bluuebunny/crossref_metadata_2025 huggingface dataset:
Papillary epithelial neoplasm of the pancreas in the pediatric population
Authors: Reed Donald N. , Turcotte Jeremiah G.
Published: February 2007

Cancer of the pancreas is an uncommon entity in the pediatric population and there have been only three reports of what may be termed papillary epithelial neoplasm of the pancreas. We recently treated a young patient with this tumor, and comparison with the previously reported cases suggests a specific histologic and clinical picture, preferred treatment approach, and likely prognosis.
Radiotherapy for prostate carcinoma
Authors: Leonard Kevin , Stryker John A.
Published: February 2007

The charts of 96 patients who received radiotherapy at The M. S. Hershey Medical Center for their prostatic carcinoma were reviewed. The 4‐year NED (no evidence of disease) survival rates for patients receiving between 6500 and 7000 rad of external beam radiation (EBR) were 92, 78, 56, ant 50% for stages A, B, C, and D1, respectively. The 4‐year NED survival rate for stage B patients was 90% for those receiving approximately 6500 rad of EBR, 75% for those receiving approximately 7000 rad of EBR and 71% for those receiving interstitial implants. Bowel or urinary complications occurred in 27% 21 % grade I, 3% grade II, and 3% grade III of those receiving approximately 6500 rad of EBR, 40% (25% grade I 10% grade II, and 5% grade III) of those receiving 7000 rad of EBR, and 0% of those receiving interstitial implants. The effects of stage, grade and treatment type on NED survival and complications are discussed.
Accurate prediction of experimental cancer chemosensitivity using the subrenal capsule xenograft assay
Authors: Bennett James A. , Pilon Vernon A. , Uppal Gurvinder S. , McKneally Martin F.
Published: February 2007

The chemosensitivity of a murine lung carcinoma grown as a xenograft under the kidney capsule of a rat was compared to the chemosensitivity of this tumor grown as a spontaneous metastasis in its syngeneic host. The chemosensitivity of the tumor to intravenously or subcutaneously administered drugs determined in the short‐term xenograft assay accurately predicted the chemosensitivity of this tumor when it was growing as a spontaneous micrometastasis in its syngeneic host, indicating that in both situations the pharmacological determinants of tumor response to anticancer drugs were similar. These results suggest that tumors growing as xenografts under the kidney capsule accurately reflect the responsiveness of these tumors to chemotherapy and support further investigation of the xenograft subrenal capsule assay as a model that may be useful in predicting effective chemotherapy for human tumors.
Blood groups and malignant melanoma
Authors: Karakousis C. P. , Evlogimenos E. , Suh O.
Published: February 2007

The charts of 168 patients with malignant melanoma were reviewed with regard to the incidence of the major blood groups. Blood group A was encountered in 39.9%, Group B in 7.7%, Group AB in 3%, and Group O in 49.4%. Although blood group O had a higher frequency compared to that of the general white population of various series, the difference was not significant. Patients with blood group A had a median survival of 67.7 months whereas patients with blood group O had a median survival of 46.6 months (p = 0.04). The improved survival for blood group A remained significant only in female patients, when the sexes were considered separately. However, group A had an incidence of 24% in early Clark's lesions while that incidence in group O was 9.8%. Female patients had longer median survival (86 months) than male patients (44 months).
Peritoneovenous shunt and neoplastic ascites: A 5‐year experience report
Authors: Campioni N. , Lasagni R. Pasquali , Vitucci C. , Filppetti M. , Spagnoli A. , Pompei S. , Romano P. , Pasqualetti A. , Sorvillo G. , Sega F. M. , Manfredi D.
Published: February 2007

The cases of 42 patients with malignant ascites treated with a peritoneal venous shunt over a 5‐year period are reviewed to establish the incidence of surgical and postsurgical complications. Although the yield of malignant cells found in the peripheral blood was increased after shunting, no new hematogenous metastases were observed after the operation. No evidence of disseminated intravascular coagulation was observed after shunt placement. While the shunt effectively relieved the discomfort due to abdominal distention and respiratory impairment, no restoration of cutaneous hypersensitivity was observed in the nine patients, who were anergic prior to surgery. The median survival of patients with breast and gynecological cancer, after surgery, was significantly longer than the survival of patients with primary gastrointestinal neoplasma. In conclusion, peritoneal venous shunt appears to be an effective and safe method to improve the quality of life of patients with malignant ascites.
Inflammatory pseudotumor of the spleen
Authors: Alpern Harlan D. , Olson John E. , Kozak Alan J.
Published: February 2007

Inflammatory pseudotumor of the spleen, an extremely rare benign inflammatory mass lesion, which clinically and radiologically mimics a neoplasm, is presented. The case is compared to the two cases previously reported in the literature. Possibilities of etiology and pathogenesis are considered.
B16 melanoma in hairless mice: A model for thermographic research
Authors: Jochimsen P. R. , Folk G. E. , Sundell M. , Loh P. M.
Published: February 2007

Little is understood concerning the mechanism of tumor‐induced thermographic abnormalities observed in man. An ideal animal model is lacking. In an effort to create such a model we have worked with hairless mice, subcutaneously inoculated with B16 melanoma cells. This report documents the progress of that work and the subsequent development of a totally satisfactory system for the study of such tumors in a hairless animal.
Carcinoids: The prognostic effect of primary site histologic type variations
Authors: Johnson Lewis A. , Lavin Philip T. , Moertel Charles G. , Weiland Louis H. , Dayal Yogeshwar Y. , Doos Wilhelm G. , Geller Stephen A. , Cooper Harry S. , Masse Serge R. , Engstrom Paul F.
Published: February 2007

