bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastroscopic cytology and biopsies in diagnosis of gastric malignancies
Authors: Gupta J. P. , Jain A. K. , Agrawal B. K. , Gupta Saroj
Published: February 2007

The outcome in gastric malignancy has changed in recent years owing to its early and accurate diagnosis employing fiber‐optic endoscopy and histocytology. One hundred and two subjects with endoscopic demonstration of various gastric lesions were subjected for brush cytology and multiple biopsies. Observing a high degree of specificity, the accuracy of brush cytology was 81% and histology 72% with cumulative diagnostic yield of 91%. There was no false‐positive report with cytology; histology, however, gave three false‐positive results. The present study thus confirms the high diagnostic accuracy of brush cytology combined with multiple biopsies in gastric malignancies.
Central venous access in oncology patients: The “peel‐away” sheath for rapid insertion
Authors: Aitken Delmar R. , Catalano Richard , Minton John P.
Published: February 2007

A safe, fluoroscopically controlled method of rapid silastic catheter introduction in oncology patients provides long‐term access to a high blood flow area near the right atrium. A “peel‐away” disposable sheath and introducer have been adapted for the rapid introduction of the catheter. Benefits of the use of this technique are that (1) it can be easily adapted from the widely known technique of central venous line placement, (2) catheter position is easily confirmed by fluoroscopy, and (3) the procedure can be performed under local anesthesia, minimizing anesthetic risks and expense.
Alternating multiagent chemotherapy for advanced ovarian cancer
Authors: Hernandez Enrique , Rosenshein Neil B. , Villar Jose , Dillon Michael B. , Ettinger David S. , Order Stanley E.
Published: February 2007

A chemotherapy regimen consisting of hexamethylmelamine (H) 150 mg/ m2 orally days 1–14, cyclophosphamide (C) 500 mg/m2 IV day 1 of a 28‐day cycle with Adriamycin (A) 40 mg/m2 IV day 1 alternating with cisdiamminechloroplatinum (C‐P) 50 mg/m2 IV day 1 every other cycle was administered to 29 patients with advanced epithelial ovarian cancer. Toxicity to this regimen included alopecia, nausea, and vomiting in all patients. Mild paresthesias occurred in four patients. Hematologic toxicity required only minimal dose modification. There was no cardiac, renal, or auditory toxicity. The clinical response rate of 55% and median survival of 14 months compare favorably with that of other reported series. This chemotherapy regimen seems to be well tolerated without jeopardizing the patients' response.
Ewing's sarcoma of the phalangeal bone
Authors: Chen KARL T. K. , McGann Peter D. , Flam Marshall S.
Published: February 2007

A rare case of Ewing's sarcoma of the toe bone is described and compared with three reported cases of phalangeal Ewing's sarcoma. The lesion in two cases was initially treated as infection and the diagnosis was delayed for several months. Roentgenographic and aspiration cytology examinations in cases with clinically unresolving infection of the hands and feet may prevent delayed diagnosis. Radical surgery alone may be curative if no metastases are found preoperatively in careful clinical investigations.
Adenocarcinoma of the sigmoid colon: Sites of initial dissemination and clinical patterns of recurrence following surgery alone
Authors: Dawson Lynne E. , Russell Anthony H. , Tong Daphne , Wisbeck William M.
Published: February 2007

Three hundred and fifty‐five patients with primary adenocarcinoma of the sigmoid colon were retrospectively reviewed. One hundred and eighteen patients who had disseminated disease at diagnosis were analyzed to identify sites and mechanisms of disease spread. Two hundred and thirty‐seven patients treated by surgery alone with curative intent were analyzed to determine clinical patterns of recurrence and identify prognostic factors. Operative findings in 27 patients undergoing second laparotomy at the time of initial disease recurrence are described, and implications for adjuvant therapy discussed.
The treatment of skin cancer by electrodesiccation and curettage
Authors: Jackson Robert
Published: February 2007

The technique of electrodesiccation and curettage as a treatment is described. Using the four criteria of cure, cosmesis, cost, and convenience it rates highly as a satisfactory treatment modality.
Cavernous hemangioma of the adrenal gland
Authors: Orringer Robert D. , Lynch John A. , McDermott William V.
Published: February 2007

Adrenal hemangiomas are rare tumors that pose difficult diagnostic chal lenges. A report of a giant cavernous hemangioma of the adrenal gland is presented. A review of the literature reveals features of this tumor that aid in understanding its characteristics and facilitate its diagnosis.
Papillary‐cystic carcinoma of the pancreas
Authors: Dales Richard L. , Garcia Juan C. , Davies Ross S.
Published: February 2007

Papillary‐cystic carcinoma of the pancreas is an extremely rare tumor which occurs in young adults, may invade locally, but is late to metasta‐size. As opposed to adenocarcinoma of the pancreas, portal vein invasion should not be included as a criteria for nonresectability. In the absence of metastatic disease, pancreatectomy combined with portal vein resection, if invasion is present, may offer a good prognosis and comparatively long survival time.
Determination of axillary nodal status in surgery of breast carcinoma: A prospective study of thirty‐five patients
Authors: Appelqvist P. , Saario I. , Pantzar P. , Lehtola A.
Published: February 2007

