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Congenital endodermal sinus tumor of the penis.

Congenitally occurring endodermal sinus tumors are very rare and frequently occur in association with teratomatous growths. The most common location for these tumors in infancy is the gonads. Tumors of the penis are rare in any age group. As far as we know, this tumor has never been reported in the penis. A 17-month-old baby boy was noted to have a pimple-like lesion at the corona of the glans penis. This was stationary and ignored for a year. At this point, the lump began increasing in size. A further delay of 6 months elapsed before a definitive diagnosis was made. This case emphasizes that any nodule in this area in the neonate is ignored with jeopardy.

Combined Modality Therapy↗

Primary endodermal sinus tumor of the penis: a case report.

We report a case of primary extragonadal germ cell tumor of the penis in a 2-year-old child with elevated serum alpha-fetoprotein. The patient responded well to a combination of bleomycin, etoposide and cisplatin, achieving a complete response within 3 cycles. He was alive and disease-free 8 months after diagnosis. To our knowledge this is the first case of an endodermal sinus tumor of the penis reported in the literature. The possible histogenesis of this tumor at such a rare site is discussed.

Antineoplastic Combined Chemotherapy Protocols↗

Successful treatment of primary endodermal sinus tumor of the endometrium.

Endodermal sinus tumor (EST) arising in the endometrium is an extremely rare malignant neoplasm. To the authors' knowledge, this is only the second report of an EST arising in this location. The tumor was exophytic, 2.4 cm in diameter, and was located in the fundus uteri. It had infiltrated the circumambient endometrium slightly. Preoperative serum alpha-fetoprotein (AFP) levels were markedly elevated, 1580 ng/ml. The patient received a simple abdominal hysterectomy and bilateral salpingo-oophorectomy followed by combination chemotherapy consisting of vincristine, actinomycin D, and cyclophosphamide. To date, there has been no evidence of tumor recurrence, and serum AFP titers, which had returned to normal 7 weeks after surgery, continue to remain within normal limits. We believe this is the first successful treatment of a documented case of primary EST of the endometrium.

Adult↗

Submandibular endodermal sinus (yolk sac) tumor in a female infant. A case report.

A submandibular endodermal sinus (yolk sac) tumor (EST-YST) is reported. The patient was a 1.5-year-old girl exhibiting a rapidly growing tumor in the submandibular region. The lesion showed the typical microscopic features including Schiller-Duval bodies and colloid bodies. Alpha-fetoprotein immunoreactivity was expressed by most tumor cells. There was no clinical or radiological evidence of the presence of this tumor elsewhere in the body.

Basement Membrane↗

Endodermal heterotopia of the atrioventricular node associated with transposition of the great arteries.

A 13-year-old girl with surgically corrected complete transposition of the great arteries died suddenly while walking to school. Postmortem examination revealed endodermal heterotopia of the atrioventricular node, a condition not previously associated with transposition of the great arteries. New immunohistochemical observations are described, and the embryogenesis of the condition and its association with complete transposition are discussed.

Adolescent↗

Intracranial endodermal sinus tumour--role for chemotherapy.

Pineal tumours are commonly of germ cell origin. The endodermal sinus tumour is a rare histologic subtype that is highly malignant and radioresistant. A single case is described and compared to six reported intracranial cases in which chemotherapy was used in addition to surgery and/or radiation. Although a beneficial effect of chemotherapy cannot be proven, the probable benefit in non-CNS cases requires that it be strongly considered. A uniform approach to diagnosis, investigation and treatment for intracranial tumours of this type is suggested.

Adolescent↗

Transient expression of CD44 variant isoforms in the ontogeny of the rat: ectoderm-, endoderm- and mesoderm-derived cells express different exon combinations.

Expression on rat tumor cells of CD44 variant isoforms containing exons v4-v7 or v6-v7 has been described as sufficient for initiation of the metastatic cascade. The question arose as to whether physiological programs may be reactivated by particular CD44 isoforms. With this in mind, expression of mRNAs for the CD44 isoforms was surveyed during ontogeny of the rat. Using available monoclonal antibodies, expression of the CD44 standard isoform (CD44s) and of an epitope of CD44 exon v6 (CD44v6) were evaluated by immunohistology also. While CD44s was expressed in cells of all three germ layers, CD44v6 expression was restricted to distinct epithelial layers and cells of the hematopoietic system. During ontogeny, expression of CD44v6 was first noted in the neural tube and the leading epithelial layer of the limb buds. Later, anti-CD44v6 (1.1ASML) stained basal layers of the epidermis, the epithelium of the gut, and the acini of the submandibular gland. Strong, but transient expression of CD44v6 was seen during lung development, in hematopoietic stem cells of the liver, in thymic epithelia and early thymic immigrants. Expression in these organs was downregulated shortly before or after birth. As revealed by Southern blotting after use of the reverse transcriptase polymerase chain reaction (RT-PCR), most CD44v6-positive organs contained more than one CD44 variant isoform, and the expression patterns differed between individual organs. Hematopoietic cells preferentially expressed exons v4-v7, endodermal tissue exons v4-v10 and only in the epidermis were exons v1-v10 detected. The temporally regulated expression during ontogeny and the different exon compositions suggest a pivotal role of CD44 isoforms particularly in hematopoesis and in pattern formation by instructive epithelia.

