bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term ambulatory treatment of metastatic colorectal adenocarcinoma by continuous intravenous infusion of 5‐fluorouracil
Authors: Quebbeman E. , Ausman R. , Hansen R. , Becker T. , Caballero G. , Ritch P. , Jenkins D. , Blake D. , Tangen L. , Schulte W.
Published: February 2007

To delineate the efficacy of continuous intravenous 5‐fluorouracil (5‐FU) infusion therapy for advanced colorectal adenocarcinoma, a study of 36 patients with measurable metastatic disease was conducted. Patients received a daily intravenous infusion of 300 mg/m2 5‐FU over a 24‐h period utilizing portable infusion devices and central venous catheters. In a population characterized by substantial pretreatment exposure to radiotherapy, chemotherapy, and other indicators of poor prognosis, 13/36 (36%) patients achieved an objective response. An additional 10/36 (28%) patients manifested stable disease (no change) and experienced survival comparable to. that of patients with objective response. Toxicity was minimal; patients were able to continue 5‐FU infusions 95% of the total time on protocol. There were no adverse hematologic effects or catheter complications. Because previously untreated patients benefited more frequently (positive response, 50%), continuous intravenous infusion should be evaluated further as a primary modality option when 5‐fluorouracil antitumor chemotherapy is contemplated.
Hemicorporectomy
Authors: Aust J. Bradley , Page Carey P.
Published: February 2007

Translumbar amputation (hemicorporectomy) was first successfully performed in 1961 after cadaver feasibility dissections. It is useful for certain slow‐growing malignancies of the pelvis and perineum and for patients with advanced sepsis involving pelvic bony structures. As indicated by our 20‐year experience, the operation may be rewarded by control of a malignant process (two patients) and/or relief from chronic pelvic sepsis (four patients), survival and discharge from the hospital after lengthy rehabilitation (six patients).
Spontaneous retroperitoneal hemorrhage secondary to a renal cause
Authors: Drago Joseph R. , York Jeffrey P. , Dagen J. Edward , Rohner Thomas J.
Published: February 2007

Spontaneous rupture of normal renal parenchyma must indeed be rare. Virtually all patients in this paper had a significant abnormality that presented with bleeding.

Our Case 5 is the only one without a clear underlying pathologic entity. We should stress the high incidence of associated disease in kidneys that bleed “spontaneously” and therefore the need for exploration and/or nephrectomy.
Seminoma arising in undescended testis clinically presenting as acute appendicitis
Authors: Sarma Deba P. , Weilbaecher Thomas G. , Hatem Ali A.
Published: February 2007

A 48‐year‐old man with a clinical diagnosis of acute appendicitis on exploration was found to have a seminoma in an undescended pelvic testis. The tumor had directly invaded the retrocecal appendix, causing acute appendicitis. Such a highly unusual occurrence has not been described in the English literature.
Malignant fibrous histiocytoma of the larynx
Authors: Godoy Jose , Jacobs John R. , Crissman John
Published: February 2007

Malignant fibrous histiocytomas of the upper respiratory tract are rare, aggressive, mesenchymal neoplasms. There have been sporadic cases reported in the English language literature. This paper reports the case of a subglottic malignant fibrous histiocytoma in a 26‐year‐old female. A review of the important clinical‐pathological features of this type of tumor is presented. The treatment of choice appears to be wide surgical resection of the tumor. Although the published experience is small, it appears that tumors of the subglottic space are characterized by a younger patient population and a better prognosis than those of the larynx.
Spindle cell mucoepidermoid carcinoma of submandibular gland
Authors: Love Gordon L. , Sarma Deba P.
Published: February 2007

A malignant tumor of the submandibular gland was found to consist predominately of spindle cell elements that initially suggested a primary sarcoma. Further examination revealed that the spindled malignant cells were derived from a high‐grade mucoepidermoid carcinoma.
Massive hemoperitoneum secondary to spontaneous rupture of hepatic metastases: Report of two cases and review of the literature
Authors: Urdaneta Luis F. , Nielsen Jeffrey V.
Published: February 2007

Two cases of massive hemoperitoneum secondary to spontaneous rupture of hepatic metastases are presented. This devastating complication of hepatic malignant disease is difficult to diagnose preoperatively. However, the diagnosis should be considered in patients with known malignant disease who present with unexplained blood loss, shock, or signs consistent with an acute surgical abdomen. The presence of fever and leukocy‐tosis with these signs and symptoms may also be part of the clinical picture. Treatment by hepatic resection is never curative. Review of the literature indicates that local control of the bleeding site by suture ligature, packing with topical hemostatic agents, or hepatic artery ligation offers the best chances of obtaining hemorrhage control and some degree of palliation in these desperately ill patients.
Cervical lymph node metastases of oral carcinoma related to the depth of invasion of the primary lesion
Authors: Thompson Stevan H.
Published: February 2007

Squamous cell carcinoma of the tongue has been found to have a greater frequency of cervical metastases on initial examination than lesions affecting other oral sites. This study analyzes a sample of 21 pathological specimens of oral carcinoma and block neck dissections relating the confirmed historical presence of cervical metastasis to the depth of invasion of the primary lesion. Tongue carcinomas were compared with lesions affecting other oral sites. An arbitrary anatomical levelling system was devised to assess the depth of invasion. Tongue carcinomas show a propensity to infiltrate more deeply than lesions affecting other oral sites. For the entire sample, carcinomas infiltrating the superficial lamina pro‐pria occurred much less frequently than lesions showing a deeper infiltration pattern. Overall, lesions infiltrating the deep lamina propria do not exhibit a reduced frequency of occurrence compared to lesions infiltrating me skeletal muscle; however, carcinomas affecting other oral sites showed a reduced frequency of deeply infiltrating lesions in comparison to more superficial lesions. Carcinomas confined to the superficial lamina propria seem to have a better prognosis in relation to developing cervical metastases, and this does not appear to be influenced by age, sex, site, size or degree of differentiation.
Malignancy and differentiation of neoplastic epithelial cells of thymoma
Authors: Monden Yasumasa , Tanioka Tsuneo , Maeda Masazumi , Masaoka Akira , Nakahara Kazuya , Kawashima Yasunaru , Kitamura And Hajime
Published: February 2007

