bluuebunny/crossref_metadata_2025 huggingface dataset:
The value of the wright‐giemsa stain for diagnosing hairy cell leukemia in body cavity fluids
Authors: Strobel Stephen L. , Brandt John T.
Published: February 2007

We compared the value of the Wright‐Giemsa stain with the Papanicolaou stain for diagnosing hairy cell leukemia in the body cavity fluids of three patients. The cytological features of the leukemic cells were much clearer on the Wright‐Giemsa‐stained preparations. This allowed for the accurate diagnosis of leukemic involvement of the body cavity fluids in 3/3 patients using the Wright‐Giemsa stain but only 1/3 using the Papanicolaou stain. A tartrate‐resistant acid phosphatase stain was used to confirm the diagnosis in each case.
Interferon‐β treatment of metastatic prostate cancer
Authors: Bulbul M. A. , Huben R. P. , Murphy G. P.
Published: February 2007

A limited clinical trial of Interferon‐β (Human Fibroblast Interferon) in the treatment of advanced, hormone‐refractory postate cancer was conducted by the National Prostate Cancer Project (NPCP Protocol 2100). Sixteen patients with metastatic prostate cancer who had failed prior hormone therapy were entered into the study. Treatment consisted of 6 × 106 units of Interferon‐β intravenously three times per week for 12 weeks. Chills and fever were seen in ten of the 16 patients (62.5%), and mild hematologic toxicity occurred in four patients. No complete or partial responses were observed. Three patients had stable disease by NPCP criteria for a mean duration of 6.3 months. Progression of disease was seen in 13 of the 16 patients, eight of whom progressed during therapy. The results of this study suggest that Interferon‐β has limited efficacy in the treatment of advanced, horomone‐refractory prostate cancer.
Significance of the “maturation” of metastases from Wilms' tumor after therapy
Authors: Omar Rawhi , Davidian Marianna M. , Marcus Judith R. , Rose Judith
Published: February 2007

Several metastatic nodules were discovered in the lungs of a 4‐year‐old boy two years after surgical excision of Wilms' tumor with subsequent chemotheraphy and local irradiation. All these metastatic nodules were composed of differentiated mesenchymal elements similar to those encountered in the primary neoplasm. Similar “mature” metastases have been observed by pathologists in other tumors of embryonic origin. Review of available literature and clinical and experimental data supports the notion that “reversion” of malignant cells into phenotypically benign counterparts may take place spontaneously or under the influence of environmental factors. Anticancer agents (cytostatics, radiation) selectively destroy the more anaplastic cells present in a malignant tumor (or its metastatic implants), thus allowing the “benign” revertants to predominate. Although such lesions are benign‐appearing, it is recommended that they be completely excised; however, but further chemo‐ or radiotherapy may not be necessary.
Symptomatic granular cell tumor of the esophagus
Authors: Sarma Deba P. , Rodriguez Fred H. , Deiparine Erico M. , Weilbaecher Thomas G.
Published: February 2007

A case of symptomatic granular cell tumor of the esophagus is described. Another 32 cases collected from the English literature are analyzed. The reported cases have occurred mostly in women of less than 50 years of age presenting with dysphagia. Excision of the lesion is curative.
Proposed method to study the factors affecting local control with combined external beam and interstitial implantation of mobile tongue and floor of mouth
Authors: Hintz Brace L. , Kagan A. Robert , Chan Paul , Rao Aroor R. , Nussbaum Herman , Ryoo Monica C. , Wollin Myron
Published: February 2007

Twenty‐seven patients with squamous cell carcinoma of the mobile tongue and floor of the mouth were treated with external beam and interstitial radiation. Good prognostic factors were T1N0, T2N0, superficial tumors, tumor shrinkage by 75% with external beam, and no apparent tumor clinically 2 months after treatment. On the other hand, T3N0, T1‐3N1, and deeply necrotic tumors had a poor prognosis. We recommend using a flexible afterloading system to implant the initial local tumor volume (not just the residual nidus) that does not exceed 45 cm3. The minimum (reference) dose was prescribed to a surface 1/2 cm beyond the most peripheral rim of radioactive sources. For acceptable local control and complication rates, our suggested minimum (reference) doses are ⩽7,500 rads for T1 (or a time‐dose‐fractionation [TDF] of 131‐140), <8,000 rads for T2 (TDF of 131‐140), and probably < 8,500 rads for T3 (TDF of ⩽ 150). These guidelines should be considered preliminary.
What is the value of the computer for the physician?
Authors: Juckett Mark , Spratt John S.
Published: February 2007

Computer technology is advancing at an increasingly rapid rate. Although the computer's former role in the health care field was primarily limited to the financial and marketing departments of health care facilities, the computer is moving beyond the managerial departments and into the realm of the practicing physician. Much of this change in the use of computers in this field is due to the pressures of cost containment, DRG requirements, the availability of microcomputers, and the desire for improved health care. In the areas of clinical care, medical research, and medical education, the computer is rapidly becoming an indispensable tool through its technological adaptation. The computer is an obvious adjunct to the problem of improving cost efficiency without compromising the efforts toward better health care.
Carcinoma of the extrahepatic bile ducts: A postmortem study of 65 cases and review of the literature
Authors: Sons H. U. , Borchard F.
Published: February 2007