Thirty‐seven axillary status of patients with breast carcinoma was studied with preoperative and peroperative palpation before mastectomy and total axillary dissection. Special attention was paid to the clinical supiciousness and size of axillary nodes. The preoperative axillary palpation gave false diagnosis of axillary content 27% of the time and peroperative, 19%. Of all 249 nodes studied, 54 were found to contain malignant growth in routine histological examination. Mean diameter of malignant nodes was 12.4 mm and of benign nodes, 6.3 mm. The most clinically suspect axillary lymph node gave correct diagnosis of axillary status in 72 % of the cases. The 2 most suspect lymph nodes together were positive in 89%. There was no case with histologically positive axilla where none of the 3 most suspect lymph nodes was malignant. We conclude that at least the 3 most suspect axillary lymph nodes must be removed for histological examination to be sure that axillary metastasizing of breast carcinoma can be found by routine histological examination.
Characterization of the preformed antibodies involved in the xenograft reaction
Authors: Cameron Deborah J. , Rajagopalan P. R. , Fitts C. Thomas , Majeski J. A.
Published: February 2007

The dog‐to‐sheep renal xenograft model was utilized to isolate the antibodies that participate in xenograft hyperacute rejection. These sheep antibodies, which were isolated from the rejected dog kidney, agglutinated and killed only dog blood and kidney cells whereas the whole sheep serum reacted with both dog and rabbit cells. The purified antibody was also utilized to obtain in pure form the antigens involved in the hyperacute rejection. When this antigen was tested for its ability to bind the serum of various species, this particular antigen was highly specific for sheep serum and would not react with rabbit, horse, calf, or mouse sera.
Influence of hepatic artery ligation on liver tumor growth in rats
Authors: Carlsson Goran , Hafström Larsolof
Published: February 2007

Liver tumors, both primary and secondary, receive their main blood supply from the hepatic artery. Hepatic artery ligation (HAL) causes a reduction in tumor growth and tumor necrosis. In this experiment, three different experimental tumors were used to study the effect of hepatic artery ligation at different intervals after the occlusion of the arterial blood supply. Hepatic artery ligation causes a reduction in liver tumor growth for all three tumors but with some variation according to age and type of tumor.
Primary retroperitoneal seminoma presenting as renal colic
Authors: Nativ Ofer , Goldwasser Benad , Jonas Paul , Many Moshe
Published: February 2007

We describe a case of primary retroperitoneal seminoma, presenting as intractable renal colic. Awareness of this entity might lead us to a correct preoperative diagnosis.
The effect of pregnancy on hormone levels and receptors in malignant melanoma
Authors: Sutherland Carl M. , Wittliff James L. , Fuchs Axel , Mabie William C.
Published: February 2007

As previous studies indicate, some cases of malignant melanoma are clearly hormonally dependent as demonstrated by their stimulation by pregnancy and regression following delivery. A case of melanoma initiated during pregnancy and stimulated by a subsequent pregnancy was studied with biochemical receptor studies before and after endocrine manipulation. The negative steriod receptor studies obtained late in the patient's disease at time of endocrine manipulation predicted the lack of response. Results of this study indicate investigations are needed to define the relationship between malignant melanoma and pregnancy.
Serum copper in carcinoma of cervix uteri as an indicator of successful radiotherapy
Authors: Birdi Ashwi , Gupta Saroj , Cambhir S. S.
Published: February 2007

Serum copper levels (SCL) have been done in 106 patients of squamous cell carcinoma of the cervix and in 15 cases of local recurrences. The mean SCL has been significantly elevated in them in comparison to controls (P < 0.001). The SCL falls to near normal range following successful therapy. There is a trend to elevation in SCL as the disease progresses. Mean SCL is unrelated to the various morphologic types of squamous cell carcinoma. SCL when compared with clinical radiation response (CRR) show that good CRR has highest mean difference of pre and posttreatment value in comparison to moderate and poor CRR. It appears that highest SCL is associated with advanced disease and poorest prognosis. The estimation of SCL can be used as a check parameter of recurrence and as a prognostic tool in the management of carcinoma of the cervix uteri.
Nonsteroid antiinflammatory drugs and tamoxifen for desmoid tumors and carcinoma of the stomach
Authors: Waddell William R. , Cerner Robert E. , Reich Marshall P.
Published: February 2007

The results of treatment of desmoid tumor patients with nonsteroid antiinflammatory drugs alone or in combination with tamoxifen are described. Tumor growth was inhibited in six of seven patients. Nonsteroid antiinflammatory drugs administered along with 5‐fluorouracil and cyclophosphamide and other inhibitors of T‐suppressor cells were used to treat nine patients with metastatic carcinoma of the stomach. Survival of these patients was extended so that after 12 months minimal follow‐up the majority are well. A prospective controlled clinical trial is indicated.
The role of the regional lymph node in breast cancer: A comparison between nodal and systemic reactivity
Authors: Reiss Craig K. , Volenec F. J. , Humphrey Mark , Singla Om , Humphrey Loren J.
Published: February 2007

Confusion remains concerning the role of the regional lymph node in the containment of cancer. Numerous investigators using a variety of assays have reported often conflicting results concerning the immunocompetency of lymphocytes residing in regional nodes. Forty‐two axillary lymph nodes from ten stage I and stage II breast cancer patients were studied in lymphocyte blast assays using mitogens and breast cancer antigen (BCA). Three general response patterns to BCA were identified which were related primarily to tumor size. In the patients with the smallest primary tumor (0.5 cm), lymphocytes in the nodes reacted to a much greater extent than peripheral blood lymphocytes (PBL). In two of three patients with intermediate‐size tumor (1.0 to 1.5 cm), a mixed pattern of responses was seen with both stimulation suppression occurring within the nodes of the same patient. In the four patients with the largest tumors (2.0 to 3.0 cm), 15 of 19 nodes had a lower stimulation index (SI) than the corresponding PBL. From the results of this study it appears that regional lymph nodes are dynamic immunologic structures which regress in responsiveness as tumor burden increases.
Usefulness of preoperative CEA levels in the assessment of colorectal cancer patient stage
Authors: Midiri C. , Amanti C. , Consorti F. , Benedetti M. , Buono S. Del , Tondo U. Di , Castagna G. , Peronace L. , Paola M. Di
Published: February 2007