Carcinoids are histologically classified as insular (A), trabecular (B), glandular (C), undifferentiated (D) or mixed. These have prognostic significance, i.e. Group 1 (most favorable, A+C); 2 (favorable, A, B, A+B); 3 (relatively unfavorable, all non A+C or A+B mixed types); and 4 (unfavorable, C, D). Midgut primaries have a better prognosis than either foregut or hindgut/cloacal primaries. Carcinoids from 114 Eastern Cooperative Oncology Group patients were studied to determine if primary site prognostic differences result from histologic prognostic group occurrence rate differences across primary sites. By primary site the following rates were observed: Foregut: 1 (0%), 2 (79.2%), 3 (12.5%), 4 (8.3%); midgut: 1 (26.7%), 2(58.7%), 3 (6.6%), 4 (8.0%); hindgut/cloaca: 1 (0%), 2 (42.9%), 3 (42.9%), 4 (14.2%); nongut: 1 (0%), 2 (75.0%), 3 (12.5%), 4 (12.5%), p < 0.01. The results demonstrate that primary site prognostic differences are highly dependent upon histologic prognostic group occurrence rate variations across primary sites. In addition multivariate analysis of survivorship by both histologic type (p < 0.05) and primary site (p < 0.05) demonstrated that each variable has independent prognostic significance.
Carcinoma of the prostate with brain metastasis
Authors: Chung Tae Soo , Thannikkary C.
Published: February 2007

Brain metastasis from prostatic carcinoma is considered rare and usually is diagnosed at postmortem examination. The authors reviewed the tumor registry of 1314 patients with proven diagnosis of prostatic carcinoma seen at Hines VA Hospital from January 1963 to December 1978 and found that 8 of the 1314 patients (0.6%) had brain metastasis. Six of eight patients (75%) were diagnosed having brain metastasis at premortem and of these, two patients presented with brain metastasis before diagnosis of prostatic carcinoma was made. Two of four patients who received palliative whole brain irradiation survived more than 1.5 years. It is our belief that patients with prostatic carcinoma who have symptoms of brain metastasis should be worked up and given palliative whole brain irradiation.
Postoperative active specific immunotherapy with supportive measures in patients suffering from recurrent metastasized melanoma: Case reports of six patients
Authors: Tallberg T. , Kalima T. , Halttunen P. , Tykkä H. , Mahlberg K. , Matous B. , Sundell B.
Published: February 2007

The clinical results from postoperative active specific immunotherapy using autologous polymerized tumor material in six patients suffering from metastasized melanoma is reported. Correction of an alleged systemic deficiency leading to malignant cell transformation was attempted by administrating certain essential trace elements, amino acids, vitamins, and a diet containing lipids, extracted from the mammalian central nervous system, after heating. Vaccinations against influenza were also given as a precaution against certain viral infections sometimes seen to precede melanoma recurrence. The clinical results with this postoperative adjuvant therapy are so encouraging that we suggest that sterile tumor tissue should be saved at operation and treated to produce insoluble particles as an option for postoperative treatment of patients suffering from metastasized melanoma. Prospective randomized studies are indicated.
Thymic hyperplasia masquerading as recurrent Hodgkin's disease: Case report and review of the literature
Authors: Edincton Howard , Salwitz James , Longo Dan L. , Roth Jack A. , Pass Harvey
Published: February 2007

While the appearance of a mediastinal mass in a patient in remission from Hodgkin's disease frequently indicates recurrence, a number of benign processes may present in a similar manner. Tissue confirmation of relapse should be obtained prior to initiating further chemotherapy to avoid the morbidity of unnecessary treatment. We present a case of thymic hyperplasia that developed in a patient previously treated for Hodgkin's disease. Thymic hyperplasia is a poorly understood, apparently benign process that may be confused with recurrent lymphoma. Total excision of such a mass is recommended to rule out coexistent malignancy.
Pathogenesis and characteristics of spontaneously metastasizing mammary carcinomas and the general principle of metastasis
Authors: Kim Untae
Published: February 2007

Chemical mammary carcinogenesis in immunologically attennuated W/Fu female rats, subjected to specific and nonspecific immunostimulations, yielded many spontaneously metastasizing adenocarcinomas with varying degrees of glandular differentiation, and growth rates. The pathogenesis of these tumors suggested that while carcinogens transform target cells, the host immune system endows them with metastatic potential. The metastatic pathways were recognizable as hematogenous, lymphogenous, or hematogenous‐lymphogenous combined, according to the capacity of the tumor cells to intravasate the lymphatic and/or vascular channel and traverse the pulmonary artery. The same metastatic pattern can be reproduced with cells from any of the organs involved, indicating that it is inherent in all cells within a given tumor, rather than being determined by the organs they colonize. The biological, biochemical and Immunological characteristics of these tumors resemble human breast cancer ihus becoming an effective tool in the formulation of the general principle of metastasis by malignant solid tumors.
Giant leiomyoma of esophagus
Authors: Kramer Marshall D. , Gibb S. Peter , Ellis F. Henry
Published: February 2007