From 1950 to 1982, 65 patients with carcinoma of the extrahepatic bile ducts were autopsied in the Institute of Pathology of the University of Düsseldorf. The average age of men was 64.5 years and that of women was 70 years. The ratio of men to women was 1 to 1.71. The greatest number of tumors was found in the common bile duct (40.1 %), followed by the hepatic ducts (29.2%) and the confluence of the common hepatic duct with the cystic duct (27.7%). Adenocarcinomas of various differentiation were found in 96.7% of the cases and anaplastic carcinoma in 3.3%. Metastases were present in 49 cases (75.4%). Cholelithiasis was found in 51 % of the cases. The results of the present postmortem study are compared with the literature.
Acute hemorrhagic pericardial effusion complicating angiosarcoma of the liver
Authors: Levy Isaac , Mozes Martha
Published: February 2007

A 42‐year‐old woman, with an acute hemorrhagic pericardial effusion, was found to have an angiosarcoma of the liver which caused a massive intraabdominal bleeding due to spontaneous rupture of the liver.
Lung cancer in men aged 75 or older
Authors: Sarma Deba P.
Published: February 2007

Sixty‐seven cases of lung cancer occurring in men aged 75 or older were examined at autopsy. There is a similar incidence of epidermoid and small cell carcinoma, but a lower incidence of adenocarcinoma and a slightly higher incidence of large cell carcinoma in this elderly group of patients compared to the incidence of various histologic types occurring in patients of all ages. The various organs involved by metastatic tumor are similar to those seen in lung cancer in general; the overall metastatic disease is less widespread in the older group.
Malignant fibrous histiocytoma of the breast with axillary lymph node involvement
Authors: Van Niekerk J. L. M. , Wobbes Th. , Holland R. , Van Haelst U. J. G.
Published: February 2007

This case history describes a 70‐year‐old female patient with a malignant fibrous histiocytoma (MFH) of the breast with secondary involvement of the skin and axillary lymph node metastases. We think that in die case of a MFH of the breast a radical or modified radical mastectomy should be pursued instead of a simple mastectomy.
Primary choriocarcinoma of mediastinum with immunohistochemical study and review of the literature
Authors: Kathuria Satinder , Jblokow Victor R.
Published: February 2007

Primary germinal tumors of the mediastinum are extremely rare. Most germ cell tumors in that location occur as metastasis from testis. A case report with immunocytochemical studies is described. Histologically, the tumor had features of choriocarcinoma and with immunoperoxidase technique stained positively for Beta human chorionic gonadotropin (BHCG). The patient is alive and asymptomatic 2 years post surgery and chemotherapy.
The effect of ionizing radiation on the primate pancreas: An endocrine and morphologic study
Authors: Du Toit Don F. , Heydenrych Jacobus J. , Smit Ben , Zuurmond Theuns , Louw Gabriel , Laker Lida , Els Daniel , Weideman André , Wolfe‐Coote Sonja , Du Toit Lorraine B. , Davids Henry , Groenewald Wilhelm A. , van der Merwe Emuel , Pistorius Stephen
Published: February 2007

In this study we evaluated the endocrine, biochemical, and haematological derangements as well as pancreatic and histological changes of the bone‐marrow in the primate following external fractionated subtotal marrow irradiation without bonemarrow reconstitution. The irradiation was administered in preparation for pancreatic transplantation. Two groups of animals (ten in each group) received 800 rad (8 Gy) and 1,000 rad (10 Gy) respectively over 4 to 5 weeks. A maximum of 200 rads (2 Gy) were administered weekly as photons from a 6 MV linear accelerator. During irradiation the animals remained normoglycaemic in the presence of transiently elevated liver enzymes and serum amylase values, which returned to normal on completion of the irradiation. Insulin release was significantly reduced in both groups during irradiation and was associated with minimally decreased K‐values in the presence of mild glucose intolerance. Pancreatic light morphologic changes included structural changes of both exocrine and endocrine elements and included necrosis of the islet cells and acinar tissue. Islet histology demonstrated striking cytocavitary network changes of alpha and beta cells, including degranulation, vacuolization, mitochondrial destruction, and an increase in lysosomes. A hypoplastic bonemarrow ranging from moderate to severe was observed in all irradiated recipients. Near total fractionated body irradiation in the primate is therefore associated with elevated liver enzymes, pancytopenia, transient hyperamylasaemia, hypoinsulinaemia, a varying degree of pancreatitis, and bonemarrow hypoplasia.
Shoulder flap for head and neck reconstruction: An alternative when everything else fails
Authors: Cohen Mimis
Published: February 2007

The use of axial and free flaps made the use of delayed random flaps for the reconstruction of the head and neck almost obsolete. Immediate reconstruction of intraoral defects using the pectoralis major musculocutaneous flap primarily, as well as other axial or free flaps, has become a common practice. However, in some selected cases due to failure of previous operations or complications of radiation and recurrence, the reconstructive surgeon is left with very little choice. The purpose of this paper is not to advocate the use of the shoulder flap as a primary reconstructive procedure, but to call attention to its availability for certain complicated cases and briefly described the details of the technique.
Diagnostic evaluation and survival analysis of colorectal cancer patients with liver metastases
Authors: De Brauw L. M. , Van de Velde C. J. H. , Bouwhuis‐Hoogerwerf M. L. , Zwaveling A.
Published: February 2007