In order to demonstrate a prognostic value of preoperative CEA levels, we have tried to define a correlation between CEA and histologie stage of tumor in 124 patients with colorectal carcinoma. CEA concentration has been evaluated by radioimmunologic assay and the histologie stage following Dukes' classification. The results show a 25.0% positivity rate for patients in stage A, 48.2% for stage B, 61.1% for stage C, and 85.7% for stage D. The mean CEA values are 7.8 ng/ml in the first group, 30.3 ng/ml in the second, 58.1 ng/ml in the third, and 134.3 ng/ml in the last group. Furthermore, we have tried to relate the histhopathologic grade of the tumor (G) with CEA levels in 54 patients of the 124. We conclude that preoperative CEA has a prognostic value, and it is useful in the staging of colorectal cancer patients. A low concentration indicates an early stage of the tumor, while a high concentration indicates a wide spread of disease; on the other hand, there are not significant correlations with cancer grading.
Primary anorectal malignant melanoma
Authors: Angerås Ulf , Jonsson Nils , Jonsson Per‐Ebbe
Published: February 2007

Eleven patients with primary anorectal melanoma were analyzed retrospectively. Clinical symptoms and signs were rather unspecific; bleeding in nine, a palpable mass in five, and local pain in three patients. Two patients had the tumor diagnosed accidentally. In all patients the primary tumor was in an advanced stage. A summary of the histopathological characteristics is given in all patients. Six patients were subjected to abdominal perineal resection, four to local excision, and one to a colostomy followed by radiotherapy. All patients developed metastatic disease after a median time of 10 months. The median survival time was 14 months after both abdominal perineal resection and local excision. One patient is still alive after 11 years. Pertinent data form the literature are given.
Renal cell carcinoma presenting as acute pancreatitis and GI bleeding
Authors: Klausner Joseph M. , Rozin Roland R. , Lelcuck Shlomo , Ilie Bianka
Published: February 2007

A 75‐year‐old woman was admitted for acute pancreatitis, jaundice, GI bleeding, and a tender mass in the right hypochondrium. Upper gastrointestinal series demonstrated a diverticulum‐like structure on the lateral aspect of the second part of the duodenum. This structure was excised and turned out to be a renal cell carcinoma invading the duodenum by direct extension from the right kidney. Although renal cell carcinoma may present in numerous and often perplexing manifestations, this is a unique presentation.
The effects of cholestyramine, colestipol, and ADR‐132 on the rat prostate and dunning R‐3327 adenocarcinoma
Authors: Brown William J. , Karr James P. , McGarry Michael , Williams Phyllis D. , Hagerman Larry M. , Murphy Gerald P.
Published: February 2007

The effects of three compounds known to have hypocholesterolemic activity in several species were investigated on the rat prostate and the hormone‐dependent R‐3327 rat prostatic adenocarcinoma. Cholestyramine, colestipol, and ADR‐132 are bile acid‐sequestering anion exchange resins which were fed to separate groups of adult male Copenhagen × Fischer (F1) hybrid rats in doses of 0.25%, 1.00%, and 2.00% of diet. The results indicate that serum cholesterol levels in tumor‐bearing rats and controls fed these compounds for 29 days were not reduced. The body and organ weights as well as the histological features of the prostate gland, seminal vesicles, and the R‐3327 tumor were unaffected by these agents.
Complications of ectopic ureterocele in adult female
Authors: Ajrawat H. S. , Imahori S. C. , Magoss I. V.
Published: February 2007

Three examples of ectopic ureterocele in adult female were presented. Of these three patients, two had unusual complications: one with a ureterovaginal fistula and the other with neoplastic transformation. Pathologic changes varied from squamous and glandular metaplasia to adenocarcinoma.
Experimental study on merits and demerits of splenectomy in tumor bearers
Authors: Saji Shigetoyo , Oshita Hiroo , Yamamoto Satoru , Takekoshi Tomoharu , Sakata Kazuki
Published: February 2007

Immunologic merits and demerits of splenectomy were studied using a rat's experimental tumor. When splenectomy was done on day — 14, 2, or 14 of tumor inoculation, subsequent tumor growth was inhibited, but when it was done on day 7, tumor enhancement was observed. On day 2, cpm values of phytohemagglutinin (PHA)‐induced blastogenesis of splenocytes was lower than in normal rats, on day 7 they significantly increased as compared with day 2, and on day 14 they significantly decreased as compared with day 7. Stimulation index (SI) ratio of PHA‐induced blastogenesis and natural cell‐mediated killing (NK) activity were also investigated using splenocytes, thymocytes, and peripheral lymphocytes. The results indicated that immunological competency of splenocytes of tumor bearers was reduced in the early, late, and final tumor‐bearing periods, while it was increased in the middle tumor‐bearing period. Tumor growth following splenectomy was considered to be controlled by these changes in immunological competency of splenocytes.
Adenocarcinoma of Meckel's diverticulum
Authors: Chen Karl T. K. , Workman Ronald D. , Kirkegaard Dale D.
Published: February 2007