This case report of a 37‐year‐old man with giant leiomyoma details some of the problems encountered in diagnosing and treating this rare form of the disease. Initial studies at another institution were interpreted as demonstrating achalasia, and thoracotomy was later undertaken because of a mistaken diagnosis of a pericardiac mass, which led to a biopsy and a resulting esophagopleural fistula. Subsequent esophagectomy and drainage of empyema space were employed to remove the tumor, which had ulcerated and bled, as well as to drain the empyema cavity. The tumor measured 20.5 cm long and weighed 540 gm. Gastrointestinal continuity was reestablished by colon interposition, and the patient has been well for the succeeding 6 years.
Fatal metastatic cystosarcoma phyllodes in an adolescent female: Case report and review of treatment approaches
Authors: Turalba Cornelius I. C. , El‐Mahdi Anas M. , Ladaga Leopoldo
Published: February 2007

The third reported case of fatal malignant cystosarcoma phyllodes in an adolescent female is described. The patterns of local recurrence and distant spread in this case, including the response to treatment, were similar to those reported in the first reported case in this age group. A review of the treatment recommendations for cystosarcoma phyllodes revealed that the surgical procedure of choice for the malignant variant has remained controversial, and the conclusions regarding the ineffectiveness of radiation and chemotherapy have been based on insufficient data handed down through the years. Our observations in this case and the information we have obtained from the literature have prompted us to recommend a multidisciplinary approach for malignant cystosarcoma phyllodes, particularly in young women, and we are calling for a multi‐institutional study group to further investigate this disease.
Home parenteral nutrition for patients with advanced intraperitoneal cancers and gastrointestinal dysfunction
Authors: Moley Jeffrey F. , August David , Norton Jeffrey A. , Sugarbaker Paul H.
Published: February 2007

The use of total parenteral nutrition (TPN) in patients with advanced, unbeatable cancer is controversial. Occasionally, however, damage to bowel by tumor, radiation, or surgery renders these patients unable to eat and TPN may be indicated to prevent premature death from starvation. We have used Home Parenteral Nutrition (HPN) to support three patients with advanced, unbeatable abdominal cancer and inability to eat. Morbidity was minimal and survival times were 24, 6 and 1.5 months. Payment was covered by third party agencies. All patients and their families were gratified by the ability to return home with nutritional support. HPN can be used to support terminal cancer patients with bowel obstruction and may afford them longer survival. Ideally, patients considered for this should be well motivated, with good support systems, and with survival estimated to be at least months.
Palliative telecobalt—60 with concentrated dose in TNM classification T4 of the breast
Authors: Patricio M. B. , Brites C. F. , Guimaraes M. F. , De Jesus E. B. , Catita J. I. , Vilhena M.
Published: February 2007

A method is presented of rapid, palliative radiotherapy for carcinoma of the breast, composed of two sessions of 6.5 or 8.5 Gy delivered at a 48‐hour interval. The radiobiological equivalence of this unconventional technique is presented. Our preliminary results in a series of 80 patients were published in 1978. The present report is based on the analysis of 112 patients with T4 of the breast submitted to the “flash” dose, from March 1978 to December 1981. The method was used not only for relief of symptoms such as pain and hemorrhage, but also as part of intensive radiotherapy in all patients with good response and with no manifestation of distant dissemination so that they were able to resume treatment 2.5 or 3 weeks later, with conventional fractionation. Some of these patients became operable. About half of the cases had castration and/or hormone. therapy and/or chemotherapy. In the group of patients with T4M0, 59.8% were alive after more than 1 year, and of them, 43.7% had no evidence of disease. These encouraging results suggest that this method be advocated in T4 of the breast because of its rapidity and good tolerance with no significant complications.
Primary carcinoma of the fallopian tube in an adolescent
Authors: Gatto Vincent , Selim Mostafa A. , Lankerani Mohammad
Published: February 2007

Only three cases of adenocarcinoma of the fallopian tube in an adolescent have been reported previously in the literature, and we report the fourth such case. The main presenting symptom in those patients was lower abdominal pain. Type of therapy and outcome of these four cases is reviewed. The small number of patients precludes definitive conclusion on optimal therapy. For this reason, we urge continued reporting of cases to insure the formation of concrete therapeutic recommendations.
One‐stage plastic reconstruction of a totally amputated cancerous penis using a unilateral myocutaneous gracilis flap
Authors: Hanash Kamal A. , Tur Juan J.
Published: February 2007

A 36‐year‐old Saudi underwent a total penectomy for cancer involving the penile shaft with no corporeal invasion or distant metastases. One year postoperatively and in the absence of tumor recurrence or metastasis, a penile reconstruction using a right myocutaneous gracilis flap was performed. The result two years later was satisfactory, with preservation of deep penile sensation and successful weekly sexual intercourse. To our knowledge, no similar case has been reported previously.
Postchemotherapy esophagitis: The endoscopic diagnosis and its impact on survival
Authors: Auguste Louis Joseph , Nava Hector
Published: February 2007

Eighteen cancer patients receiving intensive chemotherapy developed leukopenia, fever, dysphagia, and oropharyngeal soreness. Superficial esophageal ulceration suggestive of esophagitis was demonstrated by radiographic examination in 33% of the patients (5/15). Upper gastrointestinal endoscopy revealed superficial ulceration and white mucosal patches in all patients. There was no morbidity associated with the endoscopic procedures. Sixty‐one percent of the patients (11/18) had monilia albicans cultured from the oropharyngeal cavity, and 50% (9/18) had monilia cultured from the esophageal lesions. The evolution of the esophagitis correlated well with the survival of the patients. The monilial esophagitis persisted in six patients who all died within 24 days of systemic moniliasis. After initial improvement five additional patients succumbed; three of them from severe fungal infection. There was resolution of the esophagitis in the remaining seven patients who survived longer. However, two of them had recurrent monilial esophagitis and succumbed to systemic candidiasis. The other five have remained free of esophagitis, their underlying malignancies have remained under control, and so far they have survived an average of one and a half years.

