Revealing an Uncommon Presentation of Chiari I Malformation With Diverse Craniovertebral Anomalies in the Absence of Syringomyelia and Atlanto-Occipital Subluxation: A Case Report

A Chiari I malformation is a frequently encountered anomaly of the posterior fossa, occurring in a notable percentage of the population. It often coexists with various other craniovertebral junction abnormalities, albeit less frequently with Klippel-Feil syndrome. Interestingly, the majority of individuals with Chiari I malformation do not exhibit any symptoms. We present a rare case of a 25-year-old male with chronic neck and occipital pain, along with progressive weakness and sensory disturbances in all four limbs, urinary urgency, and elevated left shoulder. Examination unveiled spasticity, weakness, and brisk reflexes. On extensive radiological evaluation (X-ray, CT, and MRI), findings revealed various anomalies in the craniovertebral junction, including complete atlanto-occipital assimilation, basilar invagination, and platybasia. Furthermore, cervical segmentation abnormalities indicative of Klippel-Feil syndrome were observed, along with Sprengel's deformity. MRI confirmed Chiari I malformation with tonsillar herniation and myelomalacia, as well as compression at the cervico-medullary junction. This patient underwent a surgical procedure that included transoral odontoidectomy combined with occipito-cervical fixation, after which a good clinical response was observed. It emphasizes the necessity of radiological imaging for the diagnosis of Chiari and other associated abnormalities in the craniovertebral junction.

A Case of Lymphangioma of the Calf Region: Imaging Spectrum With Histopathological Correlation

Lymphangioma, also known as cystic hygroma are benign malformations arising from abnormal development of the lymphatic system. Most often these lesions are found in the pediatric population, having a predilection for the neck/axilla, and are less common in extremities. Symptoms can vary based on size and location. Treatment is not usually indicated until they start impacting life due to deformity or symptoms such as pain, paraesthesia, etc. Here, we report a case report of lymphangioma located in the calf region of the right lower limb presenting in adult age.

Imaging Spectrum of Severe Urinary Tract Infection Complications Presenting as a Seminal Vesicle Abscess, Prostatic Abscess, and Renal Abscess in Uncontrolled Diabetes Mellitus: A Case Report

Urinary tract infections are more common and severe, and they carry worse outcomes for patients with type 2 diabetes mellitus. The infections are typically caused by resistant pathogens, leading to many complications. Various impairments in the immune system, poor metabolic control, and incomplete bladder emptying due to autonomic neuropathy may all contribute to the enhanced risk of urinary tract infections in these patients. We present an imaging spectrum of a severe urinary tract infection presenting as renal, prostatic, and seminal vesicle abscesses in a patient with uncontrolled diabetes mellitus.

Liver Tuberculosis Presenting As Fever of Unknown Origin: A Case Report and Imaging Spectrum With a Review of Literature

Hepatic tuberculosis is not commonly seen, and it can be easily missed unless there is strong suspicion. It presents clinically with non-specific symptoms like pain in the upper right abdomen, tenderness, mild fever, sweating at night, losing weight, feeling tired, and a lump in the abdomen. We are reporting a case of a 41-year-old female who presented with an intermittent history of fever and right hypochondriac pain for 10 years. Ultrasound and contrast-enhanced computed tomography (CECT) scans of the patient revealed a mass lesion with classical imaging findings of tuberculosis. Subsequently, a biopsy was conducted, confirming the presence of liver tuberculosis.

Chondrosarcoma of Iliac Bone Imaging Spectrum With Histopathological Correlation: A Case Report

Chondrosarcoma is a rare form of carcinoma that originates in the cells of cartilage, the flexible tissue that cushions the joints and gives structure to various parts of the body. This malignant tumour primarily affects adults and is most commonly found in the bones of the arms, legs, pelvis, and ribs. The severity and prognosis of chondrosarcoma can vary widely depending on factors such as tumour size, location, and grade. We are reporting a case of an 83-year-old male patient who presented with swelling over the left hip joint. A mass was detected on radiograph and ultrasound that was further characterized using contrast-enhanced CT and MRI. Imaging findings suggested chondrosarcoma. The patient was diagnosed on histopathological examination.

