[Prostate carcinoma and syndrome of inappropriate antidiuretic hormone secretion]. / Carcinoma de próstata y síndrome de secreción inadecuada de hormona antidiurética.

Prostate cancer is an extremely rare cause of syndrome of inappropriate antidiuretic hormone (SIADH) secretion. These tend to be aggressive tumors and SIADH can carry serious clinical consequences. A 64 years old patient was diagnosed with Gleason 4+3: 7 prostate adenocarcinoma in December 2014 and received hormonal blockade therapy. By March 2015 he was admitted for symptomatic hyponatremia and SIADH secretion was diagnosed, with no other probable cause than prostate cancer. He suffered a rapid progression of his oncologic disease, surprisingly with PSA in normal range, and died in the short term. There is great clinical and histopathological variability in the cases reported in the literature of association of prostate carcinoma and SIADH. However, they all agree on the aggressiveness of these tumors. This characteristic is present in tumors that have neuroendocrine features. They are frequently resistant to hormonal treatment and may present with paraneoplastic syndromes such as SIADH. The profile of its molecular alterations is under study for the development of target therapies. The association of prostate adenocarcinoma and SIADH is very uncommon and could involve neuroendocrine differentiation. For this reason, it is essential to perform a new biopsy of the tumor or its metastases at the progressive disease in order to conduct an appropriate treatment according to its morphological, immunohistochemical and, in the future, molecular characteristics.

Down-regulation of the antisense mitochondrial non-coding RNAs (ncRNAs) is a unique vulnerability of cancer cells and a potential target for cancer therapy.

Hallmarks of cancer are fundamental principles involved in cancer progression. We propose an additional generalized hallmark of malignant transformation corresponding to the differential expression of a family of mitochondrial ncRNAs (ncmtRNAs) that comprises sense and antisense members, all of which contain stem-loop structures. Normal proliferating cells express sense (SncmtRNA) and antisense (ASncmtRNA) transcripts. In contrast, the ASncmtRNAs are down-regulated in tumor cells regardless of tissue of origin. Here we show that knockdown of the low copy number of the ASncmtRNAs in several tumor cell lines induces cell death by apoptosis without affecting the viability of normal cells. In addition, knockdown of ASncmtRNAs potentiates apoptotic cell death by inhibiting survivin expression, a member of the inhibitor of apoptosis (IAP) family. Down-regulation of survivin is at the translational level and is probably mediated by microRNAs generated by dicing of the double-stranded stem of the ASncmtRNAs, as suggested by evidence presented here, in which the ASncmtRNAs are bound to Dicer and knockdown of the ASncmtRNAs reduces reporter luciferase activity in a vector carrying the 3'-UTR of survivin mRNA. Taken together, down-regulation of the ASncmtRNAs constitutes a vulnerability or Achilles' heel of cancer cells, suggesting that the ASncmtRNAs are promising targets for cancer therapy.

Land use and food intake of future inhabitants: outlining a representative individual of the most exposed group for dose assessment.

The radiation doses to humans resulting from a potential release of radionuclides from a geological repository for long-lived waste are assessed over tens or even hundreds of thousands of years. Ingestion is expected to be the major exposure pathway, and the group with the highest exposures will be those that consume the most contaminated food. In this paper, we characterize the group of individuals with the highest exposures by considering the physical and biological characteristics of the contaminated area and human requirements for energy and nutrients. We then calculate intake rates based on land-use scenarios drawn from self-sustained communities spanning prehistoric times to an industrial-age agrarian culture. The approach is illustrated by simulating groundwater release of four radionuclides to an expected discharge area. We argue that the derived intake rates may serve as credible bounding cases when projected doses are evaluated for compliance with regulatory criteria.

Model of the long-term transport and accumulation of radionuclides in future landscapes.

Assessments of radiological impacts on humans and other biota from potential releases to the biosphere from a deep geologic repository for spent nuclear fuel are associated with several challenges. Releases, if any, will likely occur in a far future and to an environment that will have experienced substantial transformations. Such releases would occur over very long periods during which environmental conditions will vary continuously due to climate change and ecosystem succession. Assessments of radiological impacts must therefore be based on simulations using models that can describe the transport and accumulation of radionuclides for a large variety of environmental conditions. In this paper we describe such a model and show examples of its application in a safety assessment, taking into account results from sensitivity and uncertainty analyses of the model predictions.

