A rare malignant blue nevus resected from the back of a 34‐year‐old Caucasian woman is reported. Histopathologic examination showed the presence of a CBN as well as MBN. The CBN elements of this lesion showed the characteristic prominent neural type fascicles intertwined with melanocytes. The deeper regions of this skin neoplasm showed considerable variation in histopathologic patterns. Metastascs to the axillary lymph nodes and multiple subdermal soft tissue sites, invasion of the underlying skeletal muscle, and several recurrences in the chest wall indicate that this neoplasm is malignant, though of a lower order than a malignant melanoma. The ultrastructural characteristics of neoplastic cells indicate that this neoplasm is of Schwann cell origin.
Urinary excretion of nonesterified cholesterol (NEC) in men with testicular and prostatic neoplasms has been investigated. Control patients with non‐steroid‐related benign and malignant tumors and patients with nonneoplastic diseases were also studied. Normal range of NEC excretion was determined in healthy individuals and was found to be 0.10‐1.20 mg/24 hours (3 S.D., 99.5% population), with a mean of 0.65 ± 0.18 mg/24 hours. Twenty‐nine of 32 patients with adenocarcinoma of the prostate (91%) had NEC hyperexcretion. In addition, all patients with choriocarcinoma, teratocarcinoma, and embryonal cell carcinoma of the tesds (8 cases) had NEC hyperexcretion. Hyperexcretion of NEC was also present in patients with metastatic carcinoma of testes and prostate in which the primary tumor had been removed. Testicular seminomas (19 cases) on the other, hand, revealed a normal urinary excretion of NEC. The effects of therapy on NEC excretion were investigated in some of these patients, and their NEC values appeared to correlate with the clinical course of the disease. Approximately 25% of the control patients over 45 years of age without histologically demonstrable testicular and/or prostatic carcinomas revealed NEC hyperexcretion. This hyperexcretion of NEC in the control groups can possibly be explained in part by the presence of “latent” adenocarcinoma of the prostate that was not detected. It is recognized that at least 30% of necropsies performed in men at this age group will harbor an unsuspected adenocarcinoma of the prostate. Our previous work in this field has shown NEC hyperexcretion in women with carcinomas of the steroid‐producing glands and their target organs. This suggests a certain cell specificity. The specificity of the results in both men and women, in respect to type of cells involved, effects of therapy, and lack of correlation of the NEC excretion with the serum levels of cholesterol, supports the concept that most of the urinary cholesterol is of endogenous origin, and appears to represent an expression of cell biochemical function.
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