high in the smoker group. CONCLUSION: This is the first clinical study that investigates the effect of smoking on nasal polyp histopathology. In spite of the fact that smoking is associated with histopathological changes in respiratory mucosa, we did not find any significant change in histopathological characteristics of nasal polyps in smokers.

Transitional cell carcinoma with glandular differentiation metastatic to the inguinal lymph node from the urinary bladder.

Metastasis to the inguinal lymph nodes is a rare event in bladder cancer. In general, tumors at the metastatic foci are histologically similar to the primary. We report a metastatic adenocarcinoma in the inguinal lymph node from a primary, pure transitional cell carcinoma after radical cystectomy.

Cinnamaldehyde has Antifibrotic Effects on Rats with Epidural Fibrosis.

BACKGROUND: Laminectomy is a widely employed surgical procedure for the treatment of spinal stenosis, but it may lead to epidural fibrosis (EF) and failed back surgery syndrome. Cinnamaldehyde, a phenylpropanoid found in cinnamon, has demonstrated antioxidant and anti-inflammatory properties. In the present study, we hypothesized that topical application and systemic administration of cinnamaldehyde could be helpful in the prevention of EF in a rat laminectomy model. METHODS: The rats were randomly assigned to control, local, and systemic Tween-80 and local and systemic cinnamaldehyde experimental groups (n = 6, per group). In the control group, just laminectomy was performed. In local treatment groups, applications were done just after the laminectomy onto dura. In systemic treatment groups, intraperitoneal administrations were performed following skin suturing. The degree of epidural fibrosis was evaluated macroscopically and histopathologically 4 weeks later. RESULTS: Macroscopic assessment revealed decreased EF with both topical and systemic cinnamaldehyde application, whereas microscopic examination results were not significant. CONCLUSIONS: Our findings provide the first experimental evidence of cinnamaldehyde's potential protective effects against EF.

Protective effect of montelukast which is cysteinyl-leukotriene receptor antagonist on gentamicin-induced nephrotoxicity and oxidative damage in rat kidney.

Nephrotoxicity is a major complication of gentamicin (GEN). We aimed to evaluate the potential protective effect of montelukast (MK) against GEN-induced nephrotoxicity in rats. Thirty-two rats were randomly divided into four groups, each consisting of eight animals as follows: (1) the rats were control; (2) intraperitoneally injected with GEN 14 consecutive days (100 mg/kg/day); (3) treated with GEN plus distilled water via nasogastric gavage for 14 days; and (4) treated with GEN plus MK (10 mg/kg/day) for 14 days. After 15 days, rats were killed and their kidneys were taken and blood analysis was performed. Twenty-four hours urine collections were obtained in standard metabolic cages a day before the rats were killed. Tubular necrosis and interstitial fibrosis scoring were determined histopathologically in a part of kidneys; nitric oxide (NO), malondialdehyde (MDA), and reduced glutathione (GSH) levels were determined in the other part of kidneys. Statistical analyses were made by the chi-square test and analysis of variance. Serum urea and creatinine levels were significantly higher in rats treated with GEN alone, than the rats in control and GEN + MK groups.The GSH levels in renal tissue of only GEN-treated rats were significantly lower than those in control group, and administration of MK to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and MK had significantly lower MDA and NO levels in kidney cortex tissue than those that was given GEN alone. In rats treated with GEN + MK, despite the presence of mild tubular degeneration and tubular necrosis are less severe, and glomeruli maintained a better morphology when compared with GEN group. We can say that MK prevents kidney damage with antioxidant effect, independently of NO.

Pomegranate extract attenuates gentamicin-induced nephrotoxicity in rats by reducing oxidative stress.