An Aberrant Case of Pheochromocytoma in a Young Adult Presenting With Secondary Hypertension: A Case Report With Review of the Literature

Pheochromocytoma (PCC) is a rare neuroendocrine catecholamine-secreting tumour of the adrenal gland. It originates from the chromaffin cells found within the adrenal medulla or the extra-adrenal paraganglia. We present a case report of a 24-year-old female who presented with hypertension, headache, palpitations, chest pain and blurry vision. On ultrasound evaluation, a right suprarenal mass was noted, which was further evaluated using contrast-enhanced computed tomography (CT). Based on our imaging findings, the patient was diagnosed with a case of right-sided pheochromocytoma. The patient was operated on, and our diagnosis was confirmed with histopathological examination.

An Aberrant Case of Large Submandibular Gland Sialolith With Obstructive Sialadenitis in a Young Female

Sialolithiasis is a major cause of salivary gland dysfunction. Submandibular sialolithiasis with obstructive sialadenitis is a relatively uncommon condition. Submandibular gland sialolithiasis with obstructive sialadenitis accounts for about 2% of all cases of sialadenitis. We are reporting a case of a 20-year-old female who presented with acute-onset swelling in the right submandibular region. The submandibular gland had a large calculus with pericalcular abscess development, which was clearly visible on pre- and post-contrast computed tomography. Subsequently, surgical excision of the lesion was performed, and calculus was removed.

Primary Testicular Non-Hodgkin's Lymphoma With Bilateral Adrenal Metastasis: A Rare Presentation

Primary testicular lymphoma is the common testicular neoplasm in patients aged more than 65 years. It accounts for a small number of cases of adult testicular malignancies. Though the metastasis to bone marrow, liver, and central nervous system are well known, metastasis to adrenal glands is a very rare entity. It can be mistaken as a germ cell tumor or a dual malignancy. To rule out other causes, a multidisciplinary approach is required. Here, we present a rare case of primary testicular Non-Hodgkin's lymphoma with bilateral adrenal metastasis.

Budd Chiari Syndrome: A Case Report on Classic Imaging Findings With Successful Intervention

Budd Chiari syndrome is an unusual vascular disease involving the hepatic vasculature and has significant mortality and morbidity if not treated early. Ultrasonography (USG), Doppler, computed tomography (CT), and magnetic resonance imaging (MRI) have classical imaging findings that can help make a reliable and quick diagnosis. Intervention radiology plays an important role in the treatment of these patients, helping avoid various complications and proper patient management. We are presenting a case report with classical imaging spectrum and highlighting successful intervention with hepatic vein stenting.

An Aberrant Case of Foreign Body Granuloma in the Left Forearm Due to an Impacted Piece of Glass Bangle

Foreign body granuloma is an inflammatory tissue reaction around retained foreign bodies after penetrating trauma. The granulomatous reaction is a natural mechanism of the body to heal wounds by restricting the damage done by a pathological agent and containing the pathological agent to the wound site only. Here we present a classic case of a foreign body granuloma on the dorsal aspect of the forearm. This case was evaluated radiologically on high-frequency ultrasound and X-ray imagining and was operated on afterward. A piece of broken glass bangle was found inside the granuloma.

An Aberrant Seminoma as a Complication in an Undescended Testis: A Case Report and Review of Literature

Testicular germ cell tumors are testicular neoplasms in young and middle-aged men. Undescended testis dramatically increases the risk of testicular germ cell tumors. We report the case of a 33-year-old male who complained of swelling and pain in his lower abdomen. The patient also had an undescended left testis. An intrabdominal mass was detected on ultrasound that was further characterized using contrast-enhanced CT. Imaging findings suggested testicular germ cell tumor, developing as a complication in the undescended testis. The patient was operated and the diagnosis was confirmed on histopathological examination.

A Rare Case of Congenital Plunging Ranulas: Diagnosis With Intraoral and Extraoral Ultrasound and Magnetic Resonance Imaging

Ranulas are cystic lesions located in the floor of the mouth. These are "pseudocysts" and are developed due to an obstruction in the sublingual gland. Congenital variants of plunging ranulas are very rare. Here, we report a case of an eight-year-old male child presenting with congenital swelling with an intraoral component as well as extension to the submandibular gland region. The swelling was painless and gradually growing in size.