Clinical features and their prognostic value were evaluated in 83 colorectal cancer patients with liver metastasis. The clinical features analysed included presenting symptoms and signs, liver function tests, extent of liver involvement, associated extrahepatic tumor growth, and physical condition of the patients. Overall median survival time after diagnosis of liver metastases was 8.4 months. Prognostic factors related to survival were symptoms, when referable to liver metastasis, and 5′ Nt. Information is supplied to survey what selection of patients should be considered for various treatment options. A predominance of the patients showed bilobar liver involvement (79.6%), extrahepatic tumor growth (49.4%), or had an unresectable primary tumor (30.1%), thus leaving only 6% of the patients with liver metastases for surgical treatment with the intention of cure.
Pulmonary blastoma in childhood
Authors: Jimenez Jorge F.
Published: February 2007

Pulmonary blastoma (PB) has been considered a very rare primary lung malignant neoplasm. In children, it is one of the rarest cancers reported. To my knowledge, there are only 24 pediatric cases of PB in patients ranging from 2 months to 15 years of age, representing one‐fourth of all reported cases in the literature. The association of PB with an underlying abnormal pulmonary morphogenesis, characterized by “cystic lesions,” suggests that there is a teratogenic‐oncogenic relationship. Review of me literature and the clinical and pathologic features of PB in a 2‐1/2‐year‐old white female are discussed.
Serum vitamin B12 levels in patients with primary hepatocellular carcinoma during treatment with CB3717
Authors: Buamah Paul K. , James Oliver F. W. , Skillen Andrew W. , Harris Adrian L.
Published: February 2007

Elevated Serum B12 levels were found at diagnosis in five of eleven patients with primary hepatocellular carcinoma. During chemotherapy either with CB3717 or VP16 the serum B12 rose dramatically, in one case reaching levels ten times the upper limit of normal. However, the serum LD activities did not change in parallel with the serum B12 levels suggesting that there was little necrosis of the tumour or the liver. With two out of five patients with other types of cancer the serum B12 levels also increased but less markedly. This data seems to suggest that the serum B12 level may not be as good a tumour marker for hepatocellular carcinoma as has been suggested and indeed may be influenced by the chemotherapeutic agent.
Uterine sarcoma: A retrospective study
Authors: Wen B‐Chen , Tewfik Ferial A. , Tewfik Hamed H. , Long Jeffrey P. , Anderson Barrie
Published: February 2007

From 1965 to 1982, 86 analyzable patients with uterine sarcoma were treated. Nineteen patients (22%) presented with advanced disease. For the patients with curable diseases (67 patients), the disease‐free survivals with a median follow‐up of 4.5 years are 40% (surgery only), 53% (surgery + chemotherapy), 46% (surgery + radiation ± chemotherapy). The local failure rates are 43%:32%:33%, respectively. There is no statistical significance. The most important prognostic factor is the clinical extent of the tumor. The role of radiation therapy and chemotherapy will be discussed.
Effect of route of administration on the selectivity of hematoporphyrin derivative for tumor tissue
Authors: Elmer Edward B. , Wood William C. , Cohen Alfred M. , Bamberg Michael
Published: February 2007

Hematoporphyrin derivative (HPD) has the ability to localize with moderate selectivity to tumor tissue, where it can be activated by visible light and produce singlet oxygen‐mediated damage to cellular biomolecules. However, HPD is less than ideal as an agent for tumor photoradiation therapy because it produces a period of photosensitivity that can last 30 days or more, and it can be toxic to surrounding tissues such as skin when used in the treatment of subcutaneous metastases. The usefulness of intra‐arterial injection for refining the selectivity of HPD was investigated in this work. Intraarterial administration of HPD was not found to provide higher tumor levels of HPD, nor was it able to increase significantly the concentration of HPD relative to surrounding tissues, such as skin and muscle. However, fluorescence microscopy findings suggested that some fluorescent HPD component is rapidly accumulated in tumor macrophages following intraarterial injection.
Selection of optimal therapy for neuroblastoma: A Study of the Immunomodulatory Effects of Surgery and Irradiation in the Murine C1300 Neuroblastoma Model
Authors: Topalian Suzanne L. , Ziegler Moritz M.
Published: February 2007

Human neuroblastoma is an immunogenic tumor for which therapy directed in an immunologic context may offer some advantage over conventional treatment. This study examines the immunomodulatory effects of surgery and irradiation in the murine C1300 neuroblastoma model. In vivo studies of primary tumor growth characteristics after treatment demonstrated no superiority of either therapeutic modality in control of local tumor or prolongation of host survival. However, irradiated hosts showed an increased ability to reject a secondary tumor challenge, compared to their surgical counterparts. That this phenomenon may be immune‐related is suggested by in vitro studies of T lymphocyte function utilizing mixed lymphocyte‐tumor cell cultures and PHA lymphoblastogenesis.
Classification of vacuolated cells in the gastric mucosa
Authors: Rubio C. A. , Kato Y.
Published: February 2007

Five different types of vacuolated cells occurring in the gastric mucosa were described. In haematoxylin‐eosin stained preparations, one type was characterized by supranuclear clear vacuoles, the other by supranuclear dark vacuoles, another by usually supranuclear vacuoles and cilia, a fourth type by subnuclear clear vacuoles centered by a lymphocyte, and the fifth type by subnuclear empty vacuoles. In the latter three types, a battery of mucous stains were negative. The significance of some of these vacuolated cell types remains to be elucidated.
Tumor stabilization after hyperthermia: An important criterion of response to thermal therapy
Authors: Storm F. Kristian , Scanlon Edward F. , Baker Harvey W. , Roe Denise , Morton Donald L
Published: February 2007