The clinicopathologic features of a case of adenocarcinoma arising in Meckel's diverticulum are described and compared with the 21 cases reported in the literature. The prognosis is generally poor. However, the patient in the present case was alive and well 1.5 years after diagnosis, despite the fact that the lesion had perforated at initial presentation.
Computed tomography and radiotherapy in the treatment of cancer
Authors: Jose B. , Chu Ann M. , Sharma Subhash C. , Tobin Daniel A. , Scott Ralph M.
Published: February 2007

Computed tomography (CT) has shown to be of great value in the treatment of cancer with radiation therapy. It is used more and more in the estimation of tumor volume and for treatment planning, with the aid of the computerized treatment unit. At the James Graham Brown Cancer Center, Department of Radiation Oncology, CT has been used routinely for the treatment planning. From October 1, 1981 to June 30, 1982, we performed 180 CT scans for the treatment planning, 380 simple dose calculations, 237 complex treatment plans, and 42 intracavitary dosimetry using the treatment planning unit. This is a review of our experience with some illustrations. Accurate tumor dose can be delivered with reducing the complications with the use of CT and the computerized treatment unit.
Chondrosarcoma of the first metatarsal
Authors: Wiss Donald A.
Published: February 2007

Chondrosarcoma of the first metatarsal was observed in an 84‐year‐old man. Chondrosarcoma of the small bones of the foot is comparatively rare. These tumors generally arise de novo rather than from a preexisting benign cartilage lesion. Pedal chondrosarcoma presents as a painful enlarging mass. Radiographs show lytic destruction of bone with or without calcification. The histological grade, location of the tumor, and adequacy of surgical excision are the major determinants of long‐term survival.
Assessment of avascular renal masses
Authors: Greco Joseph M.
Published: February 2007

A case of an asymptomatic renal mass is presented as a diagnostic dilemma. Even with highly sophisticated radiographic evaluation, diagnosis was not apparent until surgical exploration.
Adjuvant immunotherapy with BCG in stage II malignant melanoma
Authors: Byrne M. J. , van Hazel G. , Reynolds P. M. , Lemish W. M. , Holman C. D. J.
Published: February 2007

Forty‐one patients were treated with BCG immunotherapy following block dissection of lymph nodes involved with malignant melanoma. A control group of similar patients who received no immunotherapy was drawn from a population consisting of all patients with malignant melanoma diagnosed in Western Australia in the period from January 1, 1975 to December 31, 1976. The disease‐free survival and overall survival of BCG‐treated patients were not different from that of the control group, who received no immunotherapy. The findings do not support the use of this type of immunotherapy as an adjuvant to surgery in the treatment of patients with stage II malignant melanoma.
The role of fibrin adhesive in vascular surgery
Authors: Ikossi‐O'Connor M. G. , Ambrus J. L. , Rao Uma
Published: February 2007

Fibrin Seal (FS) (a natural adhesive material composed of fibrinogen, cold insoluble globulin, factor XIII, platelet growth factor, antiplasmin thrombin, and calcium chloride) was utilized in the construction of vascular anastomosis of the femoral artery of mongrel dogs. A significant decrease in the number of sutures necessary to achieve adequate anastomosis and minimize the likelihood of postoperative bleeding was noted. There was no long‐term increase in tissue reaction or decrease in arterial patency.

On the basis of these preliminary results the role of FS as a hemostatic agent in vascular and especially microvascular surgery warrants further investigation.
Noninvasive cardiac evaluation of patients receiving adriamycin‐containing adjuvant chemotherapy (FAC) for stage II or III breast cancer
Authors: Ali M. Khalil , Buzdar Aman U. , Ewer Michael S. , Cheng Renalto S. , Haynie Thomas P.
Published: February 2007

Cardiac function was evaluated by noninvasive methods in 55 patients with stage II or III breast cancer treated with adjuvant Adriamycin containing combination chemotherapy (FAC). None of the 44 patients who remained free of disease for a median follow‐up period of 36 months, or those who were retreated with Adriamycin up to a median cumulative total dose of 450 mg/m2 (nine patients), developed clinical evidence of cardiac decompensation. The median electrocardiographic QRS voltage and ejection fraction decreased by 11% and 5%, respectively, in the former and by 21% and 10% in the latter group at the conclusion of chemotherapy. These parameters tended to return to the baseline at the time of the last visit. The decreases in QRS voltage and ejection fraction were greater in patients who received radiotherapy and had prior cardiovascular disease than in those without such risks. The remaining two patients were retreated with higher total doses of Adriamycin. Both showed clinical evidence of cardiac decompensation and gradual deterioration of the noninvasively measured parameters of cardiac function. One patient was alive six months after the discontinuation of Adriamycin at a total dose of 842 mg/m2, and the other died of pulmonary embolism two months after receiving a total of 892 mg/m2.