An Aberrant Case of Sacrococcygeal Teratoma in a Female Infant Born of Twin Pregnancy

Sacrococcygeal teratoma (SCT) is an uncommon infantile tumor. It has a female preponderance with malignant variants being more common in males. These usually manifest as palpable masses over the sacral region in infancy which may or may not be associated with neural tube defects. An initial radiological investigation is warranted to analyze the extent and components of the mass to guide an approach for surgical excision. We present a classic case of an SCT in a female infant born as a twin. This mass was evaluated radiologically by X-ray and ultrasound followed by histopathological correlation. This is a case of Altman Type-I lesion and was confirmed as a mature teratoma on histopathological examination.

Diagnostic and Imaging Features of a Non-seminomatous Germ Cell Tumor of the Testis: A Case Report and Review of the Literature

Neoplasms involving the testes are uncommon. They account for up to 10% of all malignant diseases affecting the male genitourinary system and for around 2% of all malignant neoplasms in males. Testicular tumors are the third highest cause of mortality in males between the age of 20 and 40 years. We present a case of a young patient with right-sided scrotal swelling associated with pain. Ultrasonography, elastography, computed tomography, and magnetic resonance imaging features revealed non-seminomatous germ cell tumors of the testis. The patient underwent inguinal orchidectomy for the same and was sent for histopathological evaluation. The imaging diagnosis was consistent with the histopathological diagnosis. This case report adds to the knowledge of imaging features of testicular tumors and their identification based on imaging.

Peyronie's Disease Presenting as Curvature of the Penis: A Case Report

Peyronie's disease (PD) usually affects middle-aged men. This condition is characterized by fibrosis and plaque in the tunica albuginea that results in deformity of the penis and makes sexual intercourse difficult. We report a case of a 52-year-old male who presented with complaints of curvature of the erect penis and erectile dysfunction. Based on our imaging findings, the patient was diagnosed with PD. ultrasonography (USG), elastography, and CT findings are described.

Antenatal Ultrasonographic Diagnosis of a Constellation of Alobar Holoprosencephaly, Ethmocephaly, and Hydronephrosis in a Case of Early-Onset Intrauterine Growth Retardation: A Case Report

Alobar holoprosencephaly is a congenital malformation that results from failure of the forebrain/prosencephalon to divide into right and left halves. Despite the literature on the genetic and chromosomal abnormalities associated with this condition, information on additional causes and explanations for variability in phenotypic expressivity are lacking. We report a case of early-onset intrauterine growth retardation with alobar holoprosencephaly, ethmocephaly, and hydronephrosis diagnosed on antenatal ultrasonography in a 27-year-old primigravida with no known risk factors or family history. The combination of holoprosencephaly with associated midline facial anomalies and the genitourinary abnormality, in this case, constitutes a rare phenotypic presentation. This case emphasizes the importance of antenatal ultrasonography in the early detection of lethal anomalies like alobar holoprosencephaly. The pregnancy was safely terminated in accordance with the mother’s decision.

Outcomes in juvenile onset lupus: single center cohort from a developing country

Introduction

About 10–20% of systemic lupus erythematosus (SLE) patients have onset in childhood and have more severe organ involvement. Survival of juvenile SLE patients is improving worldwide. Long-term data of childhood onset SLE from developing countries is scarce.

Methods

Clinical and laboratory data at initial presentation and follow-up visits were retrieved from clinic files, hospital information system and personal interviews. Treatment received, complications, flares, outcomes and death were recorded. Survival was calculated using Kaplan–Meier survival curves and regression analysis was done for predictors of mortality.

Results

Children with SLE ( n = 273, 250 girls) had a median age at onset of 14 years and duration of illness prior to diagnosis at our hospital of 1 year. Fever and arthritis were the most common presenting manifestations. Renal disease was seen in 60.5% and central nervous system (CNS) disease in 29%. The median follow-up period in 248 patients was 3.5 years. Fourteen children died, and 10 of these had active disease at the time of death. The mean actuarial survival was 24.5 years and survival rates at 1, 5 and 10 years were 97.9%, 95% and 89% respectively. Fever, CNS disease, anti-dsDNA levels and serious infections predicted death on univariate and multivariate analysis. Infections were seen in 72 children (26.3%), and 38 of these infections were serious. One-third of the patients had damage on the last follow-up. Flares were seen in 120 children, the majority being major flares.

Conclusion

Outcomes of pediatric SLE in North Indian children are similar to those seen in developed countries. Infections pose a major challenge in these patients.