Endoscopy is more accurate than radiography in detecting postchemotherapy esophagitis. This complication can be fatal, since it is often followed by systemic candidiasis.
Primary teratocarcinoma of the lung
Authors: Stair J. Michael , Stevenson D. Richard , Schaefer Robert F. , Fullenwider John P. , Campbell Gilbert S.
Published: February 2007

Presented is the ninth reported case of teratocarcinoma arising from the parenchyma of the lung. Treatment should include wide surgical resection and adjuvant chemotherapy. Postoperative radiation therapy should be utilized if there is residual disease or nodal metastasis. Preoperative radiation therapy should be considered if there is evidence of chest wall involvement.
An alternative method for repair of a leaking arterial chemotherapy infusion catheter
Authors: Burkhalter James L , Morano James U.
Published: February 2007

Regional chemotherapy infusion via selective arterial catheterization is frequently complicated by the development of cracks or leaks within the catheter. This frequently necessitates a catheter exchange. Herein, we report an alternative, simpler method for dealing with a defect within an infusion catheter.
Primary leiomyosarcoma of the inferior vena cava: A case report and review of the literature
Authors: Griffin Andrew S. , Sterchi J. Michael
Published: February 2007

Sixty‐six cases of leiomyosarcoma of the inferior vena cava (TVC) have been reported. We present another case and review the characteristics and treatment of this rare tumor. IVC leiomyosarcomas spread by extension into adjacent tissue planes. Direct extension into the heart is known, but not into the kidneys, adrenals, or bowel. IVC leiomyosarcomas arising below the renal vein cause pain in the right‐lower quadrant, back, and flank, and varying degrees of lower extremity edema; those arising in the middle caval segment cause right‐upper‐quadrant pain and sometimes renovascular hypertension; those arising above the hepatic vein cause varying manifestations of the Budd‐Chiari syndrome. A reasonable approach to early diagnosis involves oral and intravenous contrast studies followed by computed tomography, angiography, and vena cavography. Aggressive surgical treatment is optimal in light of the tumor's slow growth pattern and relatively low malignant potential. (Metastases have been reported in fewer than 50% of cases.) Tumors involving the lower IVC are most amenable to surgery; extensive collateral venous drainage of the left kidney preserves renal function during resection of middle caval tumors. Upper caval leiomyosarcomas are the least amenable to complete removal. Postoperative survival of all patients has ranged from a few weeks to eight years.
Primary malignant melanoma of the lung
Authors: Alghanem A. A. , Mehan J. , Hassan A. A.
Published: February 2007

A case of primary malignant melanoma of the lung in a 42‐year‐old white female is presented. A 6 cm localized mass in the left lower pulmonary lobe was discovered on a thoracic spine X‐ray done for unrelated chronic back pain. The patient underwent left lower lobectomy for cure. Multiple detailed physical examinations did not disclose any primary lesions. Other cases from the English literature are reviewed briefly.
Changes in survival with clinical stage I malignant melanoma
Authors: Karakousis C. P. , Kachrimanidis S. , Rao U. , Emrich L. J.
Published: February 2007

Inclusion of patients referred to our cancer center following recurrence, by retracing the history and characteristics of these patients back to when they were in stage I, produced a bias that lowered the estimated disease‐free survival rates. However, taking into consideration only patients referred and managed in our center when they had clinical stage I melanoma, significant differences in disease‐free survival over time were revealed <P = 0.03). Thus, the estimated five‐year disease‐free survival rate for 86 patients treated in the period 1971‐75 was 65%, whereas that from 115 patients treated in the period 1976‐80 was 81%. There was no significant increase in disease‐free survival for patients who had an elective node dissection in addition to wide excision.
Intracaval extension of pheochromocytoma simulating pulmonary embolism
Authors: Dicke Timothy E. , Henry Mitchell L , Minton John P.
Published: February 2007

Pheochromocytoma, a chromaffin tumor of the sympathoadrenal nervous system, rarely exhibits direct extension into the inferior vena cava. We report a patient with a right adrenal pheochromocytoma that caused symptoms of recurrent pulmonary emboli. Intracaval extension of the tumor was detected during investigations for the source of the emboli by abdominal CT scan, ultrasonography, and venocavagraphy. The biochemical diagnosis of pheochromocytoma was confirmed by sharply elevated catecholamine, metanephrine, and VMA urinary levels, which returned to normal upon resection of the rumor. The patient had no evidence of metastatic disease.
Response of advanced breast cancer to total endocrine ablation after exacerbation on tamoxifen: Results in seven patients and possible mechanism of action
Authors: Hartley Jack W. , Wong Jan , Fletcher William S.
Published: February 2007