Animals↗

Retrospective review of 41 patients with endodermal sinus tumor of the ovary.

Forty-one patients with endodermal sinus tumors of the ovary (EST) (23: pure EST, nine: EST with dysgerminoma; and nine: EST with immature teratoma) were treated with cytoreductive surgery, with or without subsequent adjuvant chemotherapy including VAC or PVB. Clinical staging of these patients showed 23 in stage I, six in stage II and 12 in stage III and IV. The outcome was good in the patients with stage I or II disease, with 5- and 10-year survival rates of around 80%. In contrast, all except two patients with stage III or IV disease died within 2 years. Aggressive surgery did not change the outcome of patients with stage I disease. In addition, postoperative chemotherapy was necessary, but the choice of vincristine, actinomycin-D and cyclophosphamide (VAC) or cis-platin, vinblastine and bleomycin (PVB) did not make any difference. Based on the results of the present study, VAC or PVB chemotherapy, after cytoreductive surgery, is essential for cure and conservative surgery followed by VAC or PVB regimen should be recommended for young patients.

Journal Article↗

Disassociation of MAPK activation and c-Fos expression in F9 embryonic carcinoma cells following retinoic acid-induced endoderm differentiation.

Retinoic acid induces cell differentiation and suppresses cell growth in a wide spectrum of cell lines, and down-regulation of activator protein-1 activity by retinoic acid contributes to these effects. In embryonic stem cell-like F9 teratocarcinoma cells, which are widely used to study retinoic acid actions on gene regulation and early embryonic differentiation, retinoic acid treatment for 4 days resulted in suppression of cell growth and differentiation into primitive and then visceral endoderm-like cells, accompanied by a suppression of serum-induced c-Fos expression. The MAPK (ERK) pathway was involved in mitogenic signaling in F9 cells stimulated with serum. Surprisingly, although c-Fos expression was reduced, the MAPK activity was not decreased by retinoic acid treatment. We found that retinoic acid treatment inhibited the phosphorylation of Elk-1, a target of activated MAPK required for c-Fos transcription. In F9 cells, the MAPK/MEK inhibitor PD98059 suppressed Elk-1 phosphorylation and c-Fos expression, indicating that MAPK activity is required for Elk-1 phosphorylation/activation. Phosphoprotein phosphatase 2B (calcineurin), the major phosphatase for activated Elk-1, is not the target in the disassociation of MAPK activation and c-Fos expression since its inhibition by cyclosporin A or activation by ionomycin had no significant effects on serum-stimulated c-Fos expression and Elk-1 phosphorylation. Thus, we conclude that retinoic acid treatment to induce F9 cell differentiation uncouples Ras/MAPK activation from c-Fos expression by reduction of Elk-1 phosphorylation through a mechanism not involving the activation of phosphoprotein phosphatase 2B.

Animals↗

Comparison of the ability of basement membranes produced by corneal endothelial and mouse-derived Endodermal PF-HR-9 cells to support the proliferation and differentiation of bovine kidney tubule epithelial cells in vitro.