Fifteen fetal thymuses and 100 thymomas were examined concerning the degree of differentiation of thymic epithelial cells by light and electron microscopy. The following results were obtained. 1) The embryologic process of the fetal thymus was categorized into four stages (8, 12, 15, and 17 weeks or more of gestation) based on the morphological features of epithelial cells and the maturity of thymic tissues. (2) Thymomas were classified into the undifferentiated, and poorly, moderately, and well‐differentiated types by their morphological features in comparison with the fetal thymuses. The incidences of the respective types in the 100 thymomas were 5, 16, 68, and 11 cases. (3) The moderately differentiated type was divided into three subtypes; namely, polygonal cell (49 cases), clear cell (6), and spindle cell type (13). (4) The degree of differentiation of the thymomatous epithelial cells showed strong correlations with both the invasiveness and the prognosis of the thymoma. The ratios of invasive thymomas were 36, 47, 25, and 100% for the well‐differentiated, moderately‐differentiated, poorly‐differentiated, and undifferentiated types, respectively. The 10‐year survival rates were 87.5, 62.5, 46.9 and 0% for the well‐differentiated, moderately‐differentiated, poorly‐differentiated, and undifferentiated thymomas.
Technical aspects of resection of pelvic tumors
Authors: Karakousis Constantine P.
Published: February 2007

Tumors in the greater or lesser pelvis with lateral fixation present difficulties in their resection due to inadequate exposure distally. Two illustrative examples of such tumors, of a total of 26 pelvic tumors, suggest that resection of tumors in the pelvis with lateral fixation is facilitated with the use of the abdominoinguinal incision, ligation of one or both internal iliac arteries, and dissection at clean planes away from the tumor surface.
Monitoring the histogenesis of colonic tumors in the Sprague‐Dawley rat
Authors: Rubio C. A. , Nylander G. , Wahlin B. , Sveander M. , Duvander A. , Alun M.‐L.
Published: February 2007

A total of 306 male Sprague‐Dawley rats, injected with dimethylhydrazine (DMH), dose 21 mg/kg body weight s.c, were investigated. Of the 109 rats receiving the dose once only, seven colonic adenocarcinomas developed; all seven (100%) were seen to originate in discrete lymphoid patches. Of the 97 rats treated with one dose/week for 3 months, only 6% of the 50 adenocarcinomas developed in discrete lymphoid patches, while 46% were seen to originate in a pre‐existing adenoma. Of the remaining 100 rats, receiving one dose/week for 6 months, only 3.5% of the 57 adenocarcinomas arose from discrete lymphoid patches; 43.9% arose from a pre‐existing adenoma. Thus, the histogenesis of adenocarcinomas at our laboratory appears to be dose‐dependent. Experiments are therefore being designed to monitor in detail the events of these two histogenetically different adenocarcinomas in the colonic mucosa in our animal model.
Survival and locations of recurrence following abdomino‐perineal resection for rectal cancer
Authors: Danzi M. , Ferulano G. P. , Abate S. , Dilillo S. , Califano G.
Published: February 2007

Records of 134 patients treated by abdomino‐perineal resection (1971–1979) were reviewed. One hundred and thirteen had curative operations. Mortality was 2.6% and morbidity was 51 %. Ninety‐three were evaluable and were followed for 5 to 8 years; they were evaluated for survival and pattern of recurrence. Five‐year survival for Dukes' A,B,C, and D lesions was 86,62,31, and 0%, respectively. Thirty‐seven had recurrence: Four pelvic, nine pelvic and distant, and 24 only distant lesions. The overall incidence of failures was 47 %, failure rates by stage were 11 % for stage A, 27% for B, 48% for C, and 70% for D. Incidence of local recurrence was significantly higher in stage C compared to stage B. Irrespective of stage, after detection of local or distant recurrence, survival did not differ. Furthermore, radiotherapy for local recurrence and chemotherapy for distant lesions did not improve survival time.
Endobronchial metastasis of renal cell carcinoma
Authors: Noy Shlomo , Michowitz Moshe , Lazebnik Noam , Baratz Mimi
Published: February 2007

Endobronchial metastasis from nonpulmonary carcinoma is rare. A case of metastatic renal cell carcinoma is presented and the literature reviewed. Severe haemoptysis was the initial symptom leading to the finding of a bronchial polypoid mass.
A misleading flow cytometric analysis of dna in an adenocarcinoma: A comparative flow cytometric and cytogenetic study
Authors: Lee Greta M. , Youngberg George A.
Published: February 2007

A case is presented in which flow cytometric and cytogenetic analysis was done on a biopsy from a highly anaplastic metastatic adenocarcinoma. Flow cytometric analysis of DNA content failed to show a significant population of aneuploid cells. However, histologic examination revealed a substantial number of tumor cells, and cytogenetic analysis produced chromosome counts ranging from 20 to 144.
Effect of fractionated irradiation prior to conservative and radical surgery on therapeutic gain in a spontaneous fibrosarcoma of the C3H mouse
Authors: Todoroki Takeshi , Suit Herman D.
Published: February 2007