Several investigators have indicated that changes in tumor size may not occur after hyperthermia therapy even with substantial tumor cell kill, because of early edema and subsequent fibrosis of background stroma, suggesting that “tumor stabilization” might be an important benefit of thermal therapy. Recently, 9 institutions completed a national cooperative study of localized hypetthermia for patients with advanced, recurrent, or metastatic solid cancer that evaluted the potential significance of this response variable in a standardized clinical trial. Of 960 evaluable patients who completed at least one course of hyperthermia, thermoradiotherapy, or thermochemotherapy, 85 (9%) had complete responses for 1‐34 months, 173 (18%) had partial responses for 1‐39 months, 95 (10%) had minimal responses for 1‐15 months, and 313 (33%) had disease stabilization for 1‐32 months. Of 313 patients who had no change (i.e., ± 25%) in the size of their tumors after hyperthermia, the response lasted only 1‐3 months in 170 (54%) patients, a finding of questionable clinical significance. However, disease stabilization was observed for more than 3 months in 143 (46%), for more than 6 months in 67 (21 %), more than 9 months in 33 (10%), and more than 12 months in 16 (5%). Disease stabilization was also associated with improved activity for 1‐22 months in 79 (25%) of these patients, and improved pain for 1‐22 months in 100 (32%). Disease stabilization appeared to be independent of tumor histology, location, or depth within the body, size, or minimum treatment temperature, but was somewhat more frequent after hyperthermia combination therapy. There is sufficient accumulative data to suggest that tumor stabilization after hyperthermia should not be dismissed as a placebo effect. This response variable well may be a unique and potentially important criterion of response to localized hyperthermia therapy.
Diagnosis of pulmonary nodules in the cancer patient: The role for routine culture and an unusual application of the human tumor colony‐forming assays
Authors: Friedman Howard M. , Johnston Michael , Macher Abe M. , Glaubiger Daniel
Published: February 2007

Many solid tumors that occur in humans tend to metastasize to the lungs. The etiology of pulmonary nodules in cancer patients, therefore, presents a diagnostic problem that can be resolved only by histologic evaluation or resection. We present two cases of cancer patients with preoperative and intraoperative diagnoses of metastatic lung tumors. Tissue culture using the Human Tumor Colony‐Forming Assay (HTCFA), a procedure that predicts chemosensitivity patterns of tumors, was employed to successfully diagnose those nodules as fungal infections. In one case, results using the HTCFA were crucial in the identification of the opportunistic, organism. These cases stress the importance of routine culture of all pulmonary nodules and present an unusual but noteworthy application of the HTCFA system.
Clear cell follicular adenoma of the thyroid
Authors: Chen Karl T. K.
Published: February 2007

A rare case of follicular adenoma of the thyroid gland composed exclusively of clear cells is described. This case differs from most of the previously reported cases of clear cell thyroid neoplasm in that it was clinically and histologically benign.
Liposarcoma of the spermatic cord: Case report and review of the literature
Authors: Torosian Michael H. , Wein Alan J.
Published: February 2007

This report describes a patient with liposarcoma of the spermatic cord. The clinical presentation, pathogenesis, and prognosis of this unusual sarcoma are reviewed. The low‐grade malignant potential and irregular growth characteristics of this liposarcoma render preoperative diagnosis difficult. The role of radical orchiectomy, retroperitoneal lymph node dissection, radiation therapy, and chemotherapy in the treatment of spermatic cord sarcomas is discussed.
Oncocytic pleomorphic adenoma of the parotid gland
Authors: Pulitzer Donald R. , Reitmeyer William J.
Published: February 2007

A rare case of salivary gland pleomorphic adenoma, in which the majority of cells were oncocytic, is reported. The patient, a 53‐year‐old man, presented with a parotid gland mass that was otherwise asymptomatic. Surgical treatment consisted of a superficial parotid lobectomy. The specimen was prepared in standard fashion and studied by light and electron microscopy. The microscopic features were characteristic of salivary gland pleomorphic adenomas, however, both epithelial and “mesenchymal” elements were oncocytic. Such changes may occur focally in pleomorphic adenomas, but we were unable to find documentation of a wholly oncocytic variant in a review of the medical literature. From our clinical data and previous reports of pleomorphic adenomas with focal oncocytosis, it is concluded that such changes likely do not alter prognosis in affected patients. The possible significance of this lesion in regard to the histogenesis of salivary gland pleomorphic adenomas is discussed.
Nail‐bed melanoma
Authors: Klausner Joseph M. , Inbar Moshe , Cutman Mordechay , Weiss Gerald , Skornick Yehuda , Chaichik Samario , Rozin Ronald R.
Published: February 2007

In our series of 348 patients treated over a 10‐year period, six (1.7%) had their primary lesions in the nail bed. Five of the subungual melanomas occurred in the toes and one in the thumb. Four of the lesions were of the acral lentiginous type. The delay in diagnosis was 7 months to 6 years. Four of the patients presented with advanced, neglected tumors. One had distant metastases at diagnosis. The treatment was mainly surgical. Digital amputation was carried out for local control. Five patients underwent lymph node dissection and in three of them regional metastases were found. Of the four patients with regional and distant metastases at the time of diagnosis, three died within 6 to 60 months and the fourth is alive with metastatic spread. Of the two patients with melanoma confined to the nail bed, one is free of disease 50 months following diagnosis and the other suffered from a local recurrence and has been free of disease for 30 months following wide excision and limb perfusion.
Bronchial carcinoid with multiple aerogenous implanted foci
Authors: Suzuki Keiko , Kimula Yuji , Ogata Takesaburo , Nakagawa Haruo
Published: February 2007