Our study shows that Adriamycin can be included in adjuvant therapy without inducing clinically significant alterations in cardiac function; however, patients who have additional risk factors should be monitored closely with noninvasive studies while they receive this drug.
Ligation and catheterization of the hepatic artery for palliative treatment of malignant hepatic tumors
Authors: Takagi Hiroshi , Morimoto Takeshi , Yasue Mitsunori , Ochiai Eiichi , Yamada Eikichi , Ashizawa Tatsuto , Kido Choichiro
Published: February 2007

Eleven unresectable hepatoma patients and three metastatic tumor patients with colonic cancer underwent ligation and/or catheterization of the hepatic artery of the main tumor‐bearing zone. Mitomycin C (liquid or microcapsulated) or Adriamycin were administered via the catheter intermittently or continuously with a portable pump device. In follow‐up study the tumor size was frequently visualized by arteriography via the cannula. Some tumors became smaller with calcification. The levels of α‐Fetopro‐tein of CEA in some cases dropped remarkably and stayed low for a fairly long period. There was no immediate postoperative death. Six of 11 unresectable hepatoma patients survived longer than 8 months with a maximum survival of 17.5 months. Two of three metastatic patients have survived more than 11 months at this writing. This method seems effective for prolongation of patient survival.
Humoral response of melanoma patients to two different tumor‐associated antigens
Authors: Chee Darwin O. , Gupta Rishab K. , Morton Donald L.
Published: February 2007

Sera of 8 stage II melanoma patients undergoing surgical adjunctive immunotherapy with bacille Calmette Guérin (BCG) plus melanoma cell vaccine (MCV) were assayed for humoral response by the complementdependent antibody cytotoxicity (CDAC) assay and by the microcomplement fixation (MCF) test. The patients developed high levels of cytotoxic (CTX) and complement‐fixing (CF) antibodies to the UCLA‐SO‐M14 (M14) cells, one of the three melanoma cell lines in the MCV. Significant rises in CTX and CF antibodies occurred one month post‐immunotherapy. While the level of CTX antibodies was maintained for 11 months thereafter, the titer of CF antibodies was sustained for seven months, then gradually declined. When the sera were absorbed with lymphoblastoid (ML14) cells which are autologous to the M14 cells, two residual peaks of CTX antibodies, one and four months postimmunotherapy and two peaks of CF antibodies, one and seven months postimmunotherapy, emerged. Two sera that exhibited high levels of CTX and CF antibodies one month postimmunotherapy were absorbed with ML 14 cells and human fetal brain tissue. The reactivity of one serum in both the CDAC and MCF assays was abolished, whereas the reactivity of the other serum was not significantly diminished in either assay. These data indicate that the stage II post‐surgical melanoma patients developed a humoral immune response to at least two distinct tumor antigens on the membrane of the M14 cells. One of these antigens appeared to be of fetal origin (OFA). the other M14‐associated (TAA). Both antigens, OFA and TAA, were involved in complement‐dependent antibody cytotoxic and complement fixation reactions in vitro.
Postoperative radiation therapy for muscle‐invading bladder carcinoma
Authors: Kopelson Gene , Heaney John A.
Published: February 2007

From 1974–1980, 15 patients with pT2–4 bladder carcinoma received adjuvant postoperative radiation therapy (XRT). The extent of initial surgery varied (six radical cystectomy, 5 partial cystectomy, four “total” transurethral resection). The planned XRT was 4,000–5,040 rads in 5–6 weeks to the pelvis (achieved in 14/15 patients) followed by a bladder boost in noncystectomized patients (achieved in 8/9). Survival at two years and five years was 54% (7/13 patients) and 27% (3/11 patients), respectively. Local‐regional disease control (minimum two‐year follow‐up) was achieved in 7/11 (63%). Of seven patients alive at least two years later, small bowel complications (chronic diarrhea, obstruction) occurred in two; these latter patients each had had radical cystectomy. Adjuvant postoperative XRT may be useful in the multimodality management of patients with bladder carcinoma, especially those identified as high risk after pathologic staging and initial surgery. The poor regional control rate and relatively high incidence of complications seen in this and previous studies suggest that improved radiation technique is needed, both to ensure adequate coverage of the volume at risk and to minimize complications. Representative portals are shown to illustrate these features.
High‐dose cyclophosphamide and adriamycin with DTIC maintenance for metastatic soft tissue sarcomas
Authors: Clamon Gerald , Sinkey Christine , Jochimsen Peter
Published: February 2007

Intensive chemotherapy with high‐dose cyclophosphamide and adriamycin with DTIC maintenance was given to 12 patients with metastatic soft tissue sarcomas. A partial response rate of 25% was seen; this is no better than can be achieved with single‐agent therapy. Because of substantial toxicity without improved efficacy, the trial of high dose therapy was halted.
Treatment outcome of recurrent cervical cancer
Authors: Chung C. K. , Nahhas William A. , Stryker John A. , Mortel Rodrigue
Published: February 2007

A total of 85 patients with recurrent cervical cancer were reviewed: 17 patients with recurrences were treated by radical surgery, 18 by radiotherapy, 29 by chemotherapy, and 21 cases received no further treatment. Survival was presented according to the site of recurrence and the mode of therapy. All patients were followed for a minimum of 24 months after recurrence.

Of the total group, 14% are living without evidence of disease, 29% died of metastatic disease with no involvement in the pelvis, and 45% died of pelvic cancer. Overall, 22% were living more than 2 years, and only 2% lived over 5 years after recurrence.

