Plasmacytoid variant of urothelial carcinoma of the bladder manifesting as bilateral ureteral and small bowel obstruction.

Plasmacytoid urothelial carcinoma (PUC) is a rare variant of bladder cancer characterized by distinct histopathology and advanced stage at diagnosis. Multimodal treatment is usually indicated. We present a case of PUC causing bilateral ureteral obstruction with subsequent renal failure followed shortly by malignant small bowel obstruction, demonstrating the need for a high degree of clinical suspicion in diagnosis of this aggressive subtype. Moreover, the local invasiveness of the disease cannot be understated, given that it can rapidly spread with little radiologic evidence of progression until it is at an advanced stage.

PD-L1 pathway as a novel target in carcinosarcoma of the kidney and renal pelvis.

Carcinosarcoma of the kidney and renal pelvis (CSKP) is a rare and highly-aggressive malignancy characterized by rapid progression and widespread metastases. To date, few studies describe the natural history of the disease. We present a patient placed on pembrolizumab therapy for suspected metastatic colon cancer. The patient was found to have a right renal mass with caval extension on surveillance and ultimately underwent radical surgery revealing carcinosarcoma with positive PD-L1 expression with no evidence of recurrence to date. To our knowledge, this is the first case describing PD-L1 expression in CSKP and presents a novel pathway for future treatment algorithms.

Soy glyceollins regulate transcript abundance in the female mouse brain.

Glyceollins (Glys), produced by soy plants in response to stress, have anti-estrogenic activity in breast and ovarian cancer cell lines in vitro and in vivo. In addition to known anti-estrogenic effects, Gly exhibits mechanisms of action not involving estrogen receptor (ER) signaling. To date, effects of Gly on gene expression in the brain are unknown. For this study, we implanted 17-ß estradiol (E2) or placebo slow-release pellets into ovariectomized CFW mice followed by 11 days of exposure to Gly or vehicle i.p. injections. We then performed a microarray on total RNA extracted from whole-brain hemispheres and identified differentially expressed genes (DEGs) by a 2 × 2 factorial ANOVA with an false discovery rate (FDR) = 0.20. In total, we identified 33 DEGs with a significant E2 main effect, 5 DEGs with a significant Gly main effect, 74 DEGs with significant Gly and E2 main effects (but no significant interaction term), and 167 DEGs with significant interaction terms. Clustering across all DEGs revealed that transcript abundances were similar between the E2 + Gly and E2-only treatments. However, gene expression after Gly-only treatment was distinct from both of these treatments and was generally characterized by higher transcript abundance. Collectively, our results suggest that whether Gly acts in the brain through ER-dependent or ER-independent mechanisms depends on the target gene.