A case of bronchial carcinoid with intrapulmonary dissemination was demonstrated. A right upper lobectomy was performed because of an abnormal shadow in the lung detected by an X‐ray mass survey. A carcinoid tumor originated from the spur region of the right upper lobe bronchus. The tumor protruded into the bronchial lumen and also extensively expanded into the surrounding alveolar tissue. The tumor showed typical histological features of bronchial carcinoid with a mixed insular, trabecular, and glandular pattern. Multiple implanted foci of tumor cells were found in the periphery of the lobe. The implanted tumor cells replaced the alveolar epithelium without destruction of the alveolar structure, which suggests the possibility of aergenous spread of bronchial carcinoid. This is the first report on bronchial carcinoid with aerogenous spread.
Solitary pulmonary metastasis: An enigma
Authors: Salsali Morteza
Published: February 2007

Lung metastases, which are an expression of the new phase of the underlying neoplastic disorder, have been treated in the recent years by multiple disciplinary approach. When the metastases to the lungs are multiple, it is indicative of extensive tumor burden, and the organ plays an insignificant role in the distribution of the metastases in the different lobes of the lungs. However, when the pulmonary metastases appear after a prolonged disease‐free interval it becomes an enigma; when the metastases are solitary, the majority (over 80% in this series) are located in the upper zone of the lungs. This study of 28 patients with solitary lung metastases explores the possible etiology of this clinical observation and proposes that the pattern of perfusion and anatomopathological features of the upper lobes are the main reasons why these lobes are prevalently the sites for solitary lung metastases.
Infected müllerian adenosarcoma of the endometrium
Authors: Piura Benjamin , Hacay Zion J. , Goldstein Jed
Published: February 2007

A 52‐year‐old postmenopausal woman presented with signs and symptoms of acute pelvic inflammatory disease. On vaginal speculum examination, an infected polypoid tumor protruding from a dilated cervical canal was disclosed. While the patient was under extensive antibiotic treatment, uterine curettage was performed. This was followed a few days later by a total abdominal hysterectomy and bilateral salpingo‐oophorectomy. Histopathological examination demonstrated the tumor to be Müllerian adenosarcoma of the uterine endometrium. The patient had postoperative vaginal vault irradiation, and more than 1 year later she is alive with no evidence of recurrent disease. Diagnosis and management of uterine Müllerian adenosarcoma is discussed.
Myasthenic syndrome (eaton‐lambert syndrome) associated with pulmonary adenocarcinoma
Authors: Ramos‐Yeo Yolanda L. , Reyes Cesar V.
Published: February 2007

A case of a 57‐year‐old man who presented with the clinical features of. Eaton‐Lambert syndrome preceding the diagnosis of lung adenocarcinoma at autopsy by 7 years, is reported. Although myasthenic syndrome is intimately associated with pulmonary small cell carcinoma, which connotes a grave prognosis, a small percentage of the tumor can be squamous cell carcinoma or adenocarcinoma, which may be resectable. Therefore, a continued search for evidence of intrathoracic neoplasm must be pursued following manifestations of myasthenic syndrome.
Three synchronous bilateral lung tumors: A case report
Authors: Paul Sindy M. , Bacharach Benjamin
Published: February 2007

Two synchronous primary lung carcinomas presenting bilaterally are rare. Their presentation, predisposing factors, and treatment are similar to those of single lung carcinomas. The authors present the first reported case known to them of three synchronous primary lung carcinomas involving both lungs. These tumors fulfill accepted criteria for synchronous tumors—each is malignant, each is anatomically separate and distinct from the other, and each is histologically different and is not a manifestation of metastatic disease.
Five‐year survival after extended resection of colon cancer
Authors: Gardner Bernard
Published: February 2007

Eleven cases of prolonged survival after extensive resection of colon cancer including neighboring structures are presented. Our understanding of colon cancer as a rapidly invasive but slowly metastasizing tumor has provided the rationale for this approach. Techniques of ureteral and abdominal wall reconstruction are presented. Cures are possible with this approach, and without the availability of adequate chemotherapy aggressive resections remain the mainstay of treatment.
Adenocarcinoma of the duodenum
Authors: Sarma Deba P. , Weilbaecher Thomas G.
Published: February 2007

Three patients with carcinoma of the first and the third part of the duodenum are reported. A review of the literature shows the diagnosis of this rare lesion of the duodenum is usually late. In order for surgical resection to be successful, suspicion of such a lesion and an aggressive workup is needed.
Use of the 90Sr applicator for intraoperative radiation therapy in a mouse tumor model
Authors: Hill Helene Z. , Ohanian Maimu , Hill George J. , Winne Richard
Published: February 2007

Intraoperative radiation therapy (IORT) research is limited by the lack of small‐animal models. We have implanted B16 melanoma into mouse kidneys, which we subsequently operated upon and irradiated with beta rays from a 90Sr ophthalmic applicator. The IORT has effectively prolonged survival and produced some cures. The strategy should be applicable to other murine tumors and to other internal implantation sites.
Tumor‐associated antigens in bilateral breast cancer
Authors: Lundy Joel , Mishriki Yousri , Varma Andre O. , Kufe Donald , Schuss Allan
Published: February 2007

