Background:The origin of extragonadal retroperitoneal germ cell tumors remains controversial.Whether they develop primarily in the retroperitoneum or whether they are metastases of a primary testicular tumor has long been debated. Patients and methods:We retrospectively analyzed 26 patients treated as having primary extragonadal retroperitoneal germ cell tumors based upon the findings of testicular palpation by the referring physician. Testicular evaluation was then extended with ultrasonographical and histological examinations.Results: Biopsy of the extragonadal tumor was performed in 25 patients, confirming diagnosis of extragonadal retroperitoneal germ cell tumor. Prior to treatment patients were clinically evaluated by several physicians and the testes were not considered suspicious for testicular cancer. At urological workup, testes were found to be atrophic and/or indurated in 14 (54%) patients, enlarged in one (4%) and unremarkable in 11 (42%). Ultrasound examination of the testes in 20 patients showed pathological findings in all of them. Histology of the testis was available in 25 of 26 patients and revealed active tumor in three, intratubular germ cell neoplasia in four, scar tissue in 12, sclerosis in three, sclerosis and fibrosis in one, and fibrosis alone in two.Conclusions: So-called primary extragonadal germ cell tumors in the retroperitoneum are very likely a rare or non-existing entity and should be considered as metastases of a viable or burned-out testicular cancer until proven otherwise. All of our patients with histologically examined testes had pathological finding, 76% of which were either viable tumor or scars.

Summary A human prostate tumour cell line, LNCaP C4-2, when injected into athymic male nude mice, produced tumours containing:(1) only human cancer cells similar to those injected; (2) only murine stromal cells containing abnormal chromosome constitutions; or (3) both human prostate cancer cells similar to those injected and the transformed murine stromal cells with altered chromosome constitutions.Karyotypic analysis of murine metaphases from all the host-derived tumours showed mostly pseudodiploid chromosome constitutions, with multiple copies (amplification) of mouse chromosome 15 and the absence of a typical Y chromosome. Fluorescence in situ hybridization analysis of these murine cells, using a biotin-labelled total human DNA painting probe, further demonstrated the absence of human DNA and the presence of only mouse metaphase and interphase cells in these transformed stromal cells. These results suggest that cancer cells are capable of inducing neoplastic transformation in stromal cells of the host organ by some, as yet unknown, epigenetic mechanism(s).Keywords: malignant transformation; tumour-stroma interaction; fluorescence in situ hybridization; pseudodiploid karyotype; prostate cancer progression; epigenetic mechanism of carcinogenesis Although the athymic mouse and rat are not natural hosts for the study of the in vivo biology of human neoplasms, they provide excellent models for the growth and maintenance of human tumours in vivo (Fidler, 1986) and for the study of reciprocal cellular interaction between tumour cells and host stroma (Wu et al, 1994). For many tumour biology experiments, the nude mouse routinely serves as a 'biological incubator' for primary and established tumour cells for selecting derivative cell lines with differing metastatic properties and for therapeutic trials monitoring tumour growth and levels of tumour or serum biomarkers (Fidler, 1986(Fidler, , 1990. The focus of the present communication is to document the tumour-stroma interaction that resulted in the induction of host stromal cells to assume non-random genetic alterations.When human tumour cells are injected into nude murine animals, quite frequently human tumour cells grow, but other possibilities also exist (Treit et al, 1980;Goldenberg and Pavia, 1981;Bowen et al, 1983;Hsu and Pathak, 1989;Gupta et al, 1990). In earlier experiments in which we injected human breast cancer cells into the nude mouse, the tumours produced in the host consisted of mouse cells with abnormal metaphases containing double-minute chromosomes (Bowen et al, 1983). Three types of tumour cells were harvested from such an experimental tumour model: (1) The purpose of this study was to investigate whether there were specific cytogenetic abnormalities present in several murine stromal tumours that developed after the injection of human C4-2 tumour cells that metastasized as bony tumour deposits (Thalmann et al, 1994;Wu et al, 1994). We report here cytogenetic findings from the resulting host stromal tumour cell lines from six athymic mice bearing...

PSA level should be used with caution as an end point in clinical trials using suramin therapy for hormone-refractory prostate cancer.

Adjuvant chemotherapy with one cycle of modified-BEP is a feasible and safe treatment of patients with CS I NSGCT at high risk of relapse. In these patients, it appears to be an alternative to two cycles of BEP and to have a lower relapse rate than retroperitoneal lymph node dissection. If confirmed by other centers, 1 cycle of adjuvant BEP chemotherapy should become a first-line treatment option for this group of patients.

This study evaluated the use of risk prediction models in estimating short- and mid-term mortality following proximal hip fracture in an elderly Austrian population. Data from 1101 patients who sustained a proximal hip fracture were retrospectively analyzed and applied to four models of interest: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), Charlson Comorbidity Index, Portsmouth-POSSUM and the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) Risk Score. The performance of these models according to the risk prediction of short- and mid-term mortality was assessed with a receiver operating characteristic curve (ROC). The median age of participants was 83 years, and 69% were women. Six point one percent of patients were deceased by 30 days and 15.2% by 180 days postoperatively. There was no significant difference between the models; the ACS-NSQIP had the largest area under the receiver operating characteristic curve for within 30-day and 180-day mortality. Age, male gender, and hemoglobin (Hb) levels at admission <12.0 g/dL were identified as significant risk factors associated with a shorter time to death at 30 and 180 days postoperative (p < 0.001). Among the four scores, the ACS-NSQIP score could be best-suited clinically and showed the highest discriminative performance, although it was not specifically designed for the hip fracture population.