Plant uptake of elements in soil and pore water: field observations versus model assumptions.

Contaminant concentrations in various edible plant parts transfer hazardous substances from polluted areas to animals and humans. Thus, the accurate prediction of plant uptake of elements is of significant importance. The processes involved contain many interacting factors and are, as such, complex. In contrast, the most common way to currently quantify element transfer from soils into plants is relatively simple, using an empirical soil-to-plant transfer factor (TF). This practice is based on theoretical assumptions that have been previously shown to not generally be valid. Using field data on concentrations of 61 basic elements in spring barley, soil and pore water at four agricultural sites in mid-eastern Sweden, we quantify element-specific TFs. Our aim is to investigate to which extent observed element-specific uptake is consistent with TF model assumptions and to which extent TF's can be used to predict observed differences in concentrations between different plant parts (root, stem and ear). Results show that for most elements, plant-ear concentrations are not linearly related to bulk soil concentrations, which is congruent with previous studies. This behaviour violates a basic TF model assumption of linearity. However, substantially better linear correlations are found when weighted average element concentrations in whole plants are used for TF estimation. The highest number of linearly-behaving elements was found when relating average plant concentrations to soil pore-water concentrations. In contrast to other elements, essential elements (micronutrients and macronutrients) exhibited relatively small differences in concentration between different plant parts. Generally, the TF model was shown to work reasonably well for micronutrients, whereas it did not for macronutrients. The results also suggest that plant uptake of elements from sources other than the soil compartment (e.g. from air) may be non-negligible.

Determination of the differential expression of mitochondrial long non-coding RNAs as a noninvasive diagnosis of bladder cancer.

BACKGROUND: Bladder cancer is a significant cause of morbidity and mortality with a high recurrence rate. Early detection of bladder cancer is essential in order to remove the tumor, to preserve the organ and to avoid metastasis. The aim of this study was to analyze the differential expression of mitochondrial non-coding RNAs (sense and antisense) in cells isolated from voided urine of patients with bladder cancer as a noninvasive diagnostic assay. METHODS: The differential expression of the sense (SncmtRNA) and the antisense (ASncmtRNAs) transcripts in cells isolated from voided urine was determined by fluorescent in situ hybridization. The test uses a multiprobe mixture labeled with different fluorophores and takes about 1 hour to complete. We examined the expression of these transcripts in cells isolated from urine of 24 patients with bladder cancer and from 15 healthy donors. RESULTS: This study indicates that the SncmtRNA and the ASncmtRNAs are stable in cells present in urine. The test reveals that the expression pattern of the mitochondrial transcripts can discriminate between normal and tumor cells. The analysis of 24 urine samples from patients with bladder cancer revealed expression of the SncmtRNA and down-regulation of the ASncmtRNAs. Exfoliated cells recovered from the urine of healthy donors do not express these mitochondrial transcripts. This is the first report showing that the differential expression of these mitochondrial transcripts can detect tumor cells in the urine of patients with low and high grade bladder cancer. CONCLUSION: This pilot study indicates that fluorescent in situ hybridization of cells from urine of patients with different grades of bladder cancer confirmed the tumor origin of these cells. Samples from the 24 patients with bladder cancer contain cells that express the SncmtRNA and down-regulate the ASncmtRNAs. In contrast, the hybridization of the few exfoliated cells recovered from healthy donors revealed no expression of these mitochondrial transcripts. This assay can be explored as a non-invasive diagnostic tool for bladder cancer.

Evaluation of one-dimensional model of C-14 atmospheric transport in vegetated canopies.

The evaluation of the previously developed one-dimensional model of radiocarbon atmospheric transport in vegetated canopies against C-14 concentration data collected at the site of SMEAR-II research station was presented. In most cases, the simulated vertical profiles of C-14 concentrations within the canopy layer agreed reasonably with measurements, the correlation coefficient of simulated vs. observed concentrations was 0.72. The developed model could be used to evaluate vertical variations of C-14 concentrations in vegetated canopy layers.