The purpose of our present study is to determine whether monoclonal antibodies can define an antigenic phenotype which expresses itself in a concordant fashion in synchronous bilateral breast cancer. The monoclonal antibodies DF.3 and B72.3 were reacted (ABC immunoperoxidase) with formalin‐fixed, paraffin‐embedded sections of bilateral synchronous breast cancers from 19 patients. MAb DF.3 demonstrated a P < .01 correlation of right‐sided vs left‐sided reactivity. This suggested that MAb DF .3 could be used as a biologic marker for synchronous bilateral breast cancer. We hypothesized that the majority of clinically asynchronous breast cancers are really biologically synchronous. We used the immunoperoxidase technique in a similar fashion on bilateral metachronous tumors in 17 patients. DF.3 antigen expression correlated (right to left side) at P < .01 value. This data, supported by previous information, suggests that the term “metachronous” breast cancer is a clinically arbitrary definition but that biologically most “metachronous” cancers may well be synchronous.
Hemangiopericytoma of the prostate
Authors: Chen Karl T. K.
Published: February 2007

A case of hemangiopericytoma of the prostate is described. The patient presented with a 5‐year history of episodic hematuria and lower urinary tract obstruction. A transurethral resection of the prostate showed a highly cellular mesenchymal tumor exhibiting features of a hemangiopericytoma. He died of concomitant disseminated carcinoma of the lung. An autopsy showed a large prostatic hemangiopericytoma with bladder wall invasion. This case appears to be the fifth reported case of hemangiopericytoma of the prostate.
Factors influencing the growth and metastastic behavior of tumors
Authors: Murthy M. Satya , Travis Jeanne D. , Scanlon Edward F.
Published: February 2007

The factors influencing the growth and metastatic behavior of experimental animal tumors are examined. 104 TA3Ha cells were injected intraperitoneally, intravenously, subcutaneously into the flank, and subcutaneously into the tail tissues of syngeneic strain A mice. The tumor takes from these injections were 50/50 (100%), 1/10 (10%), 10/10 (100%), and 7/12 (60%), respectively. The frequency of lung metastasis from these sites was 0, 100, 50, and 100%, respectively. At the time of host death, the flank and tail tumors were, respectively, 2.2 ± 0.5 cm (geometric mean diameter) and 1.2 ± 0.3 cm in the TA3Ha and 0.9 ± 0.1 cm and 0.4 ± 0.1 cm in the L1210 systems. TA3Ha tumors metastasized regularly to the lymph nodes but the L1210 tumors seldom metastasized to the lymph nodes. Tail implants of TA3Ha tumors behaved similarly in the athymic nude mice and strain A mice. TA3Ha cells inoculated into the Millipore chambers and maintained in mice for > 150 days were viable and able to form tumors. The results demonstrate that the anatomic location of the tumor affects the growth and metastatic behavior of the tumors, and that the tumors of different histologic origin metastasize differently even when grown in corresponding locations.
Fibromatosis of the breast: A case report and literature review
Authors: Thomas Trey , Lorino Cynthia , Ferrara John J.
Published: February 2007

Fibromatosis is an uncommon, relatively benign though locally infiltrating neoplasm consisting of well‐differentiated fibroblasts surrounded by collagen bundles. The majority of the literature suggests that prevention of local recurrence mandates wide (en bloc) excision. Few more than a dozen cases of primary breast fibromatosis have been reported. Herein the clinical characteristics, diagnostic evaluation, and therapeutic options are presented. Management should be based upon principles utilized for extra‐mammary primary disease–en bloc resection. This may require total mastectomy and removal of pectoralis major muscle. Breast reconstruction should be deferred for a minimum of 3 years, during which time the majority of recurrences will have become manifest.
Subungual melanoma: A 25‐year review of cases
Authors: Daly John M. , Berlin Richard , Urmacher Carlos
Published: February 2007

The purpose of this study was to evaluate subungual melanoma as a site specific entity, to determine the influence of regional nodal involvement, and to ascertain where possible the role of histologic grading of the primary site. Thirty‐three patients with subungual melanoma whose median age was 56 yr underwent treatment between 1950 and 1975. There were 11 male and 22 female patients. Forty‐eight per cent of lesions occurred on the hand. Of 23 clinical stage I patients, seven patients underwent amputation only, while 16 patients underwent amputation and regional nodal dissection. Histologic examination of the primary tumor suggested a trend towards thicker/ulcerated lesions to be associated with metastatic melanoma in regional lymph nodes and/or death due to disease. Early survival patterns favored female patients but there was no significant difference in 10‐year survival when analysed by patient sex. Clinical/pathologic stages were the most significant factors affecting long‐term survival with 5‐ and 10‐year survivals of 66% and 55% in stage I patients and 22% and 0% in stage II patients.
Primary squamous cell carcinoma of the colorectum: Case report and literature review of a rare entity
Authors: Pigott John P. , Williams Gary B.
Published: February 2007

A case of primary squamous cell carcinoma of the rectum is presented. Although it is a rare condition, the diagnosis, treatment, and natural history of the disease are similar to that of adenocarcinoma of the colorectum. The patient in this report has done well to date with an abdominal perineal resection and early post‐operative radiation. A review of the literature reveals that the precise etiology of this entity remains unknown.
Sebaceous adenocarcinoma of meibomian gland origin with targetoid intra‐nuclear inclusion
Authors: Goldstein Jed , Avinoah Ilana , Lifshitz Tova
Published: February 2007