Urinary B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL): potential biomarkers of active lupus nephritis

B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) help in B cell activation, maintenance and plasma cell survival. B cell infiltration has been demonstrated in kidneys of patients with lupus nephritis (LN). Serum levels of BAFF and APRIL have shown inconsistent relationships with lupus disease activity. We evaluated urinary levels of BAFF and APRIL as biomarker for LN. Thirty-six patients with proliferative lupus nephritis (AN), 10 with active lupus without nephritis (AL) and 15 healthy controls (HC) were studied. APRIL and BAFF levels were measured in both serum and urine using enzyme-linked immunosorbent assay (ELISA). Urine levels were normalized for urinary creatinine excretion. Urine levels were correlated with conventional disease activity markers and histology. Levels were reassessed in 20 AN patients at 6 months after treatment with cyclophosphamide. Urinary APRIL (uAPRIL) and BAFF (uBAFF) levels were raised significantly in AN. uAPRIL, but not uBAFF, correlated moderately with renal Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in AN (r = 0·36, P < 0·05). On receiver operator curve (ROC) analysis, uBAFF and uAPRIL showed an area under the curve (AUC) of 0·825 and 0·781, respectively, in differentiating between nephritis and non-nephritis, which performed better than low C3, C4 and raised anti-dsDNA antibodies. There was no correlation of serum levels with uBAFF (r = 0·187, P = 0·261) and uAPRIL (r = 0·114, P = 0·494). uAPRIL levels reduced after treatment (mean 125 pg/mg to 36 pg/mg, P < 0·05). uBAFF levels reduced in 16 responders while two of four non-responders had increase in levels. Thus, uBAFF and uAPRIL are potential biomarkers of proliferative lupus nephritis.

Evaluation of Sinonasal Diseases by Computed Tomography

INTRODUCTION

Computed Tomography (CT) plays an important diagnostic role in patients with sinonasal diseases and determines the treatment. The CT images clearly show fine structural architecture of bony anatomy thereby determining various anatomical variation, extent of disease and characterization of various inflammatory, benign and malignant sinonasal diseases.

AIM

To evaluate sensitivity and specificity of CT in diagnosis of sinonasal diseases and to characterise the benign and malignant lesions with the help of various CT parameters. Also, to correlate findings of CT with histo-pathological and diagnostic nasal endoscopy/ Functional Endoscopic Sinus Surgery (FESS) findings.

MATERIALS AND METHODS

In this hospital based prospective study 175 patients with symptomatic sinonasal diseases were evaluated by clinical diagnosis and 16 slice Multi Detector Computed Tomography (MDCT). The details of findings of nasal endoscopy, Functional Endoscopic Sinus Surgery (FESS), histopathological examination and fungal culture were collected in all those cases where those investigations were done. All those findings were correlated with CT findings and statistical analysis was done by using Test statistics (sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy), Chi-Square test and Z-test for single proportions. Software used in the analysis was SPSS 17.0 version and graph pad prism 6.0 version and p < 0.05 was considered as statistically significant.

RESULTS

CT diagnosis had higher sensitivity, specificity, PPV and NPV in diagnosing various sinonasal diseases in comparison to clinical diagnosis. On correlating CT diagnosis with final diagnosis, congenital conditions have 100% sensitivity and specificity. Chronic sinusitis has 98.3% sensitivity and 97.8% specificity. For fungal sinusitis the sensitivity was 60% and specificity was 99.3%. Polyps have sensitivity of 94.4% and specificity of 98.1%. Benign neoplasms have sensitivity of 90.9% and specificity of 99.2%, malignant neoplasms have sensitivity of 94.1% and specificity of 99.3%. The p-value in all instances was <0.05, i.e. <0.0001 indicating the significance of the findings.

CONCLUSION

CT is the modality of choice in imaging the sinonasal region for evaluating various congenital, inflammatory, benign and malignant pathologies and associated complications thereby planning the further management of the patient. CT is the best modality of choice for evaluating the bone erosion or destruction. The potential pitfalls to differentiate on CT are fungal sinusitis and dense secretions.

Colour Doppler Evaluation of Extracranial Carotid Arteries: A Clinical and Radiological Correlation

INTRODUCTION

Atherosclerosis (i.e. hardening and thickening of arteries) causes vascular remodeling, obstruction of lumen, abnormalities of blood flow and reduced oxygenation of target tissues. Manifestation of atherosclerosis in the form of either Myocardial Infarction or Stroke is the major cause of morbidity and mortality. This study evaluated extracranial carotid arteries of patients (>60 years) who presented with risk factors of atherosclerosis and determined the association of risk factors with carotid abnormalities.