Targeting antisense mitochondrial noncoding RNAs induces bladder cancer cell death and inhibition of tumor growth through reduction of survival and invasion factors.

Knockdown of the antisense noncoding mitochondrial RNAs (ASncmtRNAs) induces apoptotic death of several human tumor cell lines, but not normal cells, supporting a selective therapy against different types of cancer. In this work, we evaluated the effects of knockdown of ASncmtRNAs on bladder cancer (BCa). We transfected the BCa cell lines UMUC-3, RT4 and T24 with the specific antisense oligonucleotide Andes-1537S, targeted to the human ASncmtRNAs. Knockdown induced a strong inhibition of cell proliferation and increase in cell death in all three cell lines. As observed in UMUC-3 cells, the treatment triggered apoptosis, evidenced by loss of mitochondrial membrane potential and Annexin V staining, along with activation of procaspase-3 and downregulation of the anti-apoptotic factors survivin and Bcl-xL. Treatment also inhibited cell invasion and spheroid formation together with inhibition of N-cadherin and MMP 11. In vivo treatment of subcutaneous xenograft UMUC-3 tumors in NOD/SCID mice with Andes-1537S induced inhibition of tumor growth as compared to saline control. Similarly, treatment of a high-grade bladder cancer PDX with Andes-1537S resulted in a strong inhibition of tumor growth. Our results suggest that ASncmtRNAs could be potent targets for bladder cancer as adjuvant therapy.

[Technophobia: a clinical disorder associated with digital technologies]. / Tecnofobia: trastorno clínico asociado a las tecnologías digitales.

The technophobia is among the various negative impacts of technology on human life. The disease changes according to the cultural context. Therefore, the objective was to describe the disorder in the argentine adult population (22-50 years), using a scale developed locally; 12.9% of the sample meets the criteria of technophobia; 27.2% had high levels of anxiety before the technology but other indicators of technophobia. In general, the perception of the social impact of technology in Argentina is negative. Results obtained confirm the presence of disorder in the argentine population and the assumption of specific phobia.

Modeling the long-term transport and accumulation of radionuclides in the landscape for derivation of dose conversion factors.

To evaluate the radiological impact of potential releases to the biosphere from a geological repository for spent nuclear fuel, it is necessary to assess the long-term dynamics of the distribution of radionuclides in the environment. In this paper, we propose an approach for making prognoses of the distribution and fluxes of radionuclides released from the geosphere, in discharges of contaminated groundwater, to an evolving landscape. The biosphere changes during the temperate part (spanning approximately 20,000 years) of an interglacial period are handled by building biosphere models for the projected succession of situations. Radionuclide transport in the landscape is modeled dynamically with a series of interconnected radioecological models of those ecosystem types (sea, lake, running water, mire, agricultural land and forest) that occur at present, and are projected to occur in the future, in a candidate area for a geological repository in Sweden. The transformation between ecosystems is modeled as discrete events occurring every thousand years by substituting one model by another. Examples of predictions of the radionuclide distribution in the landscape are presented for several scenarios with discharge locations varying in time and space. The article also outlines an approach for estimating the exposure of man resulting from all possible reasonable uses of a potentially contaminated landscape, which was used for derivation of Landscape Dose Factors.

[Histochemical modifications of sugar residues in glycoconjugates of human palatine glands during development and maturation]. / Modificaciones histoquimicas de los residuos azucares en los glucoconjugados de las glandulas palatinas humanas durante su desarrollo y maduracion.