The efficacy of fractionated irradiation given preoperatively was examined using early generation isotransplants of a spontaneous fibrosarcoma (FSaII) growing in the right leg of syngeneic C3Hf/Sed mice and employing as endpoints local tumor control probability, normal tissue damage (5 mm leg shortening), and distant metastasis. Complete dose response assays have been performed on small (4–5 mm) and large (8 mm) tumors. TCD50s (the dose that on average would be expected to control half the irradiated tumors) for radiation given in five equal doses (1 day between treatments) were 93.6 and 111.8 Gy for the 4–5 and 8‐mm tumors, respectively. Surgery was performed under a dissecting (8×) microscope at 5–6 days after the completion of irradiation. For small tumors, radical (en bloc) and conservative (local) resection alone achieved 69.8 (30/43) and 21.9% (7/32) tumor control, respectively. The corresponding figures for large tumors were 25 (8/32) and 6.1 % (2/33), respectively. Preoperative irradiation increased tumor control rate up to 100% at dose levels much lower than TCD50 for radiation alone. Enhancement ratios (ER) were computed for preoperative radiation as follows: TCD50 for radiation alone/TCD50 for radiation and surgery. ERs were computed for local and en bloc resection for tumor control and for leg shortening. From these ER values, therapeutic gain factors (TGF) were then computed for local and en bloc resection for tumor control and for leg shortening. From these ER values, therapeutic gain factors (TGF) were then computed as ER tumor response/ER leg shortening. In small tumors, the TGFs (TCD80 and legshortening of 5 mm) were 2.1 and 2.0 for conservative and radical resection, respectively. Corresponding figures for large tumors were 1.5 and 1.5. In this experimental system for small and large tumors, radiation treatment prior to conservative surgery achieved a comparable therapeutic gain to that by combining radiation with radical surgery. No effect of preoperative fractionation on the frequency of distant metastasis was observed.
Needle biopsies in breast cancer diagnosis: Techniques in search of an audience
Authors: Smeets Harm J. , Saltzstein Sidney L. , Meurer William T. , Pilch Yosef H.
Published: February 2007

Fine‐needle aspiration cytology and Tru‐cut needle biopsy have been described as excellent techniques in the diagnosis of breast cancer. Responses to questionnaires sent to 90 pathologists in San Diego County, however, proved that in only 2‐10% of all new breast cancer cases are these techniques being used to make the initial diagnosis. This paradox appeared to be due mainly to a reluctance of clinicians to use these techniques. However, There also appeared to be a lack of confidence and training among pathologists in interpreting aspiration cytology specimens. in the authors' and other pathologists' opinion, reviewing breast aspiration cytology specimens requires special training and regular exposure to such material, whereas Tru‐cut needle biopsy specimens can be interpreted accurately by almost any pathologist without special training. The results of our own series of needle biopsies and aspiration cytology in the diagnosis of breast cancer are presented and compared to those reported in several other published reports. These data indicate that approximately 90% (89% in our series) of all palpable breast cancers can be diagnosed by needle biopsy techniques.
Association of inflammatory bowel disease (IBD) with indolent soft‐tissue sarcomas: Report of two cases and review of literature
Authors: Israel Karyn J. , Nissenblatt Michael J.
Published: February 2007

Two patients with inflammatory bowel disease (IBD) and indolent forms of soft‐tissue sarcomas (extraosseous osteogenic sarcoma and desmoid tumor) are presented. The literature is reviewed regarding these tumors, which have not previously been recognized in association with IBD. Despite the well‐established relationship between IBD and neoplasms of epithelial and lymphoreticular origin, There have been limited data in this context pertaining to mesenchymal tumors. Two preceding reports have described the coexistence of IBD with another form of soft tissue sarcoma (Kaposi's sarcoma). Given that this relationship has now been observed in four cases, The possibility that soft‐tissue sarcoma and IBD do not coexist fortuitously must be considered. This suggestion is raised in light of the rare incidence of these disorders, The limited understanding of factors governing their expression, and the known association of IBD with other forms of neoplasia.
Influence of omentum transposition on experimental tumors
Authors: Chalmers P. J. , Newing R. K.
Published: February 2007

It has been observed that in human breast cancer transposition of the greater omentum to cover the excision site after removal of recurrent tumor appears to inhibit further recurrences at the site, without affecting spread to other sites. To establish an experimental model of this, inbred rats were transplanted in two sites on the chest with pieces of either an epitholioma or a mammary tumor. A flap of the omentum was then drawn through the peritoneal wall and then secured over one of the implants. in one group, this omentoplasty was carried out 1 week after tumor implantation. in most rats, The tumor in contact with the omentum was actually larger than the control, in contrast to the clinical observations. in many animals, Theomentum was also a route of metastasis of the tumor.
The morbidity of perineal wounds following abdominoperineal resection for rectal carcinoma
Authors: Petrelli Nicholas , Rosenfield Lorne , Herrera Lemuel , Mittelman Arnold
Published: February 2007