Nephrotoxicity is a major complication of gentamicin (GEN), which is widely used in the treatment of severe Gram-negative infections. Reactive oxygen species are important mediators of GEN-induced nephrotoxicity. Because of the strong antioxidant properties of pomegranate extract (PE), we evaluated the protective effect of PE against GEN-induced nephrotoxicity. Thirty-two adult male rats were randomly divided into four equal groups: (1) controls; (2) treated with GEN for 14 consecutive days (100 mg/kg/day); (3) treated with GEN plus distilled water; and (4) treated with GEN plus PE (100 µL). After 15 days, the rats were killed and their kidneys were taken, and blood analysis was performed. Tubular necrosis and interstitial fibrosis scores were determined histopathologically; and biochemically, nitric oxide (NO), malondialdehyde (MDA), and reduced glutathione (GSH) levels in kidneys were determined. Urea, creatinine, Na(+), and K(+) levels were investigated in the blood analysis. Statistical analyses were made by the chi-square test and analysis of variance. Serum urea and creatinine levels were significantly higher in rats treated with GEN alone than rats in the control and the GEN + PE-treated groups. The GSH level in renal tissue of only GEN-treated rats was significantly lower than those in the control group, and administration of PE to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and PE had significantly lower MDA levels in kidney cortex tissue than those given GEN alone. There was no significant difference of NO levels between the groups. In rats treated with GEN + PE, despite the presence of mild tubular degeneration and tubular necrosis is less severe, and glomeruli maintained a better morphology when compared with the GEN-treated group. We think that PE prevents kidney damage by decreasing oxidative stress in kidney.

Henoch-Schönlein purpura without systemic involvement beginning with acute scrotum and mimicking torsion of testis.

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. Typical presentations of HSP are palpable purpura of the small vessels in the hips and lower limbs, abdominal pain, arthritis, and hematuria. Scrotal involvement manifested by the presence of scrotal pain and swelling during the course of the disease is rarely seen. HSP without systemic involvement with acute scrotum mimicking testicular torsion is even rare in the medical literature. In most cases, patients with this disease achieve complete recovery. Herein, we report an interesting HSP case with skin symptoms but without systemic involvement and then progression to acute scrotum resembling torsion of testis.

Caloric restriction increases internal iliac artery and penil nitric oxide synthase expression in rat: comparison of aged and adult rats.

Because of the positive corelation between healthy cardiovascular system and sexual life we aimed to evaluate the effect of caloric restriction (CR) on endothelial and neuronal nitric oxide synthase (eNOS, nNOS) expression in cavernousal tissues and eNOS expression in the internal iliac artery in young and aged rats. Young (3 mo, n = 7) and aged (24 mo, n = 7) male Sprague-Dawley rats were subjected to 40% CR and were allowed free access to water for 3 months. Control rats (n = 14) fed ad libitum had free access to food and water at all times. On day 90, rats were sacrificed and internal iliac arteries and penis were removed and parafinized, eNOS and nNOS expression evaluated with immunohistochemistry. Results were evaluated semiquantitatively. eNOS and nNOS expression in cavernousal tis- sue in CR rats were more strong than in control group in both young and old rats. eNOS expression was also higher in the internal iliac arteries of CR rats than in control in young and old rats. As a result of our study we can say that there is a positive link between CR and neurotransmitter of erection in cavernousal tissues and internal iliac arteries. CR has beneficial effect to prevent sexual dysfunction in young and old animals and possible humans.

Effects of heat stress on endocrine functions & behaviour in the pre-pubertal rat.