ANTECEDENTS: Most of the literature has focused on the morphological and histochemical characteristics of palatine glands during the development histogenesis and maturation process. However, there are no publications regarding protein glycosylation and the distribution of glycoproteins with N and O-glycoside bonds, and their possible functional role. OBJECTIVE: Based on this background we committed ourselves to studying the human palatine glands in different age groups in order to determine the beginning of mucine secretion and the presence of glycoproteins with N and O-glycoside bonds during the processes of differentiation and maturation. MATERIALS AND METHOD: Human palatine glands were obtained from embryos, fetuses, newborn infants, youngsters and adults. They were studied using histochemical methods (PAS, Dane, Alcian blue, Toluidine blue), and lectin histochemistry. RESULTS: The variations observed in glycoconjugates during the development and maturation of human palatine glands show that secretion starts at early stages of prenatal development; it is made up of various sugars that might play an important role in the pre-natal and postnatal periods. CONCLUSIONS: The study of modifications in sugar residues in the human palatine glands during embryogenesis, differentiation and maturation processes allows us to have further knowledge of their histophysiology and possible changes taking place during aging. This study may also help to understand pathological processes in mature salivary glands.

[Bibliometric analysis of doctorate thesis on the health sciences area: first part, odontology]. / Análisis bibliométrico de tesis de doctorado del área de las ciencias de la salud: primera parte, odontología.

OBJECTIVE: The purpose of the following study was to describe trends in the use of information by dentistry thesists and their research topics in Medical Education, Ethics and History. MATERIAL AND METHODS: Of a total of 290 doctorate thesis of the Dentistry Faculty made from 1965 to 2002, were identified: 3 theses on Medical Education and 1 on Ethics. On these, bibliographic quotations from periodic and non periodic publications, as well as quotations from doctorate thesis and congress acts were analyzed. In addition the antiquity of these was analyzed considering a period of five years between the date of accomplishment of the thesis and the one of the used bibliographical quotation. RESULTS: The total of analyzed quotations was of 492, presenting an average of 123 quotations per thesis. 62 per cent of the quotations corresponded to non periodic publications, 37 per cent to periodic publications and 2 per cent to quotations from doctorate thesis and congress acts. In regard of the antiquity of the quotations, 42 per cent was smaller to 5 years and 58 per cent was greater than that period of time. CONCLUSION: We concluded the doctorate thesis represent the highest degree of scientific and academic expression, and constitute a rich and valuable source of data. The analysis of these theses is very important because it provides information about the trends and innovations on the on the areas of Medical Education, Ethics and History. It would be (very) useful to extend the bibliometric analysis towards other thematic areas, generating a reference for future research.

Histochemical and ultrastructural study of the chicken salivary palatine glands.

Salivary glands are a good model to investigate the relationship between cell secretion and glandular structure. Most studies of this organ deal with mammals, but we are interested in a morphofunctional characterization of these glands in poultry in relation with particular feeding habits. For this purpose, conventional and lectin histochemical methods as well as ultrastructural methods have been applied to the chicken lateral and medial palatine salivary glands. It was found that periodic acid-Schiff (PAS)-positive, alcianophilic, and metachromatic or orthochromatic cells were present with a more homogeneous distribution pattern in lateral glands than in medial palatine glands. Lectin staining depended on the lectin type that was applied, but also on the glandular part both in lateral and medial glands. Ultrastructural studies showed cytoplasmic membranous structures with a scattered granular or filamentous content depending on the secretory cell. In conclusion, morphofunctional characteristics of salivary glands of chicken suggest that their products are involved in lubrication and humidification of food ingested, and probably in protection of the oral surface, as has been previously described for other animals showing similar histochemical staining patterns.

[Subcellular aspects of interstitial cell innervation in chick embryo ovary cultured with LH or hCG]. / Aspectos subcelulares de la inervación de las células intersticiales del ovario de embrión de pollo cultivado con LH o hCG.

