Retroperitoneal schwannomas are a rare entity. They originate from the Schwann cells of the nerve sheaths and may be of renal or pararenal origin. We report on two patients with retroperitoneal schwannomas, who received surgery under the suspicion of renal cell carcinoma.

The injection of air or water into the scrotum has been described only a few times so far in the literature. Injection of air into the penis and its consequences has not been described at all. Here, we present the case of a young man who, acting on his previously suppressed sexual fantasies, injected air into his penis and caused generalized subcutaneous emphysema.

Background: In breast cancer patients, a correlation between endothelin-1 (ET-1) and lymph node metastasis was found. While breast cancer with a positive ER status can be treated with Tamoxifen, several studies describe increasing Tamoxifen resistance in patients. We analyzed the relationship between Tamoxifen, ET-1 overexpression, and ER leading to Tamoxifen resistance. Methods: Breast cancer cell lines were treated with Tamoxifen, ET-1, estrogen and combinations. Using qRT-PCR, immune-precipitation, Western blot, EMSA and immunohistology target gene expression and ER complex partners were investigated. Human biopsies and mastectomy specimens were immunohistologically studied for Vimentin 3, and ERß. Results: Breast cancer cells stimulated with a combination of Tamoxifen and ET-1 downregulate ERα, while upregulating intracellular ET-1, and ERß. Immunoprecipation of nuclear extracts with ET-1, ERα or ERß agarose conjugated antibodies reveals a complex formation change replacing ERα by ERß once Tamoxifen forms a complex with ET-1. ERß and ET-1 migrate into the nucleus. ET-1 stimulation upregulates metastases promoting target genes (IL-6, Wnt11), including a novel one, Vimentin 3. Tissue analyses show Vim3 and ERß expression in metastases of ERα positive breast cancer, and in ERα negative biopsies/mastectomy specimens. Conclusion: We are the first to describe a complex consisting of How to cite this paper: von Brandenstein,

approved for treatment of M0 CRPC. ARN-509 as neoadjuvant treatment in organ confined disease has not been studied before. The NEAR trial is a phase II single arm study of neoadjuvant apalutamide (ARN-509) and radical prostatectomy (RP) in the treatment of D'Amico intermediate and high-risk prostate cancer (Clinicaltrials.gov identifier: NCT03124433). This study aims to report on the oncological and pathological outcomes of neoadjuvant ARN-509 before RP.METHODS: Eligibility criteria included patients between 21-75 years old diagnosed with conventional adenocarcinoma, excluding those with radio-recurrent disease, impaired liver function, and poor ECOG status (3 or below). Participants received ARN509 240mg daily for 12 weeks followed by RP within 6 weeks of the last dose of medication. Primary outcomes included tumour response defined by residual cancer burden (RCB), post-therapy morphologic characterization (groups A-C, with C being the worst response), and post-operative serum PSA levels (nadir defined as levels below 0.03ng/ml). Secondary outcomes included prevalence of significant adverse events (AE) with ARN509 and operative complications following RP. Statistical significance was defined as p<0.05.RESULTS: Of the 30 subjects enrolled, 25 participants completed the study. The median age was 68 years, and serum PSA at recruitment was 11.6ng/mL. They comprised D-Amico intermediate-risk n[12 (48%) and high-risk n[13 (52%), with ISUP grade group distributions of 1(n[1, 4%), 2(n[13, 52%), 3(n[8, 32%) and 4-5(n [3, 12%). 84% of subjects achieved post-prostatectomy nadir PSA levels, and the rest achieved nadir PSA levels of 0.03-0.05. The posttherapy morphology classifications were group A (50%), group B (10%) and group C (40%). The median reduction of serum PSA after neoadjuvant apalutamide alone was 97.3% (range 61.2 to 100.0, p<0.0001). There was one subject with an unrelated grade III AE, and no subjects with Clavien-Dindo grade III and above surgical complications.CONCLUSIONS: Results of the phase II NEAR trial show safe and reasonable oncological outcomes in patients with organ confined prostate cancer.

patients, a complete inguinal lymph node dissection (ILND) might result in overtreatment and high morbidity rate. It is known that sentinel node (SN) biopsy is a valid alternative with fewer complications compared to ILND. This study evaluated the relationship between the number of lymph nodes (LNs) removed during SN biopsy in penile cancer patients and complications, using a standardized methodology to report complications.METHODS: 404 patients with !T1G2 penile squamous cell carcinoma with at least one cN0 groin were scheduled for SN biopsy and treatment of the primary tumour at a single centre. 90-day postoperative complications were collected according to the standardized methodology proposed by the European Association of Urology panel. Multivariable logistic regression analyses (MVA) were used to identify predictors of 90-day Clavien Dindo (CD)!IIIa and inguinal wound infection. Covariates consisted of age, cT (T1 vs. !T2) and cN status (cN0 vs. contralateral cN1), repeat SN biopsy and number of LNs removed. Lowess function graphically depicted the effect of the number of LNs removed on the probability to develop inguinal wound infection.RESULTS: Overall, the median number of LNs removed at SN biopsy was 4. Overall, 126 patients (31%) had postoperative complications. Of these, 67 (n[84) and 33% (n[42) were CD