The clinical charts of 44 patients who underwent an abdominoperineal resection for adenocarcinoma of the rectum at Roswell Park Memorial Institute were retrospectively reviewed. The morbidity of an open perineal wound versus the closed perineal wound were evaluated. All of the patients received a Nichol's bowel preparation and following the abdominal portion of the dissection reperitonealization of the pelvic floor was performed. The overall morbidity for the open perineal wounds was 21% compared to a morbidity of 63% for the perineal wounds that were closed primarily. The mean length of hospitalization from the time of abdomino‐perineal resection was 21 days for the open perineal group and 22 days for the closed perineal group. The inclusion of wound sinus tracts in our morbidity assessment may explain the higher complication rate of the closed wound group than previously reported in the literature. This retrospective review emphasizes that the morbidity of the open perineal wound following abdominoperineal resection has been overemphasized. One is trading a potentially increased incidence of septic wound complications in the closed perineum for a protracted wound closure in the open perineum.
Seven cases of pelvic exenteration combined with sacral resection for locally recurrent rectal cancer
Authors: Takagi Hiroshi , Morimoto Takeshi , Hara Suguru , Suzuki Ryoji , Horio Shizuka
Published: February 2007

Local recurrence of rectal cancer following abdominoperineal resection is rarely amenable to limited resection. Carcinoembryonic antigen assay is valuable for diagnosing most recurrent rectal cancers, but it is inadequate for early detection. Pelvic computed tomography examination is very valuable for the early detection and localization of recurrence in relation to pelvic structures and can also serve as a guide in percutaneous needle biopsy of the tumor.

Seven patients with deeply invading recurrent lesions underwent pelvic exenteration combined with sacral resection. The ileal segment conduit was used for ureteral urinary diversion. The mean operation time and blood loss were 8.8 hours and 6,200 ml, respectively. No operative deaths were encountered. One patient is alive 22 months postoperatively with no evidence of disease, and another patient is alive 32 months postoperatively with pelvic wall recurrence. This procedure seems a reasonable treatment for palliation and full recovery in certain patients.
Chemotherapy in invasive thymomas: Five case reports
Authors: Donovan Patrick J. , Foley John F.
Published: February 2007

We treated 5 cases of invasive thymomas with single agent and combination chemotherapy. A carcinoid tumor of the thymus had a 13‐month objective response to monthly courses of a combination of DTIC, adriamycin, cytoxan, and vincristine. A second case of carcinoid achieved stabilization of disease with a combination of adriamycin, cyclophosphamide, and DTIC for 9 months and subsequently 10 months, with fluorouracil and methotrexate. A case of thymoma had stabilization of disease for 14 months with oral cytoxan and prednisone.
Aggressive squamous cell carcinoma of the skin after chronic lymphocytic leukemia
Authors: Bridges Nancy , Steinberg J. J.
Published: February 2007

We report two cases of squamous cell carcinoma (SCC) of the skin subsequent to chronic lymphocytic leukemia (CLL). Both cases had an unusually aggressive course for a nonmelanoma skin malignancy with extensive metastases in both, resulting in death in one patient. A literature review supports the likelihood of an increased incidence of SCC in patients with CLL. Though the mechanism is unknown, immunosuppression may play a central role. We urge patients with CLL to avoid exposure to direct sun. Any questionable skin lesion should be biopsied early, and completely excised if it is a tumor. The patient should also be examined thoroughly for metastatic disease via subsequent follow‐up visits.
Coexisting leiomyosarcoma and transitional cell carcinoma of the urinary bladder
Authors: Chen Karl T. K.
Published: February 2007

A rare case of coexisting sarcoma and carcinoma of the urinary bladder is reported and the literature is reviewed. Because of the differences in the histogenesis and prognosis, such cases should be differentiated from cases of carcinosarcoma of the urinary bladder.
Benign hamartoma of the lung presenting as massive hemoptysis
Authors: Kleinman J. , Zirkin H. , Feuchtwanger M. M. , Hertzanu Y. , Walfisch S.
Published: February 2007

A case is presented of benign pulmonary hamartoma causing episodes of hemoptysis. This is an extremely unusual manner of presentation for such lesions.
Spontaneous regional lymph node metastases of three variants of the B16 melanoma: Relationship to primary tumor size and pulmonary metastas
Authors: Nathanson S. David , Haas Gabriel P. , Mead Marilee J. , Lee Min
Published: February 2007

We studied the patterns of spontaneous regional lymph node metastases of three variants (Fl, F10, and BL6) of the B16 melanoma in C57BL/6 mice and related the incidence to primary tumor size and pulmonary metastases. The incidence of regional lymph node and pulmonary metastases correlated with increasing primary tumor size (p ⩽ 0.0001). The incidence of pulmonary metastases in mice whose regional lymph nodes did not contain tumor also correlated with increasing primary tumor size (p ⩽ 0.0001). This propensity for direct hematogenous spread was more apparent in BL6 tumors than in F1 and F10 tumors (p ⩽ 0.0001). BL6 tumors also metastasized to regional nodes at smaller primary tumor sizes (p ⩽ 0.04). Heterogeneous variants that metastasize earlier to regional lymphatic and hematogenous sites dictates the natural history of the primary tumor. Whether prophylactic lymphadenectomy for melanomas is therapeutic may depend on dissemination‐related phenotypic characteristics.
Thyroid cancer mimicking thyroiditis
Authors: van der Sluis R. F. , Wobbes Th. , Schoots F. J.
Published: February 2007

Two patients with thyroid cancer, who presented with clinical and biochemical features of subacute thyroiditis, are reported, Confusion in diagnosis delayed therapy from 3 to 8 months. The relation between thyroiditis and thyroid cancer is discussed.
Extracardiac rhabdomyoma: A report of two cases
Authors: Pradhan S. A. , Rajpal R. M. , Shrikhande S. S.
Published: February 2007

Two case reports of extracardiac rhabdomyoma (adult type) are presented. The rare occurence of extracardiac rhabdomyoma and its relatively benign nature makes a histological diagnosis very necessary, though often difficult to make. In both cases reported here, a diagnosis of extracardiac rhabdomyoma was given and treatment with local excision yielded good results.