Usage of tamoxifen in the treatment of advanced breast cancer is increasing and is advocated by some authors as primary therapy in all estrogen receptor positive cancer patients. Tamoxifen is an incomplete estrogen antagonist with partial estrogen agonist activity as well. Tamoxifen‐in‐duced exacerbation of breast cancer (“tamoxifen flare”) is reported to occur in 4‐20% or more of treated patients. Management of this condition has varied from stopping treatment to continued administration or reinstitution of tamoxifen after flare symptoms subside. Responses have occurred in some patients so treated, although the remissions do not appear durable. The seven patients with advanced breast cancer in this report experienced disease exacerbation with tamoxifen therapy. Endocrine ablation afforded all patients excellent pain relief and disease control with prolonged survival in six of the seven. There have been no studies directly examining the disease course in flare patients continuing on tamoxifen. Persistence in treating these patients with an incomplete antagonist‐agonist may deprive them of full survival benefit possible through ablative procedures when used in sequential treatment.
Granulomatous reactions in mycosis fungoides
Authors: Dabski Krzysztof , Stoll Howard L.
Published: February 2007

Granulomatous reaction characterized by the formation of noncaseating accumulations of epithelioid histiocytes and multinucleated giant cells of the foreign‐body type is a rare, poorly understood, and generally ignored phenomenon seen in various types of lymphoma. Its presence in cutaneous infiltrates of mycosis fungoides is equally unusual, but some favorable prognostic significance has been ascribed to it previously. In this paper, four patients with typical mycosis fungoides and granulomas demonstrated histologically in their cutaneous infiltrates are presented. All four died of disseminated disease with evidence of central nervous system involvement in three of them. These clinical histories lend no support to the notion that granulomatous mycosis fungoides is a benign variant of this lymphoma. Relevant literature is reviewed and discussed.
Wound healing in sarcoma‐bearing rats: Tumor effects on cutaneous and deep wounds
Authors: Lawrence W. Thomas , Norton Jeffrey A. , Harvey Anita K. , Gorschboth Catherine M. , Talbot Thomas L. , Grotendorst Gary R.
Published: February 2007

Many surgeons think that cancer causes a higher incidence of wound complications. Wound healing was examined in a cutaneous and deep model in control and sarcoma‐bearing rats to evaluate this concept. In a dorsal incisional wound, a significant decrease in wound breaking strength was observed from 19 days after tumor implantation onward. The amount of the breaking strength deficit increased with the size of tumor and the day post‐tumor implant. In a deeper wound chamber, hydroxyproline levels, 3H‐thymidine incorporation into DNA, histology, and collagen types were examined, and tumor produced no significant change in any parameter. The presence of tumor appeared to inhibit wound healing in cutaneous wounds but had no apparent effect on deeper wounds. This difference in healing in the two wound models is important to surgical oncologists. Because there is no demonstrable tumor‐induced healing deficit in deep wounds, cancer‐bearing organisms probably still heal these wounds normally.
Mastectomies for malignancy: A DRG‐based hospital utilization analysis
Authors: Bredenberg Patricia A. , Lagoe Ronald J.
Published: February 2007

The study identified hospital utilization patterns by diagnosis‐related group (DRG) produced by mastectomies for malignancy in Sacramento, California, and Syracuse, New York, for the years 1981‐1984. A total of 3,449 discharges were included. Total and subtotal mastectomy discharges per capita increased in both areas. The proportion of mastectomy discharges attributed to total mastectomies increased in Sacramento and decreased in Syracuse. Mean stays for mastectomy DRGs declined by 13.72 to 56.38%. In 1984 mean stays ranged from 4.79 to 7.49 days for total mastectomies and 1.88 to 5.44 days for subtotal mastectomies. A major problem identified by the study was the lack of DRG sensitivity to differences in types of procedures. Under DRGs, radical and simple mastectomies are combined in one type of cateogry, while subtotal mastectomies, quadrant resections, and breast biopsies are combined in another.
Epidemiology and clinical characteristics of testicular tumors in Saudi Arabia: King Faisal specialist hospital and research centre experience
Authors: El‐Senoussi Mohamed A. , Bissada Nabil K. , El‐Akkad Salah , Bedikian Agop Y. , Morcos Rafik , Bull Colin
Published: February 2007

The data on 62 patients with germinal testicular tumors seen at King Faisal Specialist Hospital and Research Centre between January 1977 and June 1983 were analyzed to determine the epidemiologic and clinical characteristics of the disease in Saudi Arabia. Fifty‐seven patients were Saudis. The geographic distribution of Saudi patients seemed to coincide with population concentrations. Testicular seminomas (TS) and non‐seminomatous testicular tumors (NSTT) comprised 50% each. The mean age was 41 and 27.8 years for TS and NSTT, respectively. Fifteen patients had cryptorchidism of the involved testicle. Three patients with NSTT had a history of trauma to the involved testicle. The most common presentations were painless testicular swelling (51.6%), painful swelling (16%), and abdominal or inguinal swelling (21%). The delay between the onset of symptoms and referral (mean 15 months) was considerable. Eighty percent of patients with NSTT and 45 % of those with TS had advanced disease at referral.
Pediatric infiltrating lipomas: Case report and review of the literature
Authors: Winkler Martin , Petrelli Nicholas , Cohen Arthur
Published: February 2007

A case of pediatric infiltrating lipoma and a collected literature review of four pediatric patients with well‐documented infiltrating lipomas are presented. These lesions tend to recur after resection but there are no reported incidences of distant metastases or degeneration into frankly malignant lesions. Treatment consists of excising the lesion with a margin of normal muscle.
Localized deep hyperthermia increases the traffic of lymphocytes through peripheral lymph nodes of sheep in vivo
Authors: Moore Thomas C. , Nur Khalid , Storm F. Kristian
Published: February 2007

