Sumary Decreased expression of E-cadherin (E-CD). a homotypic intercellular adhesion molecule, is considered to elicit detachment of tumour cells from primary lesions, which is the first stage of metastasis. Since renal cell cancer (RCC) shows a relatively high frequency of metastasis, we focused our interest on E-CD expression in RCC and its clinicopathological implications. We examined E-CD expression in normnal kidney and RCC by immunohistochemical staining. In normal kidney, E-CD expression was localised in distal tubules and collecting ducts. In RCC, 20 of 106 primary lesions (18.9%) expressed E-CD. whereas none showed positive staining for eight metastatic lesions. There was a statistically significant correlation between loss of E-CD expression and advanced stages of RCC. Kaplan-Meier analysis showed better prognosis in the group with preserved E-CD expression than without E-CD expression (Cox -Mantel test. P = 0.022, the average follow-up was 32 months or until death). This study suggests that the patients with decreased E-CD expression may be associated with metastasis, resulting in poor prognosis. However, frequency of E-CD expression in RCC is lower than in other cancers, which may be derived from the localised distribution of E-CD expression in normal kidney.Keywords E-cadherin; renal cell cancer: metastasis It is well known that cadherins, a family of Ca2+-dependent intercellular adhesion molecules, play essential roles in organogenesis and in the maintenance of normal structure and function (Behrens et al., 1985;Eidelman et al., 1989;Takeichi, 1991). Recently, E-cadherin (E-CD), a subclass of cadherins, has come to be considered to be important as an inhibitory factor in metastasis (Behrens et al., 1985; Frixen et al., 1991;Takeichi, 1991 (1991) showed that loss of E-CD can generate an invasive phenotype, which can be prevented by transfection with E-CD cDNA. Clinically, the correlation between decreased E-CD expression and advanced stages or dedifferentiation was also reported in a variety of tumours (Frixen et al., 1991;Shiozaki et al., 1991; Oka et al., 1992;Umbas et al., 1992;Bringuier et al., 1993; Oka et al., 1993;Terpe et al., 1993). However, reports in relation to the prognosis of malignant tumours have been rare until now (Bringuier et al., 1993 Immunohistochemical staining Anti-E-CD monoclonal antibody (HECD-1, Takara Biomedicals, Tokyo, Japan) was used in this study, and immunoperoxidase staining was performed by modifying the streptavidin-biotin bridge technique described previously (Katagiri et al., 1993

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Retroperitoneal laparoscopic adrenalectomy is feasible for primary aldosteronism. However, Cushing's syndrome is presently a much more difficult indication than primary aldosteronism for this new operative technique.

E-cadherin (ECD) is a homophilic Ca²⁺-dependent adhesion molecule associated with cell-to-cell interactions and normal growth. Recent reports have suggested that decrease or loss of ECD facilitates tumor progression and/or metastasis. ECD functions in a complex called an adherens junction, which includes several other proteins including α- and β-catenin. In the present study, fresh-frozen sections from 32 testis cancers, 16 seminomas and 16 non-seminomatous germ cell tumors (NSGCT), were examined immunohistochemically. E-cadherin was not expressed on normal germ cells, but expressed on 3 (18.8%) of 16 seminomas and 10 (62.5%) of 16 NSGCTs, mainly on the epithelial component of teratoma cells. α-Catenin was detected on 0 (0%) of 13 seminomas and 4 (25%) of 16 NSGCTs. β-Catenin was detected on 10 (71.4%) of 14 seminomas and 13 (81.2%) of 16 NSGCTs. ECD was detected significantly more frequently on NSGCTs than on seminomas. Immunoblot analysis confirmed the expression of ECD and β-catenin in NSGCTs. Expression of ECD and catenins may reflect the degree of differentiation and provide some information on the character of the tumor.

We report a rare case of primitive neuroectodermal tumor arising from adrenal gland in adulthood, diagnosed preoperatively as having non-functional adrenocortical adenoma. Laparoscopic adrenalectomy was performed. Immunohistological examination revealed the definite diagnosis as primitive neuroectodermal tumor of the adrenal gland. Although primitive neuroectodermal tumor is a highly malignant neoplasm, there is no evidence of local recurrence and distant metastasis 16 months after surgery.