The importance of a histological diagnosis and treatment by only a local excision is stressed.
Effects of administration routes on the uptake of uridine and 5‐fluorouridine into an adenocarcinoma transplanted to rat liver
Authors: Erichsen Christian , Christenson Per‐Inge , Eriksson Göran , Yngner Torsten , Jönsson Per‐Ebbe , Stenram Unne
Published: February 2007

In a model of secondary liver cancer in Wistar rats, the effect of different administration routes on the uptake of 3H‐uridine into tumor and several normal tissues was studied. The rats were inoculated with a tumor cell suspension in the central liver lobe. Ten days later, they were distributed into four groups with a catheter placed in the gastroduodenal artery, the portal vein, one of the femoral veins, or in the peritoneal cavity. 3H‐uridine was injected 46 h later and after an additional 90 minutes the animals were anesthezised and pieces of liver tumor and normal tissues were removed and frozen. The incorporation into the acid‐soluble fraction and RNA was analyzed. In a separate experiment, 3H‐fluorouridine was administered by the gastroduodenal artery and a comparison was made with the uptake of 3H‐uridine. A significantly higher amount of uridine was incorporated into the tumor by me arterial route. The intraportal and intraperitoneal routes were comparable, while a somewhat higher incorporation was found by the systemic route. The consequences of using the different routes upon the incorporation into RNA of tumor and dose‐limiting organs are demonstrated. With the aid of this experimental model, it is possible to evaluate further the effect by different manipulations on different drugs regarding the administration route.
Limitation of immunohistochemical localization of estrogen receptor
Authors: Chaudhuri Prabir K. , Chaudhuri Bina , Beattie Craig W. , Bigham Beatrice Z. , Das Gupta Tapas K.
Published: February 2007

Although the radioreceptor method is widely used for estrogen receptor assay in human tissue, it has several limitations and a number of alternative methods are being explored. An immunohistochemical method of estrogen receptor assay using a specific antibody to estradiol has been proposed as a suitable alternative. The present study was designed to evaluate the validity of this method in detecting true estrogen receptors in human tumor tissue. Using radioiodinated antibody to estrogen, we have demonstrated that the estrogen antibody can detect the estrogen when it is bound to 4S type receptor but is unable to bind to estrogen when the hormone is bound to 8S type receptor. Our observations suggest that the immunohistochemical method of detection of intracellular cytosolic receptor for estrogen is not a suitable alternative to the currently used radioreceptor method.
Threatened carotid artery rupture: A complication of radical neck surgery
Authors: Sanders Elissa M. , Davis Kenneth R. , Whelan Charles S. , Deckers Peter J.
Published: February 2007

Carotid artery rapture is an infrequent but highly dangerous postoperative complication of radical head and neck surgery. The principal predisposing factors are radiation therapy, infection, tissue necrosis, vessel exposure, and pharyngeal fistula formation. Actual or threatened carotid artery rupture has been most commonly managed by ligation of the involved vessel. We present a patient who showed signs of impending carotid artery rupture after both irradiation and radical neck surgery. Balloon embolization was employed in preference to traditional carotid artery ligation. The patient's risk factors for carotid artery rupture are analyzed and the application of balloon embolization is discussed.
Distant metastases of nasopharyngeal carcinoma: A study of 256 male patients
Authors: Ahmad Anwar , Stefani Stefano
Published: February 2007

The records of 256 patients with nasopharyngeal carcinoma have been reviewed to determine the incidence and location of distant metastases, Sixty‐three patients underwent autopsy. The incidence of distant metastases was 36% overall, and 51% in the autopsy patients. Bones, distant lymphnodes, liver, and lungs were the most common sites of distant metastases. Liver was the most common site in the autopsy patients. Compared to other major histological subtypes, undifferentiated carcinoma had the highest incidence of bone but lowest incidence of lung metastases. There was a strong correlation between advanced locoregional disease and distant metastases. Of those patients who developed distant metastases, 98% were discovered within 3 years or earlier. Thorough evaluation of the above organs/systems is indicated at the time of initial staging work‐up and at follow‐up, specifically for patients with advanced locoregional disease. A literature review of distant metastases in nasopharyngeal carcinoma is presented.
Good tolerance to high‐dose hepatic arterial infusion therapy
Authors: Wile Alan G. , Kasimis Basil S. , Iyer Padmini , Kaneshiro Claudia A. , Moran Edgar M.
Published: February 2007

A pilot study was designed to evaluate the efficacy of high‐dose FUDR administered through the hepatic artery for the treatment of cancer involving the liver. Three dose schedules were used beginning with a dose of 0.5 mg FUDR/kg/day for 2 weeks followed by normal saline infusion for 2 weeks (schedule A). Elevation of serum bilirubin was the sole indication to deescalate to schedule B (0.3 mg FUDR/kg/day for two weeks followed by saline‐infusion for 4 weeks). Tolerance to this schedule escalated the patient to schedule C (0.5 mg FUDR/kg/day for 2 weeks followed by normal saline infusion for 4 weeks). Eighteen patients were treated, sixteen with metastatic colon cancer, one with metastatic leiomyosarcoma, and one with hepatoma. The patient with hepatoma developed progressive disease after one cycle of therapy. Of the 17 patients with metastatic cancer only 5 patients failed therapy yielding a 70% response rate. High‐dose FUDR was well tolerated with only six patients requiring deescalation to schedule B. Elevation of alkaline phosphatase and glutamic oxaloacetic transaminase was universal. Two patients developed peptic ulceration. Sclerosing cholangitis was not observed. We conclude that high‐dose FUDR administered through the hepatic artery is as safe as conventional dose infusion therapy but probably not more effective. The safety of high‐dose FUDR infusion therapy suggests that sclerosing cholangitis is association with hepatic arterial infusion therapy is not related to the FUDR dose.
Recurrent olfactory neuroblastoma treated by radiation, surgery, and chemotherapy: “A case report”
Authors: Mohanti B. K. , Rath G. K. , Baser B. , Bahadur S. , Mathur M.
Published: February 2007