The production of localized deep hyperthermia by the radio frequency wave magnetic‐loop induction method has been utilized to study the effects of deep hyperthermia on lymphocyte traffic in sheep in vivo. Deep hyperthermia has been applied both to primary peripheral lymph node drainage areas alone (popliteal and prefemoral) and directly over the study lymph node (popliteal). Deep tissue core temperatures were monitored in all studies and the findings were correlated with alterations in the levels of lymphocyte outputs into study node efferent lymph and the volume of efferent lymph flow. In all of 32 studies, there was a prompt and sharp increase in the output of lymphocytes into efferent lymph at 40‐43 °C. Efferent lymph flow also was increased promptly but to a lesser degree than the output of lymphocytes. The two were not closely correlated. High deep temperature in the nodal area (45 °C) appeared to cause delayed nodal malfunction, which depressed lymphocyte output but did not affect lymph flow. Localized deep hyperthermia is an effective and noninvasive means for the local increase of lymphocyte traffic and lymph flow and may prove to be a useful means for the evaluation of the immunological consequences of altering both deep tissue temperature and lymphocyte traffic.
Anesthesia for intraoperative radiation therapy in children
Authors: Friesen Robert H. , Morrison John E. , Verbrugge Joseph J. , Daniel William E. , Aarestad Norman O. , Burrington John D.
Published: February 2007

Intraoperative radiation therapy (IORT) is a relatively new mode of cancer treatment which is being used with increasing frequency. IORT presents several challenges to the anesthesiologist, including (1) patients who are debilitated from their disease or chemotherapy, (2) operations involving major tumor resections, (3) intraoperative interdepartmental transport of patients, and (4) remote monitoring of patients during electron beam therapy. This report discusses the anesthetic management of ten children undergoing IORT. With adequate preparation and interdepartmental communication, complications can be avoided during these challenging cases.
Hepatic adenoma within a spindle cell carcinoma in a woman with a long history of oral contraceptives
Authors: Grigsby P. , Meyer J. S. , Sicard G. A. , Huggins M. B. , Lamar D. J. , Deschryver‐Kecskemeti K.
Published: February 2007

The case of a young woman is presented who had a long history of oral contraceptive use and who was found to have a focal hepatic adenoma within a large spindle cell carcinoma of the liver. The pleomorphic tumor is positive for keratin and α1‐antitrypsin by immunohistochemistry, has intracellular lumina by electron microscopy, a moderately high thymidine labeling index, and is negative for estrogen and progesterone receptors. A review of the literature concerning liver tumors occurring in young patients indicates that there is an underlying disturbance of the hormonal milieu in all instances reported. The prognosis is widely variable and unpredictable.
Conservative surgery in zollinger‐ellison syndrome: Report of a case with an eight‐year follow‐up
Authors: Michowitz M. , Lazebnik N. , Noy S. , Baratz M.
Published: February 2007

The patient described here, with malignant non‐beta islet cell tumor of the head of the pancreas, was treated by resection of the tumor and metastases. Additional pathology of perforated duodenal ulcer and pyloric stenosis required vagotomy and pyloroplasty. The maintenance of normal gastrin levels after the operation indicates a good prognosis. We believe that the low‐risk Zollinger‐Ellison patient should be treated surgically and the tumor removed. When no tumor can be detected, parietal cell vagotomy should be performed to assist the pharmacological control of the gastric acid hypersecretion. Extensive surgery, such as total gastrectomy, is no longer the treatment of choice and is reserved for the so‐called “Cimetidine failure.”
Sequential elaboration of lymphocyte‐enhancing and ‐suppressing factors in the sera of tumor‐bearing animals
Authors: Wile Alan G. , Cohen Robert A. , Terem Theresa M. , Contino Michael F. , Kar Rita
Published: February 2007

Serum‐mediated impairment of lymphocyte function was studied in an animal model. Sprague‐Dawley rats inoculated intraperitoneally or subcutaneously with the Walker 256 carcinoma underwent sequential sampling of blood. The effect of these serum samples upon phytohemagglutinin‐induced blastogenesis of normal rat splenocytes was monitored in an assay utilizing incorporation of (3H)‐thymidine. The effect of serum samples from both the subcutaneously and the intraperitoneally inoculated tumor‐bearing animals was biphasic. Early on, serum enhanced blastogenesis and later suppressed blastogenesis. Separation of sera into high and low molecular weight components by ultrafiltration demonstrated the enhancing activity to reside in the high molecular weight fraction. The enhancing activity of sera decreased over time from tumor inoculation. Conversely, suppressor activity increased over time from tumor inoculation. This study demonstrated that suppressor activity of sera obtained from animals with advanced tumors is the result of the lack of enhancing activity coupled with the elaboration of suppressor activity.
Primary liver cancer in a referral hospital in Hawaii
Authors: Geer Deborah A. , Lee Yeu‐Tsu Margaret , Brooks Viola P. , Berenberg Jeffery L.
Published: February 2007