BACKGROUND & OBJECTIVES: Heat stress related hyperthermia may cause damage to various organ systems. There are very few studies on the effects of hyperthermia on the endocrine system. We therefore, investigated effects of exogenously induced hyperthermia on adrenal, testicular and thyroid functions and behavioural alterations in pre-pubertal male Sprague-Dawley rats. METHODS: Three groups of 30-day old rats (n=7 per group) were used. Body temperature was increased to 39 °C (Group I) and 41 °C (Group II) in a hyperthermia induction chamber for 30 min. The rats in the Group III served as control (36 °C). All animals received saline and were decapitated 48 h after the experiments. Serum free triiodothyronin (fT3), free thyroxine (fT4), total testosterone and dehydroepiandrosterone sulphate (DHEA-S) levels were determined by chemiluminescence assay, and corticosterone by enzyme immunoassay. Testes, pituitary and adrenal glands were dissected out and processed for histopathological examination. To assess activity and anxiety of the animals, the open field test and elevated-0-maze test, respectively, were used in all groups 24 h before (day 29) and after (day 31) hyperthermia induction. RESULTS: Serum corticosterone levels (3.22 ± 1.3) were significantly reduced in the 39 °C (1.3 ± 0.9) and 41 °C (1.09 ± 0.7) hyperthermia groups (P<0.01) compared to controls. Serum levels of thyroid hormones did not significantly differ among the groups. DHEA-S and testosterone values were below the limit of detection in all groups. Histopathological examination revealed that there was mild hydropic degeneration in the pituitary and adrenal glands. Apoptotic germ cells were seen in the seminiferous tubules of pre-pubertal male rats exposed to hyperthermia (41 °C). Progression time in the open field test was significantly decreased and anxiety test scores increased in animals exposed to 39 °C compared to the control group (P<0.01). These parameters were more pronounced in the 41 °C hyperthermia group. INTERPRETATION & CONCLUSIONS: Our results show that heat exposure-induced stress may cause delayed reduction in serum corticosterone levels which may be associated with behavioural deficits in pre-pubertal male rats.

Impact of smoking on p65 nuclear factor κB, p38 mitogen-activated protein kinase, and inducible nitric oxide synthase expression levels in oral mucosa.

OBJECTIVES: Smoking plays an important role in oral cancer development; however, the molecular carcinogenesis mechanism in oral mucosa is not well understood. The aim of this study was to examine and compare the levels of p65 nuclear factor κB (NF-κB), p38 mitogen-activated protein kinase (MAPK), and inducible nitric oxide synthase (iNOS) expressions between oral mucosa of nonsmoker and smoker volunteers. METHODS: Oral cheek mucosa was collected from 78 volunteers. Smokers were divided into 2 subgroups: light smokers (<40 pack years) and heavy smokers (≥ 40 pack years). Paraffinized tissue immunochemistry was carried out for p65 NF-κB, p38 MAPK, and iNOS expression with specific antibodies. Results were evaluated based on diffuseness and intensity of staining. RESULTS: Group 1 composed of 40 nonsmokers: 52.5% were female and 47.5% were male, with a mean age of 46.4 years. Group 2 composed of 38 smokers (20 light smokers, 18 heavy smokers): 39.5% were female and 60.5% were male, with a mean age of 48.9 years. Total immunohistochemical staining scores of smokers were significantly higher compared with those of nonsmokers in p65 NF-κB, p38 MAPK, and iNOS expression (P < 0.001). The highest p65 NF-κB, p38 MAPK, and iNOS expression levels were detected in the oral mucosa of heavy smokers. The expression of iNOS and p65 NF-κB in heavy smokers was significantly higher compared to that in light smokers (P < 0.01 and P < 0.05, respectively). Although p38 MAPK expressions were higher in heavy smokers compared with light smokers, the difference was not statistically significant (P > 0.05). CONCLUSIONS: Our results show for the first time the significant increase in the expression of p65 NF-κB and p38 MAPK in the oral mucosa of smokers. Levels of p65 NF-κB, p38 MAPK, and iNOS expression in the oral mucosa of smokers were related to the number of pack years.

Comparison of tumor grade and stage with nuclear factor kappa b and p38 mitogene activated protein kinase expressions in renal cell cancer.

OBJECTIVES: Renal cancer is common among urinary system cancers. Most common one is clear cell carcinoma and it makes up 60-70% of renal cell carcinomas. Invasion pathophysiology and molecular mechanisms that take part are crucial for the diagnosis, treatment and prognosis of this disease. In this study, nuclear factor kappa B (NFKB/p65) and p38 mitogene activated protein kinase, which play an important role in signal transduction system of clear cell renal carcinoma, are assessed. MATERIALS AND METHODS: We considered 40 patients who had radical nephrectomy or partial nephrectomy for renal tumor in Okmeydani Training and Research Hospital 1st Urology Clinic. Normal tissue samples of these patients were used as control group. Paraffin embedded samples of renal cancer were studied with immunohistochemistry using spesific monoclonal and polyclonal antibodies of NFKB and MAPKC Expression density was compared with tumor grade and diameter, semiquantitively. Results were assessed with Spearman correlation and Pearson chi-square tests. RESULTS: There were 28 (70%) males and 12 (30%) females in our study. Age range of patients was between 19 and 80 years, and mean age was 59.3 +/- 13.4. NFKB and p38MAPK expressions were higher in cancer specimens compared with control group (p < 0.05). Tumor diameter and grade increase were directly correlated with p65(NFKB) and p38MAPK expression (p < 0.05). CONCLUSIONS: MAPK and NFKB expression is related to tumor grade and stage. Also more studies are needed to define the relationship with lymph node metastasis, organ metastasis and survival rates.