Olfactory neuroblastoma is a rare tumor. The role of CT Scan, morphological details and the electron microscopic findings have been highlighted in the diagnosis of the lesion. The present patient, in which the tumor had recurred following surgical excision, was treated successfully with a combination of radiation, further surgery, and maintenance chemotherapy. We also feel that such a planned multidisciplinary approach is justified as the initial treatment for all advanced lesions in view of high recurrence rates reported following use of radiotherapy or surgery alone.
Renal cell carcinoma in a patient with situs inversus totalis
Authors: Bertini John E. , Boileau Michel A.
Published: February 2007

Situs inversus occurs with a frequency of about 1 in 8,000. We present a case of renal cell carcinoma in a patient with situs inversus totalis treated with nephrectomy. Uneventful operative management was attained by adequate preoperative radiologic evaluation.
Mucoepidermoid carcinoma of the stomach
Authors: Hayashi Itsuro , Muto Yukiro , Fujii Yoshio , Morimatsu Minoru
Published: February 2007

A rare case of mucoepidermoid carcinoma of the stomach in a 70‐year‐old man is reported. The protruded mass with central depression resembled a submucosal tumor, located on the posterior wall of a part of the cardia, fornix, and upper corpus. Histologically, submucosal ectopic glands composed of columnar cells, mucus‐producing cells that closely resemble gastric epithelium, and ciliated epithelium were observed. The tumor consisted of an admixture of cuboidal, columnar cells, mucus‐producing cells, singled or pseudostratified ciliated epithelium, and squamous metaplastic cells. The tumor cells were intimately continuous with the submucosal ectopic glands. Gradual transition between tumor cells and epithelium of submucosal ectopic glands was recognized. It is supposed that mucoepidermoid carcinoma of the stomach in this case derived from preexisting submucosal ectopic mucous glands of the stomach.
Leiomyosarcoma of the scrotum
Authors: Collier David St. J. , Pain James A. , Hamilton‐Dutoit Stephen J.
Published: February 2007

A case of leiomyosarcoma arising from the dartos muscle of the scrotum is described. Review of the literature reveals only eight other cases, and aspects of management of these and our case are discussed.
Secondary urinoma mimicking recurrent tumor as a cause of bilateral ureteral obstruction
Authors: Zein Tawfik A. , Huben Robert P. , Petrelli Nicholas J. , Reid Stephen , Pontes J. Edson
Published: February 2007

A case is reported of a previously resected adenocarcinoma of the rectum presenting with recurrent tumor in the pelvis and an abdominal mass that was found to be a large urinoma. Dialysis was discontinued after drainage of the extravasated urine, and the patient's condition became stable. A review of the literature is also discussed.
Hepatocellular carcinoma causing obstructive jaundice
Authors: Sarma Deba P. , Weilbaecher Thomas G. , Deipairine Erico M.
Published: February 2007

A 67‐year‐old man presented with signs and symptoms of obstructive jaundice. At autopsy, a hepatocellular carcinoma was noted to have obstructed both hepatic ducts and the common hepatic duct. Literature is reviewed to elaborate on this unusual manifestation of hepatocellular carcinoma.
An evaluation of routine follow‐up for detection of breast cancer recurrences
Authors: Zwaveling A. , Albers G. H. R. , Felthuis W. , Hermans J.
Published: February 2007

Four hundred patients who were radically treated for breast carcinoma during the period May 1974 to December 1980 were followed for a minimum of 4 years. The outcomes of the 128 patients with recurrences were studied. A differentiation into two groups was made: those in whom recurrences were detected as a real result of follow‐up (27%) and those in whom this was not the case (73%). Both groups were comparable as regards age, period “at risk,” nature and site of recurrence, type of therapy instituted, and their response to it. No differences could be found in any of these factors. The recurrence‐free interval, the survival after institution of therapy, and the total survival after the primary procedure were the same in both groups.
Metastatic colon carcinoma to the jaw: A case report and review of the literature
Authors: Mast Harold L. , Nissenblatt Michael J.
Published: February 2007

Presented is a case of adenocarcinoma of the cecura metastatic to the anterior mandible. The patient had a Duke's C2 cecal adenocarcinoma resected twenty months prior to her development of loose teeth, jaw pain, and jaw mass. A biopsy of the mass revealed metastatic adenocarcinoma, identical to her primary neoplasm. Metastatic carcinoma to the mandible is a rare event. A review of the literature reveals only nineteen cases of colon carcinoma metastatic to the jaw. When further subdivided, there is only one other case of cecal adenocarcinoma metastasizing to the jaw. Almost half of the other cases have been rectal carcinomas. Treatment of these patients has been uniformly unsuccessful, with life expectancy reported between one and seven months. The literature has shown that 5‐FU and radiotherapy may produce palliation of symptoms. The patient presented here responded well to 5‐FU and radiotherapy.
Early metastatic patterns and survival in malignant melanoma
Authors: Nambisan Raman N. , Alexiou George , Reese Peter A. , Karakousis Constantine P.
Published: February 2007