UNLABELLED: Several authors have shown the effect of LH or hCG gonadotrophins on steroid secretion in the chick embryo ovary. However, the effects of luteinising hormone or human chorionic gonadotropin on chick embryo ovary innervation have not been studied. The purpose of the present work was to study the subcellular aspects of interstitial cells innervation in chick embryo ovaries cultured with LH or hCG. Coob's White Rock female chick embryos at 7, 11, 15 and 19 days of incubation (in ovo) were employed. Explants of the left and right ovaries were cultured separately for 4 days in: 1--Basic medium (control): minimum essential medium (MEM-GIBCO) with 10% bovine fetal serum, 2--Basic medium with added LH or hCG (problems). The cultures were processed to be studied ultrastructurally (TEM). Left and right ovary explants were fixed two hours at room temperature in Karnovsky's fixative. The tissues were then post-fixed in osmium tetroxide in 0.1 M cacodylate buffer for one hour and after a rinse in buffer were dehydrated in acetone: afterwards they were embedded in Araldite resin. Thick sections stained with 1% Toluidine blue were examined and photographed using a Zeiss Photo II microscope. Thin sections were stained with uranyl acetate and lead citrate and examined in a Siemens ElmisKop 101 electron microscope. CONTROLS: In both ovaries the isolated interstitial cells and the appearance of nerve fibers and nerve endings were observed in the explants of 11 day cultured during four days and in a similar way at the age of 15 days of in ovo development. PROBLEMS: With LH or hCG nerve fibers and nerve endings were observed both in the right gonad and in the medulla of the left ovary in close contact with the steroid-producing interstitial cells. Ultrastructurally, the interstitial cells are recognized by their typical organoids: SER, Golgi apparatus, mitochondria with tubular crests and abundant lipidic droplets. The innervation of these cells were seen in ovaries at 7 days development, cultured during 4 days. The present state corresponds to that of 11 days development in ovo. The nerve endings had mitochondria, microtubules and small and medium-sized vesicles, some with an electrodense content. These results in vitro suggest that innervation of the ovaries is controlled by an indirect mechanism via the hypothalamic-pituitary system and another local with production neurotrophic factors modulated by LH.

[Oral histology and embryology clinically integrated as a teaching tool in an undergraduated dentistry course of studies]. / Histología y embriología oral clínicamente integradas como herramienta didactica en un curso de grado de la carrera de odontologia.

The teaching of Oral Histology and Embryology clinically integrated was designed as a pilot experience to be developed during the 2005 academic year at the Division of Histology and Embryology (Chair "A") of the National University of Cordoba School of Dentistry. This experience, in which the members of the faculty of the Department of Clinical and Basic Sciences have an active participation, is based on a systemic conception of the learning-teaching process and on the recommendations made by the OPS/OMS. This approach will allow us to optimize the quality of our undergraduate programs through better teacher training and the gradual integration of basic and clinical sciences. Our aim is to provide a better education with clinical relevance in basic sciences and scientific basis in clinical assistance.

Multifocal canalicular adenoma of the minor labial salivary glands.

Canalicular adenoma (CA) is an uncommon benign neoplasia of salivary glands which is clinically difficult to recognise. Despite having an excellent prognosis, the histological diagnosis and clinical management of this entity can be troublesome. While the main differential diagnosis to consider is basal cell adenoma (BCA), similar histological patterns and multifocality have been observed in adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA), both locally-aggressive malignancies which require radically different treatment to CA. An emphasis has been placed on the value of immunohistochemistry in avoiding diagnostic and surgical errors. CA is positive for AE1/AE3, CD117 and S-100 protein, and negative for p63, α-SMA, Ki 67 and vimentin. Here we discuss the case of a 61-year-old female with CA in her right upper lip, showing multifocal growth histologically. The differential diagnosis with other adenomas is discussed in addition to the role of immunohistochemical studies that can confirm the clinical and surgical findings.

Proliferaciones Oncocíticas de Glándulas Salivales: Estudio Estructural e Inmunohistoquímico de 7 Casos / Oncocytic Proliferations of Salivary Glands: Structural and Immunohistochemical Study of 7 Cases