Stem cell markers aldehyde dehydrogenase type 1 and nestin expressions in renal cell cancer.

OBJECTIVES: To identify stem cell markers aldehyde dehydrogenase type 1 (ALDH-1) and nestin expression in renal cell carcinoma (RCC). MATERIALS AND METHODS: 95 RCC patients who had radical or partial nephrectomy were included in this study. Normal renal tissue samples of the same patients were designated as the control group. Paraffin blocks of RCC patients were studied immunohistochemically. Expressions were analyzed semiquantitively. Relation of tumor grade and stage with these expressions was determined. Results were calculated with Mann Whitney U and Kruskal Wallis tests. RESULTS: There were 55 male (57.8%) and 40 (42.2%) female patients in the study. Age and sex of the patients were not correlated with their antibody expressions (p > 0.05). ALDH-1 and nestin expression was higher in cancer tissues than normal tissues (p < 0.05). Nestin expression in renal cencer tissue was inversely related with tumor stage (p < 0.05) but there was no relation with Fuhrman grade. ALDH-1 expression was correlated with tumor grade (p < 0.05) but not with tumor stage (p > 0.05). CONCLUSIONS: ALDH-land nestin expression have a role in RCC pathophysiology. There is a need to perform more studies about stem cell markers in RCC with more patients and in these future studies lymph node metastasis, distant organ metastasis and survival rates should be included.

Primary Hydatid Cyst of Lumbar Paravertebral Muscle.

Hydatid cyst disease as a zoonosis usually infests the liver and lungs, and it rarely affects muscles. Here, we presented a 36-year-old female patient with low back pain. Radiological evaluation revealed a soft tissue lesion located at the left paravertebral region without vertebral invasion. Surgical exploration and removal of the cyst were performed. The pathological diagnosis was hydatid cyst. After the surgery, the patient was treated with albendazole which is used to decrease the consequences of spillage and the possibility of recurrence. Hydatid cyst disease is rarely seen in paravertebral muscle tissue and needs to be correctly managed. Primary muscle involvement of hydatid cyst must be kept in mind for differential diagnosis of paravertebral cystic mass lesions.

Isolated Pituitary Metastasis of Renal Cell Carcinoma: A Case Report and Systematic Review of the Literature.

BACKGROUND: Isolated pituitary gland metastasis is an extremely rare event in renal cell carcinoma. We present a unique case of isolated pituitary metastasis of renal cell carcinoma and a systematic review of literature on it. CASE REPORT: In this case, an abdominal ultrasound in an asymptomatic 51-year-old female patient showed a mass in her left kidney. Radical nephrectomy was performed and the tumor was diagnosed as a stage 1 clear cell carcinoma. Throughout the 3 months of the follow-up period, the patient started complaining of visual disturbances and headaches. A pituitary mass was found on brain magnetic resonance imaging and was suspected to be a macroadenoma. Surgical resection of the tumor was performed and the final pathological diagnosis was made as a pituitary metastasis of the renal cell carcinoma. After surgery, radiotherapy with sunitinib, a receptor tyrosine inhibitor, was performed. CONCLUSION: The clinical symptoms are usually related to the mass effect of the tumor and anterior pituitary involvement. Most of the cases mimic pituitary macroadenoma on MRI. The most preferred treatment combination is surgery and radiotherapy. We recommend adding sunitinib to this combination. This illustrative case and those found in a systematic review of the literature highlight the importance of histopathologic diagnosis and appropriate management since isolated pituitary metastasis is challenging to preoperative diagnosis.