AIM

To evaluate the prevalence of atherosclerosis, haemodynamic and morphological changes that take place in extra cranial portion of carotid arteries in patients with risk factors of atherosclerosis (Diabetes Mellitus, Hypertension, Smoking, Stroke, Coronary Artery Disease, Hypercholesterolaemia) and determine the association of risk factors with carotid abnormalities.

MATERIALS AND METHODS

The prospective cross-sectional analytical study included the examination of Extracranial carotid arteries of 1043 patients over a period of 2 years (2013-2015) using duplex ultrasound. Assessment of CCA-IMT, ICA-IMT and percent stenosis was done using a linear probe of 8-12 MHz.

STATISTICAL ANALYSIS

Correlation between risk factors of atherosclerosis, wall thickness of common carotid (CCA-IMT), internal carotid arteries (ICA-IMT) and stenosis was studied using statistical tools like multiple logistic regression analysis and analysis of variance (p<0.05) using SPSS 17.0.

RESULTS

Maximum percent stenosis increased with increase in age. Prevalence of severe stenosis (>70%) was low while the prevalence of mild stenosis (<50%) was quite high. In all age groups, stenosis was more prevalent and more severe in men as compared to women. Hypertension showed the strongest positive correlation with all three measures of interest CCA-IMT, ICA-IMT and maximum percent stenosis. Stroke history showed strong positive correlation with CCA-IMT and stenosis. Smoking, Diabetes Mellitus, Hypercholesterolaemia, Heart disease showed strong association with all three measures as well. Atherosclerotic plaques were mostly found at the site of carotid bifurcation.

CONCLUSION

CCA-IMT was strongly associated with hypertension, smoking and diabetes mellitus. ICA-IMT was strongly associated with hypertension and history of heart disease. Percent stenosis was strongly associated with smoking and history of heart disease.

Investigating the Role of Plasma Glucose Concentration as a Phenotypic Marker for CYP2C9 Genetic Variants, in the Diabetic Population of Gujarat

The present study was aimed to investigate the role of plasma glucose concentration as a phenotypic marker and to study the frequency distribution of CYP2C9 genetic variants in Gujarat state diabetic population. One hundred and nine unrelated diabetes mellitus patients treated with sulfonylureas were genotyped for CYP2C9*2 and CYP2C9*3 alleles. Their pre- and posttreatment postprandial blood glucose levels were recorded and mean glucose drop per milligram of drug values were calculated and further used as an index for phenotypic correlation. The frequencies of CYP2C9*1, CYP2C9*2 and CYP2C9*3 alleles in the Gujarat state diabetic population were 0.84, 0.07 and 0.09, respectively. The distribution of CYP2C9*1/*1, CYP2C9*1/*2, CYP2C9*1/*3, CYP2C9*2/*2, CYP2C9*2/*3 and CYP2C9*3/*3 genotypes were 0.73, 0.08, 0.13, 0.0, 0.06 and 0.0, respectively. Patients with CYP2C9*1/*2 genotype did not show any significant difference in the mean glucose drop per milligram of drug values when compared with wild-type patients in glipizide-treatment group. Patients with CYP2C9*1/*3 genotype showed greater mean glucose drop per milligram of drug values than patients with CYP2C9*1/*1 wild-type genotype for both glipizide and glimepiride while patients with CYP2C9*2/*3 genotype showed greater drop than patients with CYP2C9*1/*1 genotype only in the glipizide-treatment group. The presence of CYP2C9*3 allele significantly affected plasma glucose drop per milligram of drug values in patients taking glipizide and glimepiride, while effects of CYP2C9*2 allele were insignificant. Further studies are needed to confirm the effects of CYP2C9*2 allele on plasma glucose drop per milligram of drug values. However, plasma glucose concentration is a complex physiological marker that cannot be used to establish perfect genotype-phenotype correlation. Hence studies exploring robust phenotypic markers must be initiated.

A clinical study to compare the efficacy and safety of pregabalin sustained release formulation with pregabalin immediate release formulation in patients of diabetic peripheral neuropathic pain

OBJECTIVE

To compare the efficacy and safety of sustained release (SR) formulation of pregabalin with immediate release (IR) formulation in patient with diabetic peripheral neuropathic pain.