Two hundred fifty patients with distant metastasis from malignant melanoma were analyzed at the first appearance of systemic metastasis. Commonly involved sites were lung, subcutaneous tissue, brain, and liver. Frequency of liver metastasis was higher with eye and mucous membrane primary sites (P < 0.01). Liver involvement had the worse survival compared to lung and brain. Patients with mucosal or unknown primary sites had decreased survival compared to other sites (P < 0.01). Patients with primary melanomas thicker than 4 mm had significantly shorter survival (P < 0.02). Single‐organ involvement correlated with ionger survival compared to multiple‐organ involvement (P < 0.04). Survival of metastatic disease was more favorable in patients with involvement of subcutaneous tissue only and in those with a disease‐free interval of 2 years or longer. Five‐year survival from first appearance of metastasis was 7% and median survival was 8 months.
Early postoperative pancreatic endocrine function after segmental and pancreaticoduodenal allotransplantation in nonimmunosuppressed primates
Authors: Du Toit Don F. , Heydenrych Jacobus J. , Smit Ben , Louw Gabriel , Zuurmond Theuns , Laker Lida , Els Daniel , Weideman André , Wolfe‐Coote Sonja , Toit Lorraine Du , Davids Henry
Published: February 2007

In this study we evaluated the short‐term hormonal effects of segmental and whole pancreatic allotransplantation on the glucose intolerance produced by hemipancreatectomy in the primate. In hemipancreatectomized animals without grafts the K‐values were reduced to 0.6 ± 0.05, plasma insulin increased from 27.5 ± 2.5 to 63.5 ± 6.3 μU/ml, and glucagon levels declined from 252 ± 29.9 to 216.5 ± 33.0 pg/ml. Hemipancreatectomized segmental allograft recipients rendered K‐values of 0.79 ± 0.05, plasma insulin increased from 19.98 ± 3.43 to 66.0 ± 17.03 μU/ml, and glucagon release declined from 395.6 ± 63.0 to 226.2 ± 37.6 pg/ml during IVGTT postoperatively. Hemipancreatectomized, pancreaticoduodenal allograft recipients rendered K‐values of 0.82 ±0.1, results not significantly different from hemipancreatectomized or segmental allograft recipients. Plasma insulin increased from 29.5 ± 4.0 to 186.0 ± 25.0 μU/ml, and glucagon release declined from 1,087.0 ± 31.6 to 656.0 ± 12.7 pg/ml. In summary, segmental pancreatic allotransplantation could not, in the short‐term, restore the reduced K‐values and hypoinsulinaemia in hemipancreatectomized primates to that of normal, unstressed controls. Although K‐values of hemipancreatectomized recipients were not significantly improved, whole pancreas transplantation resulted in improved insulin release and hyperglucagonaemia during IVGTT when compared to segmental allograft recipients. The unexpected findings of hypoinsulinaemia and hyperglucagonaemia in both transplant groups may only reflect a function of the stressed state of the animals in the immediate postoperative phase.
Augmentation of lymphoproliferative activity of tumor‐bearing BALB/c mice to soluble tumor antigens by surgical manipulation: The possible role of macrophages
Authors: Laing Calbert A. , Japal Knoxley M. , Baker Mark E.
Published: February 2007

Lymphoproliferative activity was assessed by 3H‐thymidine incorporation in spleen cells of mammary tumor bearing BALB/c mice, mice which had their tumors surgically removed, and mice with sham surgery after stimulation in vitro with a soluble extract of syngeneic tumor antigens. Surgical removal of tumors caused an average of 65 % decline in reactivity at 5 days postoperative as compared to reactivity of animals with their tumors intact. Sham surgery caused an average of 33% elevation in reactivity. Macrophages added to cultures at spleen cell/macrophage ratio of 100: 1 caused an average 171%, 59%, and 12% elevation in the activity of surgery, tumor‐bearing, and sham‐surgery animals, respectively. Surgical manipulation of tumor‐bearing mice, therefore, augmented in situ the ability of spleen cells to exhibit lymphoproliferative activity to a soluble syngeneic antigenic extract in vitro, possibly by a mechanism involving the activation of macrophages and requiring the presence of a sizable antigenic load.
Diagnostic histochemical and immunohistochemical studies in malignant mesothelioma
Authors: Lucas Joel G. , Tuttle Steven E.
Published: February 2007

This study was undertaken to evaluate the relative utility of histochemical and immunohistochemical stains in diagnosing malignant mesothelioma of the thorax. We performed a battery of histochemical stains, including periodic acid Schiff (PAS) with and without diastase, mucicarmine, colloidal iron (Coll Fe) with and without hyaluronidase, and immunohistochemical stains for keratin and carcinoembryonic antigen (CEA) on 12 pleural mesothelioma specimens obtained from 11 patients, five primary pulmonary adenocarcinomas, and one metastatic adenocarcinoma each to pleura and pericardium. All diagnoses were established by autopsy or through clinical and surgical evaluation. The diagnosis of mesothelioma was established following rigid anatomic criteria. All tissue was formalin fixed and paraffin embedded. Commercially available reagents and antisera were used in all cases. Results showed a high rate of positivity for keratin and hyaluronidase‐sensitive Coll Fe in the mesotheliomas while adenocarcinomas were uniformly positive for CEA and keratin and generally positive for PAS‐D (diastase) and mucicarmine. Mesotheliomas were negative for CEA, mucin, and PAS‐D. Positive keratin staining was also seen in the spindle cell components of mesotheliomas. Immunohistochemical stains often added significantly to our ability to establish the diagnosis of mesothelioma with confidence, since they were more frequently and more clearly positive than histochemical stains.
Colorectal carcinoma in young adults: An autopsy study
Authors: Sarma Deba P.
Published: February 2007