The proliferation and morphological differentiation of bovine kidney collecting-tubule epithelial cells has been examined as a function of substrata and plasma factors. Collecting kidney tubule explant maintained in vitro gave rise to two distinct cell populations; one was composed mostly of fibroblastic cells whereas the other was epithelioid (EP cells). The proliferation of fibroblastic cells when exposed to serum-supplemented medium was best expressed when cells were maintained on a basement membrane produced by bovine corneal endothelial cells. This basement membrane has a composition, which in previous studies has been shown to favor the proliferation of mesenchymal cells. In contrast, the proliferation of EP cells was best expressed when cells were maintained on a basement membrane produced by the mouse-derived endodermal cell line PF-HR-9 (HR-9-BM). This basement membrane has a biochemical composition very similar to the basement membrane underlying the kidney tubules. Although the fibroblast confluent monolayer maintained on bovine corneal endothelial cell extracellular matrix did not undergo morphogenesis, the confluent monolayer of EP cells maintained on HR-9-BM shows hemicyst formation, suggesting that they were capable of vectorial fluid transport. They also built a complex three-dimensional kidney tubulelike network. Some tubules became grossly visible and floated into the tissue culture medium, remaining tethered to the cell monolayer at either end of the tubule. On an ultrastructural level, the tubules consisted of cells held together with junctional complexes arranged so as to form a lumen. The smallest lumen were bordered by 2-3 cells, and the largest ones by 8-15 cells. The lumens of the larger tubules did contain granular fibrillar and amorphous debris. Low-density EP cell cultures maintained on HR-9-BM could be induced to proliferate at a rate approaching that of cultures exposed to serum when they were exposed to medium supplemented with high-density lipoprotein (HDL, 750 micrograms protein/ml) and transferrin (50 micrograms/ml). When exposed to HDL concentrations equal or lower than 250 micrograms protein/ml, low-density cultures proliferated at a slow rate and readily formed tubulelike structures. This observation indicates that EP cells do not need to reach confluence to undergo morphogenesis, and that HDL, which in the presence of transferrin supports the cell proliferation, can favor their differentiation into tubulelike structures once its concentration becomes limiting for mitogenesis.

Animals↗

Casparian strips in needles are more solute permeable than endodermal transport barriers in roots of Pinus bungeana.

The structure and development of endodermal Casparian strips in Pinus bungeana needles and roots were studied by scanning electron microscopy and fluorescence microscopy. Primary pit fields (PFs) frequently occurred in radial walls of Casparian strips isolated from needles, whereas PFs were never detected in Casparian strips from roots. Formation of Casparian strips in needles as well as roots started at the outer parts of the radial walls and they finally occupied the entire radial walls of the endodermis. Fourier transform infrared (FTIR) spectroscopy of Casparian strips isolated from roots revealed significant absorption bands characteristic for suberin. However, in Casparian strips of needles, evidence for suberin was rarely detected by FTIR spectroscopy. The apoplastic permeability of Casparian strips in needles and roots was probed by the apoplastic tracers calcofluor and berberine. Casparian strips in roots efficiently blocked the apoplastic transport (AT) of calcofluor and berberine. Casparian strips in needles blocked the AT of calcofluor, but diffusion of berberine was not inhibited and berberine thiocyanate crystals were detectable in the vascular tissue of the needles. From the data presented, it must be concluded that Casparian strips in needles, which are characterized by the absence of suberin, are more solute permeable compared with Casparian strips in roots.

Biological Transport↗

Pulmonary endodermal tumor resembling fetal lung. The optically clear nucleus is rich in biotin.

Pulmonary endodermal tumor resembling fetal lung (PET) is a rare pulmonary neoplasm that may represent a distinctive form of pulmonary blastoma lacking the sarcomatous component. A peculiar histologic feature of PET is the presence in the morular area of optically clear nuclei (OCN), which commonly show false-positive immunostaining by the avidin-biotin peroxidase complex (ABC) method. Because recent studies have shown that the nuclei of an identical change seen in endometrioid adenocarcinoma of the ovary and endometrial glandular epithelium during pregnancy are rich in biotin, we conducted an investigation to see if the same was true of a PET occurring in a 45-year-old man. Only the OCN were positively stained when the tissue section was incubated with peroxidase-labeled avidin or streptavidin and developed in a chromogen solution. The reaction was completely blocked by pretreatment with free avidin. An identical nuclear staining pattern was observed when the antibiotin antibody was applied as the primary agent by the indirect immunoperoxidase method. The neoplastic cells were negative for estrogen and progesterone receptors in immunostaining on frozen tissue sections. Ultrastructurally, the OCN were occupied by filamentous substructures of chromatin measuring approximately 10 to 12 nm in diameter. These results suggest that the OCN in PET are part of the unique nuclear change of certain neoplastic and non-neoplastic cells in the body in which abundant biotin accumulates within the nucleus in association with the characteristically arranged chromatin substructure. Further study is necessary to determine whether the OCN generally develop under the influence of female sex hormones. When immunostaining by the ABC method or related techniques is performed in PET and certain other epithelial lesions, the possibility of false positivity in the OCN should be kept in mind to avoid any misinterpretation of the results.

Adenocarcinoma↗

Endodermal sinus tumor of the anterior mediastinum.

An endodermal sinus tumor presenting as a lobulated anterior mediastinal mass in a 20-year-old white man is reported. The clinical implications, histology, and origin of this rare germ cell tumor are discussed. The invasive nature of this highly malignant neoplasm prevented complete surgical resection.

Adult↗

Can Ca2+ fluxes to the root xylem be sustained by Ca2+-ATPases in exodermal and endodermal plasma membranes?