MATERIALS AND METHODS

In this open label, randomized, comparative, multicentric study, the primary efficacy measure was reduction in visual analogue scale (VAS) of short form McGill pain questionnaire (SF-MPQ) score from baseline to last visit. The secondary evaluation measures included reduction in SF-MPQ descriptive score and present pain intensity score and change in clinical global impression - improvement of illness (CGI-I) and clinical global impression - severity of illness (CGI-S) from baseline to last visit. Total duration of the study was 12 weeks. Safety evaluation was done by recording treatment emergent adverse events and laboratory investigations at baseline and end of treatment.

RESULTS

Of 265 randomized patients, 133 received pregabalin SR tablets and 132 pregabalin IR. Patients randomized to both treatments responded to respective treatments. The least square means of VAS score in both the groups were reduced significantly (P <0.01). Reduction in both groups was similar (P = ns). At the end of the trial in both the groups, there was a significant reduction in the SF-MPQ descriptive score (P <0.01), severity of illness as well as clinically significant improvement in the symptoms. Difference between the groups for CGI-I (P = 0.37) and CGI-S (P = 0.41) score was not statistically significant. Treatment in both the groups was found safe and well tolerated.

CONCLUSION

The study shows that the pregabalin SR is safe and effective in patients of diabetic peripheral neuropathic pain. The results of the study demonstrated that pregabalin SR has comparable efficacy and safety as pregabalin IR.

A rare foreign body in the maxillary antrum

A case of metallic foreign body getting impacted into maxillary antrum and orbit due to a blast in a furnace, presenting primarily with 20% facial burn & ocular symptoms is presented for its rarity.

Embryonal rhabdomyosarcoma with intracranial extension

A case of embryonal rhabdomyosarcoma of the middle ear presenting with facial paralysis and a polypoidal aural mass who subsequently had convulsions due to intracranial extension is presented for its rarity.

Congenital teratoid tumour of nasopharynx with cleft palate

A case of congenital nasopharyngeal teratoid tumour presenting since birth projecting into oral cavity through the palatal cleft & gradually increasing in size thus causing breathing & feeding difficulty in a four months old female child is presented here for its rarity. A brief review of literature and management of such patients is also discussed here.

Congenital teratoid tumour of nasopharynx with cleft palate

A case of congenital nasopharyngeal teratoid tumour presenting since birth projecting into oral cavity through the palatal cleft and gradually increasing in size thus causing breathing and feeding difficulty in a four months old female child is presented here for its rarity. A brief review of literature and management of such patients is also discussed here.

Localization of the human Ror1 gene (NTRKR1) to chromosome 1p31-p32 by fluorescence in situ hybridization and somatic cell hybrid analysis

Ror1 is an orphan cell surface receptor with strong homology to the tyrosine kinase domain of growth factor receptors, in particular the Trk family. Southern blot analysis of genomic DNA from somatic cell hybrids revealed that Ror1 is located on chromosome 1. We have mapped the Ror1 gene to chromosome 1p12-p32 using PCR on a somatic cell hybrid panel that subdivides chromosome 1p. We have further localized the gene to chromosome 1p31-p32 by fluorescence in situ hybridization using a PAC clone that contains the Ror1 gene.

Human neural tissues express a truncated Ror1 receptor tyrosine kinase, lacking both extracellular and transmembrane domains

Human heart, lung and kidney express a 6 kb mRNA encoding Ror1, a member of the receptor tyrosine kinase (RTK) family with as yet unknown ligand specificity. We used a Ror1 cDNA probe to screen a cDNA library prepared from the human neuronogenic teratocarcinoma line, NTera2, and cloned a 2373 nucleotide transcript. This transcript contains an open reading frame that encodes a 388 amino acid protein identical with the cytosolic, C-terminal region of ror1 but lacking the ror1 transmembrane and entire extracellular domains. Northern blots demonstrate that mRNA encoding this truncated Ror1 ('t-Rorl') is abundantly expressed in fetal and adult human CNS, in human leukemia, lymphoma cell lines, and in a variety of human cancers derived from neuroectoderm. While previous studies have documented alternative splicing patterns within 5' and 3' regions of mRNAs encoding various RTKs altering their ligand binding specificity or their intracellular signaling, the present report is the first to demonstrate tissue-specific alternative mRNA splicing causing loss of the entire extracellular and transmembrane regions of an RTK.