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We construct a combined non-perturbative path integral over geometries and topologies for two-dimensional Lorentzian quantum gravity. The Lorentzian structure is used in an essential way to exclude geometries with unacceptably large causality violations. The remaining sum can be performed analytically and possesses a unique and well-defined double-scaling limit, a property which has eluded similar models of Euclidean quantum gravity in the past.

Metastases to the pituitary gland from systemic cancers is a rare phenomenon and usually occurs in patients with disseminated disease. The neurohypophysis is the most commonly involved site, and diabetes insipidus is the most common presentation in these patients. Breast and lung cancer are the most common cancers metastasi-zing to the pituitary. Involvement of the pituitary by renal cell carcinoma (RCC) is exceedingly rare. Mild-to-moderate degree of hyperprolactinemia is a rare presentation of pituitary metastases. We report the case of a woman with metastatic RCC to the pituitary presenting an unusually high degree of hyperprolactinemia.

Abstract.: A case of renal granular cell carcinoma with inferior vena cava and right atrium involvement is presented. Spin-echo and single breath-hold gradient-recalled-echo magnetic resonance pulse sequences demonstrate a patchy flow signal within the cavoatrial thrombus. This pattern, in correlation with the histopathologic findings, represents tumoral neovascularity characteristic of renal carcinoma venous invasion, which was previously reported by angiography, computed tomography, and color Doppler duplex ultrasound.