The NED (no evidence of disease) rate for radical surgery group was 47 and 44% for the radiotherapy group. There were no significant differences in median survival between the chemotherapy group and the notreatment group (6.8 versus 4.8 months). New chemotherapy agents and adjuvant systemic therapy are discussed.
Colorectal cancer in patients under 40 years of age
Authors: Lundy Joel , Welch John P. , Berman Martin
Published: February 2007

A retrospective chart review was undertaken on all Hartford Hospital Tumor Registry patients under age 40 with a diagnosed adenocarcinoma of the colon or rectum between the years 1955 and 1980. Of the 45 patients who could be accurately staged by the Dukes classification, only about one‐third had disease localized to bowel. No unique histological pattern was observed. An excess of multiple primary tumors was observed (13%). Stage of disease at the time of presentation, rather than histology, was the most important prognostic factor in this study. Carcinoma of the rectum in our series had a 5‐year survival rate of 8%. This group of young patients should be managed with aggressive multimodal therapy.
Unusual tumours of the lung
Authors: Wright E. S. , Pike E. , Couves C. M.
Published: February 2007

Unusual lung tumours are not simply pathological curiosities. They demonstrate features of major significance in diagnosis, treatment, and prognosis. Six of these tumours are discussed: (1) Carcinosarcoma is rarely found in the lung. The histogenis of the lesion is unclear and the prognosis is poor. (2) Only three cases of pleomorphic adenoma have previously been described. Differentiation from other “mixed tumours” of the lung is essential. (3) A rare case of bronchial adenoma producing ectopic ACTH is described. Early recognition of these polypeptide hormone‐secreting tumours is streessed. (4) Oat cell carcinoma with the myasthenic (Eaton‐Lambert) syndrome shows the clinical features which should permit early tumour diagnosis. The hazards of muscle relaxants must be recognized. (5) Prostatic carcinoma with endobronchial metastases is discussed. The importance of localization of the primary tumour is emphasized. (6) An example of double primary carcinoma is presented. The rarity of this finding may be related to the poor prognosis of patients with bronchogensis carcinoma.
Male breast carcinoma: An updated experience at a veterans administration hospital and review of the literature
Authors: Bavafa Shariar , Reyes Cesar V. , Choudhury Abdul M.
Published: February 2007

Ten cases of male breast carcinoma are reviewed. Male patients with breast cancer on the average are 10 years older than females, and they delay twice as long as females after noting a breast mass before seeking medical attention. Because of this patient's delay, male breast cancer tends to be more advanced at the time of diagnosis and initial therapy than female breast cancer.
Esophageal metastasis from a peripheral lung carcinoma masquerading as a primary esophageal tumor
Authors: Inoshita Tsuyoshi , Youngberg George A. , de Koos Paul Thur
Published: February 2007

A 65‐year‐old man presented with progessive dysphagia, which proved to be the first clinical manifestation of a periperal lung carcinoma (secondary to a submucosal metatasis in the esophagus). The lung tumor, hidden by the diaphragm on chest x‐ray, was not suspected until a thoracotomy was done. Although dysphagia is known to be the first manifestation of bron‐chogenic carcinomas, such presentation in a case of a peripheral lung carcinoma has not been well described. This case is reported with a review of the literature for cases with dysphagia secondary to a metastatic tumor in the esophagus.
Sulindac for polyposis of the colon
Authors: Waddell William R. , Loughry Richard W.
Published: February 2007

Four members of a Gardner's syndrome family had rectal and colon polyposis treated with nonsteroid anti‐inflammatory drugs. Three of these patients had had subtotal colectomy and ileoproctostomy and the residual polyps arose in the rectal mucosa. The polyps almost completely disappeared when sulindac was administered. Indomethacin therapy over the course of a preceding year was ineffective in one of these patients. One patient (case 4) had diffuse polyposis in an intact colon. After sulindac therapy for a year, only three small mucosal polyps could be identified by air contrast barium enema and colonoscopic examination. These observations confirm those of Pollard and Luckert [1,2] on rats with chemically induced polyposis of the intestinal tract.
Granular cell tumor of the bronchus coexisting with a bronchogenic adenocarcinoma: A case report
Authors: Gabriel Juan B. , Thomas Louys , Mendoza Concepcion B , Chauhan Prem M.
Published: February 2007

A case of endobronchial granular cell tumor and an adenocarcinoma in the same lobe of the lung are presented. A review of the literature documents 2 cases where there was coexistence of a bronchogenic carcinoma and a granular cell tumor. The different theories regarding the origin of granular cell tumors are considered. The treatment of choice would be that indicated for the carcinoma irrespective of the granular cell tumor.
Combined modality treatment of pancreatic cancer: Implications for the surgeon
Authors: Metzger Urs F. , Kisner Daniel L. , Ghosh Bimal C.
Published: February 2007

Since pancreatic cancer is still increasing and has a poor prognosis, there is great interest in improving treatment results by combined modality approaches. This paper considers the most appropriate studies to analyze the status of treatment and future implications for surgeons. With new radiation sources and more sophisticated treatment plans, intra‐ and post‐operative radiotherapy now has an established role in local tumor control. Combination chemotherapy has yielded response rates of 40–45% and improved chemotherapy will play a role in the treatment and perhaps in the prevention of disseminated disease. Although it seems likely that chemotherapy combined with newer radiotherapeutic technique could improve treatment results in advanced pancreatic cancer, treatment‐related and limiting toxicity still must be defined. There are suggestions that more surgeons become involved in the combined modality approach, as both radiotherapy and chemotherapy may be more valuable in primary management. The unsatisfactory results of surgical treatment imply the need for adjuvant treatment, which must be tested in randomized multicenter trials. Future efforts will require an interdisciplinary approach to this disease.
Cervical metastases from small bowel carcinoid tumors
Authors: Marks William H. , Strodel William E. , Lloyd Ricardo V. , Eckhauser Frederic E. , Thompson Norman W. , Vinik Aaron I.
Published: February 2007

