The clinical significance of PYCR1 expression in renal cell carcinoma

Pyrroline-5-carboxylate reductase 1 (PYCR1) is an enzyme involved in cell metabolism and is upregulated in cancer. However, the correlations of PYCR1 expression with the clinicopathological features and prognosis of renal cell carcinoma (RCC) remain unclear. The purpose of this study was to identify the expression of PYCR1 and its clinical relevance in RCC patients.PYCR1 mRNA expression differences between RCC and the adjacent normal renal tissues were assessed using the Cancer Genome Atlas database (TCGA). Subsequently, the expression of PYCR1 mRNA and protein were evaluated by quantitative real-time polymerase chain reaction, Western blot, and immunochemistry using 30 paired frozen samples of RCC and the adjacent normal renal tissues. The protein expression of PYCR1 was evaluated by immunostaining formalin-fixed, paraffin-embedded sections of RCC samples from 96 patients who underwent radical nephrectomy, and its relationship with clinical features were analyzed. Nonpaired t tests were used to statistically analyze the differences between the 2 groups. Cox univariable and multivariable analyses of overall survival (OS) among RCC patients were performed.The expression of PYCR1 mRNA was significantly upregulated in RCC tissues compared to adjacent normal renal tissues in the TCGA database (P < .01). The area under the receiver operating characteristic curve value was 0.748. The expression of PYCR1 mRNA and protein was significantly upregulated in RCC compared with that in paired normal renal tissues (P < .01). Higher PYCR1 levels were associated with metastasis (P < .01). Kaplan-Meier survival curves indicated that higher PYCR1 expression was correlated with poorer OS. Therefore, PYCR1 may act as a novel prognostic marker and therapeutic target in the diagnosis and treatment of RCC.

Clinicopathological characteristics of renal solitary fibrous tumor: A single institution experience

To analyze the clinical characteristics, treatment modalities and outcomes of adult renal solitary fibrous tumors (SFT) treated at a single institution. Demographic, diagnostic, surgical, and pathological findings of patients who had undergone radical nephrectomy (RN) due to renal SFT were collected from the database of a single institution and were retrospectively reviewed. Ten patients (6 men and 4 women) were diagnosed with renal SFT in our institution between January 1, 2000 and December 31, 2016. The mean age was 50.9 ± 8.2 years (range, 38-63 years). Of the 10 patients, 6 were asymptomatic, 2 presented with flank pain, 1 presented with abdominal discomfort, and 1 presented with haematuria. Computed tomography scans were obtained for all patients. Open RN was performed on 6 patients, and laparoscopic RN was performed on 4 patients. The mean tumor size was 10.23 ± 4 cm (range, 5.3-19 cm). Pathological diagnosis revealed that the tumors in 8 patients were benign, while those in the other 2 patients were malignant renal SFT. No recurrence occurred during a mean follow-up period of 47.3 ± 21.5 months (range, 16-85 months). Renal SFT is extremely rare, and its diagnosis may be challenging because of a lack of typical imaging manifestations. RN is a safe treatment modality for benign or low-grade malignant renal SFT, ensuring favorable outcomes.

Cutaneous and systematic metastasis of testicular choriocarcinoma: Case report and literature review

RATIONALE

Cutaneous metastasis of testicular choriocarcinoma is exceptionally uncommon. To our knowledge, only 14 cases have been reported in the past 10 years in the pubmed. We have an uncommon case of testicular choriocarcinoma who has metastasized to the adjacent skin and organ systems.

PATIENT CONCERNS

An 18-year-old male was diagnosed with initial presentation of cutaneous mass at the left back. Followly,biopsy was performed under local anesthesia.Histopathological examination was consistent with the diagnosis of metastatic choriocarcinoma.

DIAGNOSES

The histopathological assessment of the biopsied tissue, in combination with elevated serum β-HCG levels and presentation of testicular mass, indicated primary testicular choriocarcinoma with cutaneous and systemic metastasis.

INTERVENTIONS

Subsequently radical orchiectomy was performed.

OUTCOMES

Despite the case completed one cycle of cisplatin-based regimen chemotherapy, he died of multiple organ dysfunction syndrome 2 months after surgery.

LESSONS

In this report, cutaneous metastasis with testicular choriocarcinoma is extremely rare. It is important to recognize that this unusual variant of testicular choriocarcinoma has the potential to behave aggressively and to metastasize.