The pathway of Ca2+ movement from the soil solution into the root stele has been a subject of controversy. If transport through the endodermis is assumed to be through the cytoplasm, the limiting factor is believed to be the active pumping of Ca2+ from the cytoplasm into the stele apoplast through the plasma membrane lying on the stele side of the Casparian band. By analogy, for similar transport through the exodermis, the limiting step would be the active pumping into the apoplast on the central cortical side of the layer. Such effluxes are mediated by Ca2+-ATPases. To assess whether or not known Ca2+ fluxes to the stele in onion (Allium cepa) roots could be supported by Ca2+-ATPases, the percentages of total membrane protein particles required to effect the transport were calculated using measured values of membrane surface areas, an animal literature value for Ca2+-ATPase V(max), plant literature values for Ca2+-ATPase K(m), and protein densities of relevant membranes. Effects of a putative symplastic movement of Ca2+ from the exo- or endodermis into the next cell layer, which would increase the surface areas available for pumping, were also considered. Depending on the assumptions applied, densities of Ca2+ pumps, calculated as a percentage of total membrane protein particles, varied tremendously between three and 1,600 for the endodermis, and between 0.94 and 1,900 for the exodermis. On the basis of the data, the possibility of Ca2+ transport through the cytoplasm and membranes of the exodermis and endodermis cannot be discounted. Thus, it is premature to assign an entirely apoplastic pathway for Ca2+ movement from the soil solution to the tracheary elements of the xylem. To verify any conclusion with certainty, more detailed data are required for the characteristics of exo- and endodermal Ca2+-ATPases.

Arabidopsis↗

Chemical Composition of Hypodermal and Endodermal Cell Walls and Xylem Vessels Isolated from Clivia miniata (Identification of the Biopolymers Lignin and Suberin).

The occurrence of the biopolymers lignin and suberin was investigated with hypodermal (HCW) and endodermal cell walls (ECW) and xylem vessels (XV) isolated from Clivia miniata Reg. roots. Both biopolymers were detected in HCW and ECW, whereas in XV, typical aliphatic suberin monomers were missing and only representative lignin monomers such as guaiacyl (G) and syringyl (S) units could be detected. The absolute amounts of lignin were about one order of magnitude higher compared with suberin in both HCW and ECW. The ratios of the two aromatic lignin units (G/S) decreased from 39 in XV and 10 in HCW to about 1 in ECW, indicating significant differences in lignin structure and function between the three investigated samples. Additionally, compared with the detectable lignin-derived aromatic units G and S, significantly higher amounts of esterified p-coumaric acid-derived aromatic monomers were obtained with HCW, but not with ECW. This is interpreted as a functional adaption of HCW toward pathogen defense at the root/soil interface. The final aim of this study was to provide a thorough chemical characterization of the composition of HCW, ECW, and XV, which in turn will form the basis for a better understanding of the relevant barriers toward the passive, radial, and apoplastic diffusion of solutes from the soil across the root cortex into the root cylinder.

Journal Article↗

A case of AFP-positive pancreas papillary carcinoma suggestive of a primitive endoderm phenotype.

In a 70 year old woman with a tumor in the head of the pancreas, the lesion was predominantly composed of papillary adenocarcinoma protruding into the main pancreatic duct, with periductal invasion. The major portion of the adenocarcinoma was intraductal and was composed of tall columnar epithelial cells with pseudostratified nuclei, had the appearance of primitive endodermal epithelium and was positive for carcino-embryonic antigen. In contrast, in the other portion of the adenocarcinoma which had the predominant component of periductal invasion, neoplastic cells had an irregular, eosinophilic cytoplasm, resembled ordinary pancreas adenocarcinoma of ductal origin and was positive for CA19-9. Neuro-endocrine and alpha-fetoprotein-positive cells with a primitive appearance were scattered among the neoplastic epithelial linings. In addition, a vimentin-positive sarcomatoid component intermingled with the adenocarcinoma. These findings suggest that the adenocarcinoma observed in this tumor with the primitive appearance also had a primitive phenotype. This was evidenced by immunohistochemistry and the divergent directions of differentiation. This particular case illustrates that pancreas adenocarcinoma of the ordinary histologic type can arise secondarily from the more primitive neoplastic cells during carcinogenesis within the pancreatic duct.

Adenocarcinoma↗

Endodermal sinus tumour of the ovary: serum alpha-fetoprotein levels before and after treatment and during pregnancy. Case report.

We report the apparently successful treatment of an endodermal sinus tumour. The patient became pregnant after unilateral oophorectomy and adjuvant chemotherapy, and was delivered of a normal female infant. The levels of serum alpha-fetoprotein, having been raised before treatment of the tumour, were within the normal range during pregnancy and undectactable before and afterwards.

Adult↗