Small bowel carcinoid tumors usually metastasize to regional lymph nodes and the liver but metastases to the neck are extremely rare. Over a ten‐year period 48 cases of small bowel carcinoid were diagnosed at our institution and of these, three cases (6%) were associated with neck metastases—one to the thyroid gland and two to cervical lymph nodes. The former patient and one of the latter patients had symptoms of the carcinoid syndrome. The other patient was asymptomatic and presented with a solitary neck mass. Urine levels of 5‐hydroxyindolacetic acid (5‐HIAA) were elevated in the two symptomatic patients but were undetectable in the asymptomatic patient. Extirpation of the involved cervical nodes and the primary small bowel lesion was performed in two patients. In addition, both patients have received chemotherapy with 5‐fluorouracil. One patient remains asymptomatic four years after diagnosis but the other patient continues to have five to six bowel movements per day nine months after operation. Small bowel resection was performed in the patient with a metastasis to the thyroid. This patient died of sepsis after a second operation for an intraabdominal abscess. The histological patterns of the primary tumor and the metastatic lesions were similar and the cells of the metastases contained argentaffin‐positive granules. We conclude that 1 an intraabdominal carcinoid tumor should be considered as the location of the primary tumor in patients who present with a neck mass containing metastatic carcinoid and 2 the prognosis for patients with extraabdominal metastases is similar to that for patients with intraabdominal disease only.
Hemangioma of the urinary bladder
Authors: Sarma Deba P. , Weiner Marshall
Published: February 2007

A hemangioma of the urinary bladder occurring in a 66‐year‐old man is described. Although hemangioma is a common lesion in many parts of the body, it remains a very rare primary tumor in the bladder. Clinically the patient usually presents with recurrent hematuria, control of which may necessitate a segmental cystectomy.
Hepatic trisegmentectomy for metastatic colorectal cancer
Authors: Nims Thomas A.
Published: February 2007

Radical Hepatic Resections For Metastatic Liver Disease Have Been Infrequently Done And Widely Criticized. Seven Patients Are Evaluated Who Had Trisegmentectomies Performed For Extensive Liver Metastases From Colorectal Primaries. There Was 1 Postoperative Death. Of The 6 Evaluable Patients, 4 (66%) Were Alive At 12 Months. Mean Survival Curently Exceeds 20 Months With The Longest Survivor Alive At 41 Months. Radical Hepatic Resections May Offer This Group Of “Hopeless” Patients Many Months Of Productive Life.
Hematoporphyrin derivative: Quantitative uptake in dimethylhydrazine‐induced murine colorectal carcinoma
Authors: Agrez M. V. , Wharen R. E. , Anderson R. E. , Laws E. R. , Ilstrup D. M. , Cortese D. A. , Shorter R. G. , Lieber M. M.
Published: February 2007

The selective affinity of hematoporphyrin derivative (HpD) for dimethyl‐hydrazine‐induced colorectal malignancies in mice was evaluated both visually and by a quantitative microfluorescent photometric technique. A significant corelation was found between higher concentrations of HpD in colon biopsies determined by microfluorescence spectroscopy and the presence of carcinoma cells in these biopsies as identified by histologic examination. Visual inspection of the gross fluorescence of tumor‐bearing colons in this experimental model, however, was not helpful in differentiating malignant from nonmalignant tissue. The implications of this study regarding the clinical application of HpD tumor fluorescence for the detection of colorectal carcinoma are discussed.
ABO (H) cell surface antigens in benign and malignant parotid neoplasms
Authors: Woltering Eugene A. , Tuttle Steven E. , James Arthur G. , Sharma Hari M.
Published: February 2007

Twenty‐two inflammatory, benign, or malignant parotid lesions were studied by means of the specific red cell adherence test (SRCA), a modification of the Coombs' mixed cell agglutination reaction. In 22 normal parotid tissues the acinar structures were devoid of red cell agglutination, but it was present in ductal epithelium. Findings were similar in 2 cases of parotitis, 11 benign mixed tumors, and 1 malignant mixed tumor. All lacked red cell agglutination in areas of neoplastic change. Benign Warthin's tumors (4 cases) demonstrated antigenicity in the co‐lumnar epithelial component of the tumor, but lacked red cell agglutination in areas of the lymphoid component. One malignant Warthin's tumor showed agglutination in areas of normal columnar epithelium but not in areas of malignant dedifferentiation. Undifferentiated carcinoma (1 case) and adenoid cystic carcinoma (2 cases) did not possess detectable ABO (H) antigens in neoplastic areas of the gland. The absence of ABO antigens in normal acinar glands supports their suggested myoepithelial or mesenchymal derivation, as the absence of antigen in benign and malignant mixed tumors supports their proposed mesenchymal derivation. Ductular epithelium and the epithelial components of benign Warthin's tumors have ABO (H) antigens, while the loss of antigen in the epithelial portion of the malignant Warthin's tumor is characteristic of epithelial neoplastic dedifferentiation. Loss of antigen in adenoid cystic and undifferentiated carcinomas of the parotid supports the concept that antigen is absent in epithelially derived malignant neoplasms.
Treatment of advanced ovarian cancer with cisplatin, adriamycin, and cyclophosphamide: Effect of treatment and incidence of intracranial metastases
Authors: Budd G. Thomas , Webster Kenneth D. , Reimer Ronald R. , Martimbeau Pierre , Livingston Robert B.
Published: February 2007