RESUMEN: Los oncocitos son células originadas probablemente por transformación metaplásica del epitelio ductal o acinar de parótida y submandibular. Su proliferación puede originar condiciones patológicas que incluyen hiperplasias oncocíticas adenomatosas multinodulares (HOAM), oncocitomas y carcinomas oncocíticos. Los tumores oncocíticos constituyen el 1 % de todos los tumores salivales y entre el 82 y 90 % se desarrollan en la parótida; el resto se divide entre la glándula submandibular y las glándulas salivales menores. Las hiperplasias oncocíticas multinodulares son extremadamente raras. En el presente trabajo se analizaron 5 casos de oncocitomas de parótida y dos casos de HOAM, uno de parótida y otro de submandibular y se describieron las características estructurales e inmunohistoquímicas de los oncocitos. Cortes seriados de las biopsias incluidas en parafina se colorearon con Hematoxilina - Eosina, Hematoxilina/ácido fosfotúngstico (PTA/H), PAS y se marcaron con AC antimitocondrial, CK 5/6, CK 20 y EMA. Los tumores mostraron un crecimiento nodular encapsulado por tejido conectivo denso. En los cortes histológicos se identificaron oncocitos eosinófilos (oscuros) y granulaciones violáceas con PTA/H. En dos casos de parótida y el caso de HOAM de submandibular presentaron además oncocitos claros PAS positivos. La inmunomarcación fue positiva en todas las células siendo la marcación para mitocondrias periférica en los oncocitos claros. Las células eosinofílicas PTA/H positivas y con fuerte marcación con AC antimitocondrial, CKs y EMA confirman el diagnóstico de patología oncocítica. En tres casos coexisten oncocitos claros y oscuros. Las células claras son oncocitos que acumulan glucógeno en su citoplasma desplazando a las mitocondrias hacia la periferia. En el diagnóstico diferencial de este tumor debemos considerar los tumores salivales con células claras, el carcinoma renal metastásico, el tumor de Whartin, la variante de células claras del carcinoma epitelial/mioepitelial y el carcinoma mucoepidermoide con metaplasia oncocítica.

ABSTRACT: Oncocytes are cells probably originated by metaplastic transformation of the ductal or acinar epithelium of parotid and submandibular. Its proliferation can cause pathological conditions that include multinodular adenomatous oncocytic hiperplasia (HOAM), oncocytomas and oncocytic carcinomas. Oncocytic tumors make up 1 % of all salivary tumors and between 82 and 90 % develop in the parotid; the rest of the tumors are divided between the submandibular gland and the minor salivary glands. Multinodular oncocytic hyperplasias are extremely rare. In the present work we analyzed five cases of parotid oncocytomas and two cases of HOAM, one of parotid and the other of submandibular; structural and immunohistochemical characteristics of the oncocytes were described. Biopsies were included in paraffin, serial cuts were stained with H&E, Hematoxylin / phosphotungstic acid (PTA / H), PAS and were marked with antimitochondrial AC, CK 5/6, CKs 20 and EMA. The tumors showed a nodular growth encapsulated by dense connective tissue. The histological cuts showed dark eosinophilic oncocytes and violaceous granulations with PTA / H. In two cases of parotid and the case of submandibular HOAM, PAS positive clear oncocytes were also present. The immunostaining was positive in all the cells, being the labeling for peripheral mitochondria in the clear oncocytes. Eosinophilic cells PTA / H positive with strongly marked with antimitochondrial AC, CKs and EMA confirm the diagnosis of oncocytic pathology. In three cases, light and dark oncocytes coexist. Clear cells are oncocytes that accumulate glycogen in their cytoplasm, displacing the mitochondria to the periphery. In the differential diagnosis we should consider salivary tumors with clear cells, metastatic renal carcinoma, Whartin's tumor, the clear cell variant of epithelial / myoepithelial carcinoma and mucoepidermoid carcinoma with oncocytic metaplasia.

Reporte de caso Adenocarcinoma de celulas basales de glandula parotida: estudio clinico/patologico e inmunohistoquimico / Case report of Basal cell adenocarcinoma of the parotid gland: clinicopathological and immunohistochemical study

El adenocarcinoma de células basales es una neoplasia epitelial con las características citológicas del adenoma de células basales pero con un patrón morfológico de crecimiento infiltrante indicativo de malignidad. Debido a su baja incidencia es a menudo difícil de diagnosticar. El objetivo del presente estudio fue identificar características morfológicas e inmunohistoquímicas que contribuyen a su diagnóstico. Se resecó un tumor de parótida en una paciente de 52 años; se realizó biopsia postoperatoria e inmunomarcación con Ki-67, CK19, p63 y alfa actina de músculo liso. Se diagnosticó adenocarcinoma de células basales mixto sólido y tubular con invasión perineural y de la cápsula tumoral, grasa periglandular y nodos linfoides. La inmunomarcación con Ki-67, CK19, p63 y alfa actina de músculo liso resultó positiva. Posteriormente se diagnosticó una metástasis en seno maxilar. Las características morfológicas, la inmunomarcación Ki-67 positiva y la metástasis le dan el carácter maligno a este tumor, lo que lo diferencia del adenoma de células basales