Autopsy records of ten patients aged 40 or younger with colorectal carcinoma were reviewed. The local and metastatic spread of the cancer was similar to that seen in colorectal cancers occurring in older people. Colorectal cancer in young people is biologically not more aggressive or virulent than that in older patients.
Relationship of nuclear appearance to stromal invasion in human breast cancer
Authors: Bell C. D. , Stadler J. , Michowitz M. , Inbar M.
Published: February 2007

Two biopsies of intraductal and invasive lobular carcinoma of the breast and 11 biopsies of intraductal and invasive carcinoma of the breast were examined by automated micromensurative techniques for mean nuclear area of carcinoma cells in intraductal and in invasive compartments. The nuclei of invasive carcinoma cells tended to be smaller when they invaded stroma as single cells or as “thin strands” than when they invaded as part of large sheets of cells. Cells in direct apposition with the stroma usually had smaller nuclei than cells which were found centrally in large confluent sheets of cells. Intraduct carcinoma cells approached, in size, invasive cells which formed confluent sheets, rather than cancer cells which invaded as single cells. The nuclei of cells which invaded in small groups were usually darker than those of cells in confluent sheets, which were usually more vesicular.
Synchronous and metachronous colon lesions in squamous cell carcinoma of the anal canal
Authors: Klompje Jan , Petrelli Nicholas J. , Herrera Lemuel , Mittelman Arnold
Published: February 2007

The charts of 79 patients with a histologic diagnosis of squamous cell carcinoma of the anal canal were reviewed to determine the incidence of synchronous and/or metachronous colon lesions. Forty‐six patients underwent an adequate preoperative evaluation of the colon and rectum. Ten patients underwent colonoscopy, 33 patients underwent a barium enema, and three patients underwent colonoscopy and a barium enema. In this group six adenomatous polyps and three hyperplastic polyps were discovered. An adenocarcinoma of the sigmoid colon was found in another patient six months prior to the diagnosis of a squamous cell carcinoma of the anal canal. Twenty‐three patients had follow‐up evaluation of the large bowel for metachronous lesions following treatment of the squamous cell carcinoma of the anal canal. Ten patients underwent colonoscopy, three patients had a barium enema, and ten autopsies were available for analysis. In this group metachronous lesions consisted of two adenomatous polyps and one hyperplastic polyp.
Extra‐adrenal paraganglioma and pulmonary chondroma: A case report and review of the literature
Authors: Keyhani‐Rofagha Sedigheh , O'dorisio THOMAS M. , Lucas Joel G. , Fontana Mary Beth , Tuttle Steven E.
Published: February 2007

This report describes the findings of an extra‐adrenal paraganglioma and chondroma of the lung in an elderly man. Tissue analysis of the paraganglioma showed a high level of catecholamines, as well as the presence of somatostatin and small amounts of other peptide hormones. Immunoper‐oxidase staining demonstrated the distribution of peptide hormones in the tumor. This case illustrates two important points. First, it confirms the ability of paraganglionic tissue to secrete peptide hormones. Secondary, it adds yet another case to the unusual group of patients described by Carney.
Breast carcinoma post‐augmentation mammaplasty: Therapy with limited surgery and radiation
Authors: Lafreniere Rene , Ketcham Alfred S.
Published: February 2007

Due to the recent surgical and technical developments in aesthetic surgery and occasional dissatisfaction of women with their external contour, augmentation mammaplasty has become a common occurrence in the surgical practice of the aesthetic surgeon. Breast carcinomas, incidentally associated with augmentation mammaplasty, have been sporadically reported in the literature and have all been treated with a mastectomy when resection was possible. We present a case of breast carcinoma occurring 5 years after augmentation mammaplasty performed with silicone‐gel‐filled implants. Therapy of this carcinoma was achieved through a segmental mastectomy followed by postoperative radiation. The patient remains well 15 months postoperatively. A large number of breast implants are performed each year and the likelihood of a higher incidence of incidental breast carcinomas seen with implants is certainly possible as these patients become older; thought should be given to the notion that possibly not all of these cases need to be managed with radical surgery.
Torre's syndrome in association with premalignant and malignant tumors and suspected familial polyposis
Authors: Maipang Tanaphon , Herrera‐Ornelas L. , Sanford C. , Vasquez Michael , Petrelli Nicholas , Mittelman Arnold
Published: February 2007

Torre's syndrome was diagnosed in a patient with the clinical characteristics of familial polyposis coli, an association, that to our knowledge, has not been reported previously.
Bladder cancer detection and surveillance: Carcinoembryonic antigen as a monitor of neoplastic transformation
Authors: Boileau Michel , Swartz Douglas , Schmidt Karmen , Schmidt Waldemar
Published: February 2007

Routine cytopathology of exfoliated urothelial cells will identify only 70% of patients with transitional cell carcinoma (TCC) because most welldifferentiated bladder tumors are not detected. Carcinoembryonic antigen (CEA) was identified on urothelial cancer cells from 66% of patients with grade I TCC, 65% with grade II TCC, 65% with grade III TCC, and 80% of patients with CIS. Immunoperoxidase labelling of CEA can enhance the sensitivity of exfoliative cytology.