A retrospective analysis of 42 patients with stage III, IV, or recurrent epithelial ovarian carcinoma treated with monthly cisplatin, Adriamycin, and cyclophosphamide (PAC) was made. Of 36 patients with measurable disease, 18 (50%) achieved a clinical complete response (CR) and 12 (33%) achieved a partial response (PR) for an objective response rate of 83%. Six stage III patients remained without measurable disease after surgery and postoperative PAC and are included in the survival data. The median survival of all patients was 22 months (10 months for nonresponders), with a median duration of response of 15 months (19+ months for clinical complete responders). Of 16 patients who underwent second‐look laparotomy while in clinical CR, 8 were pathologically free of disease. Of these 8 surgically staged CRs, 2 have suffered CNS relapses, while the rest remain free of disease. One additional patient, who had been found to have only microscopic disease at the time of second‐look surgery, subsequently relapsed in the CNS, for a total of 3 patients with CNS relapse. We conclude that PAC is an effective regimen, but that prolonged survival of these patients may put them at greater risk for CNS relapse.
Proliferative potential of cells from normal human colon epithelium, adenomas, and carcinomas of the large bowel
Authors: Agrez M. V. , Barham S. S. , Tarara J. E. , Wolff B. G. , Reiman H. M. , Ilstrup D. M. , Lieber M. M.
Published: February 2007

The proliferative potential of nonmalignant and malignant cells obtained from the human large bowel was assessed with a soft agar culture colony‐forming technique and by flow cytometry to analyze cell cycle kinetics. No colony formation occurred with samples of normal human adult colon mucosa. The absence of colony formation in all but 1 of 24 evaluable colorectal adenomas suggested that malignancy of tissue in vivo is generally necessary for colony formation to occur in soft agar cultures. A high proliferative index (S + G2/M), as assessed by flow cytometry, was significantly associated with higher soft agar culture counts in a series of 25 colorectal carcinomas.
Verrucous carcinoma of the frontal sinus: A case report and review of the literature
Authors: Newman Anita N. , Colman Marc , Jayich Steven A.
Published: February 2007

Carcinoma of the frontal sinus is rare. Treatment is controversial, and prognosis is poor, The etiology is unknown, although some risk factors for other paranasal sinus carcinomas have been identified.

A 70‐year‐old male presented with proptosis and x‐ray findings consistent with a mucocele of the frontal sinus. At operation the patient was felt to have a cholesteatoma. Pathologic diagnosis was verrucous carcinoma of the frontal sinus. The case is discussed and the literature is reviewed.
Primary malignancy of the fallopian tube: A clinical review of 13 cases
Authors: Johnston George A.
Published: February 2007

Thirteen cases of primary fallopian tube cancer are presented from The Ohio State University Hospital. The majority of these tumors were diagnosed in the advanced stage of the disease with a considerable variety in histology for a small series.

The Pap smear was quite meaningful in the diagnosis of malignancy in three of the cases; however, none of these cases was diagnosed preoperatively as a tubal primary cancer per se. A careful consideration of the history of pain, vaginal discharge, and pelvic mass is most important in making this diagnosis of tubal cancer preoperatively, along with a high index of clinical suspicion.

In our experience, the stage of the disease was the single most important factor effecting patient survival. The mode of therapy appears to be a less important factor influencing survival. Patients treated with surgery and adjuvant chemotherapy had slightly better survival than did those patients in advanced stages treated by surgery and adjuvant radiation therapy.
Microinvasive squamous carcinoma of the vulva
Authors: Yoonessi Mahmood , Goodell Thomas , Satchidanand Sateesh , Fett Wolfgang , Solis Faustino
Published: February 2007

The clinico‐pathologic aspects of 15 cases of microinvasive squamous cell carcinoma of the vulva are analyzed and the literature on this subject is reviewed. Three patients in this group and 12.5% of the 279 reported cases, all with 5 mm or less depth of invasion, have had lymph node metastases and/or recurrences or have ultimately died of their disease. The prognostic value of lymphatic/vascular permeation, the degree of cellular anaplasia, the pattern as well as the depth of invasion, all have been alluded to, and the latter is popularized. It is noted, however, that the arbitrarily chosen 3 or 5 mm depth of invasion alone does not allow for consistent identification of individuals with a negligible risk for groin lymph node metastasis. There is indeed documentation of nodal metastases in 20 of 178 (11%) of the reported cases with 1–3.5 mm invasion. It is suggested that the level of invasion, as determined by Clark's classification, which provides a histologic reference point, may correlate better with the incidence of groin nodal metastasis, and its use may allow for individualized therapy and eventually aid in identifying cases of microinvasive carcinoma of the vulva that could safely be treated without lymphadenectomy.
Epididymal metastasis from prostatic cancer
Authors: Sarma Deba P. , Weiner Marshall , Weilbaecher Thomas G.
Published: February 2007

A case of prostatic adenocarcinoma metastasizing to the epididymis is described, and the literature is reviewed.
The influence of intravenous hyperalimentation (IVH) on wound healing in tumor‐bearing rats
Authors: de Graaf Peter W. , Zwaveling Albert
Published: February 2007

Two studies were conducted to measure the metabolic influence of tumor growth in rats. Parameters for the metabolic state were wound‐healing qualities of colon and skin. Both early and later stages of tumor growth lowered wound healing qualities to a statistically significant degree. No anorexia or weight loss was found in this rat‐tumor model during the study period. Intravenous hyperalimentation (IVH; with proteins and carbohydrates) of tumor‐bearing rats stimulates tumor growth but at the same time restores wound‐healing qualities to control levels, both during early and later stages of tumor growth. It is suggested that tumor growth leads to an as yet not measurable disturbance of the metabolic equilibrium but that IVH can replenish the tumor‐bearing host and restore the metabolic equilibrium.