Neoplastic proliferation of the meibomian glands is most often characterized by a tarsal tumor of the eyelid conjunctiva, having the clinical appearance of a chalazion. As such, the tumor is frequently not recognized as a neoplasm and is treated conservatively as an inflammatory lesion. A protracted clinical course combined with repeated surgical excisions typify this slow‐growing tumor of sebaceous gland cells. In addition to the usual features of polygonal cell shape, abundant cytoplasm, and numerous fat vacuoles, we describe the presence of a peculiar nuclear inclusion seen only in the parenchymal cells of this tumor, and having the appearance of concentric layers of electron‐dense material surrounding an opaque electron lucent core.
Bleomycin‐associated pulmonary fibrosis: Rapidly fatal progression without chest radiotherapy
Authors: Dee Gary J. , Austin John H. M. , Mutter George L.
Published: February 2007

Two patients with carcinoma of the tonsil were treated with bleomycin (396 and 224 units, respectively) but not with radiotherapy. Respiratory insufficiency led to death 45 and 52 days, respectively, after onset of therapy. Chest radiographs before bleomycin therapy revealed no evidence for lung disease. Postmortem examinations showed severe interstitial and intraalveolar pulmonary fibrosis. Comparably rapid progression from radiographically normal pulmonary parenchyma to fatal fibrosis has been documented previously only in patients with thoracic neoplasia as well as, in all but one instance, either prior or concurrent chest radiotherapy. These two cases indicate that chest radiötherapy is not a necessary cofactor for the development of rapidly progressive, fatal, diffuse interstitial pulmonary fibrosis after bleomycin therapy.
Regulation of tumor growth by soluble spleen factors: Effect of tumor resection
Authors: Jasnis Marí Adela , Eiján Ana Marí , Oisgold‐Dagá Sara
Published: February 2007

Supernatants of cultured spleen cells (SCS) from small‐tumor‐bearing mice (STBM) and large‐tumor‐bearing mice (LTBM) were tested in vivo by their ability to modify tumor development. We found that when inoculated with S13 tumor cells into the foot‐pad of syngeneic normal BALB/c mice, SCS enhanced tumor growth as well as accelerated tumor takes. When STBM and LTBM were operated on, the persistence of the enhancing activity by SCS was found to be associated with tumor size at the time of tumor removal. As early as 24 hours after small‐tumor resection, enhancing activity disappeared or diminished to undetectable levels. On the other hand, enhancing activity by SCS from large‐tumor‐resected mice (LTRM) persisted until 15 days after surgery, and then faded. Enhancing activity associated with SCS from S13‐tumor‐bearing mice (TBM) was also seen when injected with M3 cells, a syngeneic unrelated tumor. Normal SCS did not affect tumor development. It seems that the rate of disappearance of enhancing activity observed in SCS from S13‐tumor‐resected mice (TRM) is mainly dependent on the size of tumor burden at the time of surgery.
New laser technique for the treatment of malignant esophageal obstruction
Authors: Pietrafitta Joseph J. , Dwyer Richard M.
Published: February 2007

Endoscopic laser therapy for malignant esophageal obstruction is rapidly gaining widespread acceptance by the medical community. The standard approach utilizing the neodymium: yttrium, aluminum, garnet (Nd: YAG) laser was first described by Fleischer for squamous cell carcinoma of the esophagus and subsequently for adenocarcinoma of the gastroesophageal junction. According to his technique, treatment was begun at the proximal tumor margin and proceeded distally; as many as 13 treatments were necessary to complete therapy and relieve the obstruction. A new technique has been developed utilizing tumor dilatation so that treatment can be started at the distal tumor margin working retrogradely. This new technique has allowed treatment to be completed in a single session in most patients. This rapid completion of therapy has reduced the length of hospitalization and thereby hospital costs. It has also allowed patients to aliment earlier, thereby minimizing the metabolic consequences of prolonged intravenous feedings, has allowed patients to receive other forms of therapy on an outpatient basis, and has obviated the need for the chronic placement of tubes for drainage and feeding. The technique is described and discussed.
Estrogen and progesterone receptor levels are lower in specimens taken from previously biopsied breast tumor tissue
Authors: Sharoni Yoav , Feldman Bianca , Inbar Ilana , Haruzi Ilan , Levy Joseph
Published: February 2007

Estrogen and progesterone receptor (ER and PgR) levels and peroxidase activity were measured in the first biopsy and in tissue removed 4–10 days later during mastectomy of previously biopsied tumor. The proportion of ER‐ and PgR‐positive tumors declined from 71% and 63%, respectively, in the biospy group, to 46% and 36% in the mastectomy group. Peroxidase activity was low or absent in all biospy specimens, but was present in 16 out of 25 tumors which had been biopsied previously. Receptor levels in paired specimens obtained from the same patient were lower in the mastectomy in 14 out of 18 receptor‐positive cases. This decrease in the receptor level was accompanied by a significant increase in peroxidase activity. We suggest that an attempt be made to perform receptor analysis from “virgin” tumor tissues at initial biopsy. If this is not possible, measurement of peroxidase activity could be helpful in evaluating the degree of receptor deterioration.
Management of apparent single foci of epithelial ovarian cancer
Authors: Bruckner Howard W. , Gorbaty Mayer
Published: February 2007

Four patients with proven ovarian cancer were found to have single lesions in the liver parenchyma after completing chemotherapy. They otherwise appeared to be in complete clinical remission. Percutaneous needle biopsy was sometimes misleading and dangerous. Laparoscopy and laparotomy were required for optimum safe diagnosis, staging, and treatment. Definitive resection appeared to be beneficial but usually only as a palliative form of debulking. Subsequent adjuvant combination chemotherapy may sometimes improve the duration of useful remissions. Unusual sites of metastatic ovarian cancer appear to be increasing in frequency. Successful management of late recurrences in the liver is possible, provided the diagnosis is immediately suspected and one utilizes both definitive surgery and chemotherapy.
A glucagon‐secreting pancreatic alpha islet cell tumor presenting as spinal cord compression
Authors: Staren E. D. , Steinecker G. A. , Gould V. E.
Published: February 2007