Basal cell adenocarcinoma is an epithelial neoplasm with the cytological characteristics of a basal cell adenoma but with a morphological pattern of infiltrative growth indicative of malignancy. It is often difficult to diagnose it because of its low incidence. The objective of this study is to identify the morphological and immunohistochemical characteristics that aid its diagnosis. A parotid tumor was resected in a 52-year-old patient; postoperative biopsy and immunostaining with Ki-67, CK19, p63 and α-smooth muscle actin were performed. The diagnosis was basal cell adenocarcinoma invading the tumor capsule, periglandular fat and lymph nodes. Immunolabeling with Ki-67, CK19, p63 and α-smooth muscle actin was positive. Subsequently, maxillary sinus metastasis was diagnosed. Given the morphological characteristics, elevated Ki-67 expression and metastasis, this is a malignant tumor, which differentiates it from the basal cell adenoma

Carcinoma de próstata y síndrome de secreción inadecuada de hormona antidiurética / Prostate carcinoma and syndrome of inappropriate antidiuretic hormone secretio

El cáncer de próstata es una causa extremadamente rara de síndrome de secreción inadecuada de hormona antidiurética (SIADH). Se trata de tumores agresivos asociados a un síndrome que puede aparejar consecuencias graves. Un paciente de 64 años fue diagnosticado de adenocarcinoma de próstata Gleason 4+3: 7 en 2014 y recibió terapia de bloqueo hormonal. En 2015 debió ser ingresado por hiponatremia sintomática y se le diagnosticó un SIADH, sin otra causa probable más que el cáncer de próstata. Sufrió rápida progresión de su enfermedad oncológica, llamativamente cuando su PSA se encontraba en valores normales, y falleció al corto plazo. Existe gran variabilidad clínica e histopatológica de los casos informados en la literatura de asociación de carcinoma de próstata y SIADH, sin embargo, todos coinciden en la agresividad de estos tumores. Estas características se presentan en tumores con diferenciación neuroendocrina, frecuentemente resistentes al tratamiento hormonal y que pueden presentar síndromes paraneoplásicos como el SIADH. El perfil de sus alteraciones moleculares se encuentra en estudio para el desarrollo de terapias target. La asociación de adenocarcinoma de próstata y SIADH es muy infrecuente y podría implicar diferenciación neuroendocrina. Por tal motivo es esencial una nueva biopsia del tumor o de sus metástasis a la progresión de la enfermedad para poder conducir un tratamiento adecuado de acuerdo a sus características morfológicas, inmunohistoquímicas y, en un futuro, moleculares.

Prostate cancer is an extremely rare cause of syndrome of inappropriate antidiuretic hormone (SIADH) secretion. These tend to be aggressive tumors and SIADH can carry serious clinical consequences. A 64 years old patient was diagnosed with Gleason 4+3: 7 prostate adenocarcinoma in December 2014 and received hormonal blockade therapy. By March 2015 he was admitted for symptomatic hyponatremia and SIADH secretion was diagnosed, with no other probable cause than prostate cancer. He suffered a rapid progression of his oncologic disease, surprisingly with PSA in normal range, and died in the short term. There is great clinical and histopathological variability in the cases reported in the literature of association of prostate carcinoma and SIADH. However, they all agree on the aggressiveness of these tumors. This characteristic is present in tumors that have neuroendocrine features. They are frequently resistant to hormonal treatment and may present with paraneoplastic syndromes such as SIADH. The profile of its molecular alterations is under study for the development of target therapies. The association of prostate adenocarcinoma and SIADH is very uncommon and could involve neuroendocrine differentiation. For this reason, it is essential to perform a new biopsy of the tumor or its metastases at the progressive disease in order to conduct an appropriate treatment according to its morphological, immunohistochemical and, in the future, molecular characteristics.