This is a retrospective review of 43 patients who had primary liver cancer diagnosed during 1974‐1983. Patients' ages ranged from 27 to 84 years (median 52.5). Nine of 39 patients with hepatoma were females, while two of the four patients with cholangiocarcinoma were women. Hepatitis surface antigen was positive in 90% tested, and 62% had cirrhosis. Also, 60‐65% were heavy users of alcohol and cigarettes. Alpha‐fetoprotein was elevated in one of four white patients, and in six of eight patients of other races (75%). Tissue diagnosis was obtained by peritoneoscopy in 16, by percutaneous biopsy in 7, by laparotomy in 9, and at autopsy in 11. Only one of 11 patients who were explored has his lesion resected. About half of the cases diagnosed antemortem died 1 month or less after diagnosis. The median survival of hepatoma patients who had no specific treatment or systemic chemotherapy was 2 months. Two patients who received chemotherapy in conjunction with occlusion of the hepatic artery lived 16 to 19 months.
Right and left colon carcinoma: A retrospective comparative study
Authors: Kashtan Hanoch , Werbin Nahum , Aladjem David , Barak Yoram , Wiznitzer Theodore
Published: February 2007

We studied 347 patients with primary colorectal carcinoma treated by surgery during 1973‐1983: 64 (18.2%) with right colon carcinoma, 158 (45.7%) with left colon carcinoma, 14 (4.2%) with transverse colon carcinoma, and 110 (31.9%) with rectal carcinoma. We compared the right‐sided carcinoma (RSC) and left‐sided carcinoma (LSC) groups. Obstruction was found in 17.2% of RSC compared with 20.3% LSC patients (P > 0.05). Advanced disease (Dukes stages C and D) was found in 34.4% on the right and 47.8% on the left side (P = 0.01). Crude 5‐year survival rate, by life table method, was 71% on the right and 66% on the left side (P > 0.05); this difference became significant (P = 0.03) when Dukes stage B patients were compared. We conclude that patients with RSC are not diagnosed, as is commonly believed, at advanced stages of the disease. We found that the 5‐year survival rate of RSC patients was the same or, occasionally, better than that of LSC patients.
Needle aspiration cytologic diagnosis of metastatic malignant melanoma of unknown primary origin: Report of a case and review of the literature
Authors: Eftichiadou Chariclea , Vartholomeos Anastasios , Salem Nicolaos , Destouni Evangelia , Apostolidis P.
Published: February 2007

A rare case of metastatic malignant melanoma of unknown primary origin in a 49‐year‐old woman is reported. The swelling, localized in the right inguinal region, was partially immovable and associated with propgressively increasing pain. Initial diagnosis was set by needle aspiration cytology and was confirmed postoperatively by histologic examination of a surgical specimen. Cytomorphologic features of metastatic malignant melanomas are described and the difficulties of identification discussed. A brief review of the literature is also made, and the rarity of the case and the value of cytologic diagnosis are emphasized.
Short‐term prophylaxis with cefuroxime in colorectal surgery for cancer
Authors: Colizza S. , De Fazio S. , Addari A. , Grande R. , Cucchiara G.
Published: February 2007

A controlled study of short‐term prophylaxis with cefuroxime was performed on a group of 52 patients with colorectal neoplasms who underwent elective surgery. The patients were divided into two groups, A and B. Group A received the antibiotic immediately before surgery, intraincisionally and immediately after the end of operation; group B was treated only postoperatively. Each patient received a total of 5,250 mg of cefuroxime. Wound sepsis was demonstrated in 11.5% of cases of group A and 23.0% of group B (P < 0.01); another type of sepsis was observed in 34% of group A and 11.5% of group B (P < 0.001). There was no difference in the operative mortality in the two groups.
Somatostatinoma: A case report and review of the literature
Authors: Harris Gary J. , Tio Fermin , Cruz Anatolio B.
Published: February 2007

Somatostatinomas are rare endocrine tumors that were first described in 1977. In addition to the present case report, there have been 31 cases reported in the literature. We have reviewed the literature to integrate the symptoms, physical findings, diagnostic tests, treatment, and length of survival of these patients. Although the symptoms that occurred in the majority of cases were those that are seen in most patients with intra‐abdominal neoplasms, symptoms relating to the presence of excess circulating somatostatin—diabetes, maldigestion, and cholelithiasis—were frequently seen. Physical findings and the results of diagnostic tests were usually nonspecific. The majority of the patients underwent radical surgical procedures (Whipple procedure or pancreatic resection). The pancreas was the most frequent site of involvement (21/31 cases), but primaries in the duodenum, ampulla of Vater, cystic duct, and jejunum have been described as well. Metastases were most frequently seen in the liver and lymph nodes. Chemotherapeutic agents were administered to 10 patients, usually as adjuvant therapy, and appear to be useful in treating recurrent and metastatic disease. The one‐year survival of these patients is 48%, which is better than that for patients with carcinoma of the pancreas or biliary tree. Therefore, it is important that the diagnosis of somatostinoma be made so that the patient may be treated accordingly and followed by serial somatostatin levels for evidence of metastasis or recurrent disease.
Intraoperative interstitial hyperthermia in conjunction with intraoperative radiation therapy in a radiation‐resistant carcinoma of the abdomen: Report on the feasibility of a new technique
Authors: Merrick Hollis W. , Milligan Andrew J. , Woldenberg Lee S. , Ahuja Rajender K. , Dobelbower Ralph R.
Published: February 2007