We describe a patient with a pancreatic islet carcinoma presenting with spinal cord compression owing to vertebral metastases. Subsequent studies demonstrated a typical islet cell carcinoma by light microscopy. By electron microscopy, the neurosecretory granules were morphologically suggestive of glucagon production. Radioimmunoassay studies revealed markedly elevated levels of serum glucagon. Notably, the patient did not exhibit the characteristic glucagonoma syndrome. This case exemplifies clearly that elevated levels of immunoreactive neuropeptide hormones are not necessarily associated with overt hormonal syndromes. Possible mechanisms for explaining this apparent discrepancy include the production of immunoreactive molecules with weak or absent systemic biological activity. Nevertheless, the determination of immunoreactive adjunct method for in neuroendocrine neoplasms is an extremely effective adjunct method for their diagnosis and monitoring.
Emergency subtotal colectomy for obstructing carcinoma of the left colon
Authors: Halevy A. , Ponczek M. , Orda R.
Published: February 2007

Eight patients with obstructing carcinoma of the left colon underwent emergency subtotal colectomy and ileosigmoidostomy or ileoproctostomy. Based on the results obtained by us and those reported in the literature, it is our opinion that emergency subtotal colectomy with primary ileocolonic anastomosis should be considered as the procedure of choice for patients with obstructing carcinoma of the left colon.
Primary pulmonary angiosarcoma associated with multiple synchronous neoplasms
Authors: Ott Richard A. , Eugene John , Kollin Jozef , Kanas Robert J. , Conston David E. , Chi Jocelyn C. H.
Published: February 2007

A 60‐year‐old man presented with a 3‐month history of shortness of breath. He was found to have a right thoracic mass involving the right middle and lower lobes, pulmonary hilum, and mediastinum. Diagnosis could not be established by pleural fluid cytology, pleural biopsies, bronchoscopy, and ultrasound‐guided needle biopsies. A diagnostic exploratory thoracotomy was performed. Massive hemorrhage was encountered upon opening the pleura, and bleeding was controlled by performing a radical pneumonectomy. Histology revealed angiosarcoma, pulmonary primary. The patient survived for 68 days. At autopsy, he was found to have adenocarcinoma of the prostate, adenocarcinoma of the rectum, carcinoid of the ileum, and leiomyoblastoma of the stomach as well as diffuse metastases from the angiosarcoma. This represents the fourth reported case of primary pulmonary angiosarcoma.
Primary liver cancer: Pattern of metastasis
Authors: Lee Yeu‐Tsu Margaret , Geer Deborah A.
Published: February 2007

The causes of death and patterns of metastasis of 43 patients with primary liver cancer were studied and discussed in comparison with reports in the literature. Data from 6 recent reports of 1,673 patients showed that the 3 leading causes of death from hepatoma were liver failure (34%), bleeding (30%), and advanced cancer (24%). Distribution of sites of metastasis in 1,497 patients with hepatoma from 7 reports showed that the 3 leading sites were: lung (median 44%), portal vein (35%), and portal lymph node(s) (27%). The pattern of metastasis of hepatoma arising from cirrhotic liver is somewhat different from that of the noncirrhotic liver; the former are more likely to involve the portal vein, whereas the latter involves more regional lymph node(s). Compared to hepatoma, cholangio‐carcinoma is less likely to metastasize to the lung or portal vein, but more likely to involve lymph node(s), peritoneum, and bone and/or marrow.
Triple lumen venous access for pediatric bone marrow transplantation candidates
Authors: Weese James L. , Trigg Michael E.
Published: February 2007

Multiple routes of vascular access are required in children undergoing bone marrow transplantation to facilitate total parenteral nutrition (TPN); blood withdrawal; and administration of blood products, antibiotics, fluids, and immunosuppressive drugs. Placement of multiple catheters frequently requires multiple venotomies in separate vessels. We have found that both a Broviac catheter and pediatric dual‐lumen Raaf catheter can be placed through separate venotomies in the external jugular vein, which provides sufficient routes of vascular access without complications. This technique places only one vessel at risk while minimizing the chance for infection by utilizing two exit sites. We consider this to be the procedure of choice in young patients requiring multiple routes of vascular access.
Adjuvant chemotherapy in high‐risk malignant melanoma
Authors: Karakousis Constantine P. , Emrich Lawrence J.
Published: February 2007

Fifty‐nine patients with regional or hematogenous recurrence of malignant melanoma following resection of all the gross tumor were randomized to observation or chemotherapy. The chemotherapy consisted of BCNU 80 mg/M2 I.V. every 4 weeks, actinomycin‐D 0.01 mg/kg and vincristine 1.0 mg/M2 I.V. every 2 weeks, for a total of 6 months. The chemotherapy protocol was tolerated well without appreciable objective side effects. At a median follow‐up period of 11.5 months, the disease‐free survival time for the chemotherapy treated group is significantly longer than for the control group (P = 0.01). The estimated median disease‐free survival time is 4 months in the surgical control group and 9 months in the chemotherapy group. At present, the proportion of patients remaining disease‐free is 43% for the surgical control and 55% for the chemotherapy treated group. More patients and follow‐up are needed, but this preliminary report suggests that nitrosourea‐based protocols need to be evaluated further as adjuvant treatment of malignant melanoma.