The application of a new technique of intraoperative interstitial hyperthermia (IOHT) and intraoperative radiation therapy (IORT) was investigated for unresectable abdominal carcinoma. A 43‐year‐old white male presented with severe back pain due to metastatic adenocarcinoma in the left paravertebral area, producing erosion of the body of T12. The disease had not responded to external beam radiation therapy. The tumor was approached through a thoraco‐abdominal incision and IOHT was delivered via interstitial electrodes. Temperature was monitored at 16 locations within the tumor. An LCF hyperthermia unit was utilized to deliver RF power and produced a treatment temperature of 43°C for 60 minutes uniformly throughout the treatment volume. Immediately following hyperthermia treatment, the lesion was treated with 15 meV electrons via IORT to a tumor dose of 25Gy. The patient recovered without complication and had complete relief from pain. Posttreatment CT scans have demonstrated control of disease over a 5‐month follow‐up period. A clinical pilot study has been established to further investigate the application of this combination therapy.
Benign mixed tumor (pleomorphic adenoma) of the breast: Ultrastructural study and review of the literature
Authors: Cuadros C. Luis , Ryan Stephen S. , Miller Robert E.
Published: February 2007

A patient is presented with a benign mixed tumor (pleomorphic adenoma) of the breast. There are 11 well‐documented cases of this rare breast neoplasm. It is histologically and ultrastructurally identical to that seen in the salivary gland and follows a similar benign course. A central role of the ductal myoepithelial cell is proposed for the histogenesis of this tumor.
Survival of operated bronchus carcinoma patients: A prospective study
Authors: Kayser K. W. , Bülzebruck H. , Merkle N. , Vogt‐Moykopf I.
Published: February 2007

Maximum diameter, tumour volume, and inflammatory response of host tissue in 282 surgical specimens with primary carcinoma of the bronchus were measured. Cell type, pT‐ and pN‐stage, maximum diameter and volume of the primaries, and inflammatory response of host tissue were analyzed in respect to survival of the patients. Date of death was evaluated by quarterly communications with the house physicians. Survival rates were computed by use of Kaplan‐Meier estimation. Mean survival of all patients was calculated at 480 days. Lymph node involvement and tumour volume were found to have a major influence on survival. In accordance with the weak contribution of maximum diameter of the tumour to survival, no major differences in survival between pT1‐ and pT2‐stage were found. If severe inflammatory response at the tumour boundary was noted, patients showed slightly increased survival in all tumour stages. Cell type and tumour grading were found to be of minor influence in respect to survival.
Two‐stage operation for poor‐risk patients with carcinoma of the esophagus
Authors: Sugimachi Keizo , Kitamura Masayuki , Maekawa Sohichiro , Matsufuji Hidemasa , Kai Hidenobu , Okudaira Yasuyuki
Published: February 2007

We have devised a two‐stage operation for poor‐risk patients with carcinoma of the thoracic esophagus. The first‐stage operation consists of a right thoracotomy, subtotal esophagectomy, and lymph node dissection. Two to three weeks later, the second‐stage operation of esophageal reconstruction with gastric tube is performed under laparotomy. During this 3‐week period of no esophagus, the nutritional status can be adequately maintained by intravenous hyperalimentation. We describe herein the technique, postoperative complications, and mortality of our two‐stage operation as compared with events during an ordinary one‐stage operation for carcinoma of the thoracic esophagus.
Primary adenocarcinoma of the appendix: Report of five cases and review of the literature
Authors: Ben‐Aaron U. , Shperber J. , Halevy A. , Negri M. , Bogokovski H. , Orda R.
Published: February 2007

Five patients with primary adenocarcinoma of the appendix are reported. All patients presented with symptoms resembling those of acute appendicitis or periappendicular abscess. In none of them was malignancy suspected prior to operation. It is advisable that every patient above 50 years of age presenting with symptoms of appendicitis undergo laparotomy, thus enabling a better exploration of the cecal region. If an appendiceal mass is present and frozen section shows malignancy, a right hemicolectomy should be performed. The prognosis of adenocarcinoma of the appendix is dismal as most patients present with an advanced stage of the disease.
Management of endoscopically removed malignant colon polyps
Authors: Conte Charles C. , Welch John P. , Tennant Robert , Forouhar Faripour , Lundy Joel , Bloom G. Peter
Published: February 2007

The medical records of 87 patients with 89 malignant colorectal polyps removed endoscopically between 1971 and 1983 were reviewed retrospectively. Fifty‐five polyps contained carcinoma‐in‐situ. Four polyps had “pseudo‐invasion” by displaced mucosal glands. Thirty polyps contained invasive carcinoma. No patients with carcinoma‐in‐situ or “pseudo‐invasion” had either local residual disease or metastatic disease at the time of colectomy or which was detected during subsequent follow‐up. Four patients (14%) with invasive cancer would have been inadequately treated by polypectomy alone, since one had residual disease at the polypectomy site, one had nodal metastases, one had liver metastases at the time of colectomy, and one subsequently developed liver metastases. Three histologic criteria correctly predicted all four cases where residual or recurrent disease was present: involvement of the polypectomy resection margin, lymphatic invasion within the polyp, and poorly differentiated histology. Polyp size, histology (villous adenoma, adenomatous polyp, or villo‐adenomatous polyp), or anatomic location did not identify those patients who warranted further therapy. We conclude that polypectomy alone is adequate treatment for polyps containing carcinoma‐in‐situ. Polypectomy alone is also adequate treatment for most polyps containing invasive carcinoma. However, patients with lymphatic involvement within the polyp, poorly differentiated cancer, or resection margin involvement should probably undergo colectomy.