bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum sialic acid is a biologic marker for malignant disease
Authors: Khanderia Ujjaini , Keller James H. , Grossman H. Barton
Published: February 2007

Serial serum sialic acid (N‐acetylneuraminic acid) was measured in 16 patients with advanced cancer of various histologic types. In the 15 evaluable patients serial changes in sialic acid correlated with the clinical course. Isolated sialic acid values were not predictive of clinical response. Serial determination of serum sialic acid appears to be a useful monitor of tumor burden.
Brain metastasis from prostatic cancer
Authors: Sarma Deba P. , Godeau Linda
Published: February 2007

Four cases of prostatic carcinoma with metastasis to brain are described. Two of those cases are diagnosed antemortem. Our experience from postmortem case studies and review of the literature point to the fact that metastasis to brain from a prostatic cancer remains a rare occurrence.
Prognostic factors in invasive gallbladder carcinoma
Authors: Friedman Richard B. , Anderson Renae E. , Gilchrist Kennedy W. , Carbone Paul P.
Published: February 2007

The medical records of 52 patients from the University of Wisconsin Hospital and Clinics with carcinoma of the gallbladder were examined retrospectively. The cases were reviewed for factors in their medical history, presenting physical examination, laboratory data, therapy, pathological grade, and histology that might effect median survival. Only a prior complaint of anorexia, an elevated lactic dehydrogenase (LDH), or advanced pathologic stage at time of diagnosis provided significant prognostic information. Combining pathologic stage and histologic grade additively provided the most significant prognostic information [1]. Division of gallbladder carcinoma patients in future clinical trials by this combined (stage and grade) stratification scheme may prove helpful in assessing the efficacy of new therapies. The knowledge that anorexia and elevated LDH are poor prognostic findings may assist physicians in counseling patients with this malignancy.
Second malignancies diagnosed in patients receiving chemotherapy at the pennsylvania hospital
Authors: Lerner H. , Marcovitz E. , Schoenfeld D. , Zaren H.
Published: February 2007

During the past 15 years, the records of 2,020 patients who received chemotherapy on the surgical oncology, chemotherapy service at the Pennsylvania Hospital were reviewed. Thirty‐five patients had pathologically confirmed second independent malignant tumors (not recurrences). The second cancers that developed were varied. The patients who developed these second malignancies ranged in age from 35 to 77 years (24 females, 11 males). The time interval involved was two to 102 months. Nine patients in this group of second malignancies received prior radiation therapy.

The following is a list of the second cancers. There were 8 colons, 5 ovaries, 5 lungs, 6 acute myelogenous leukemias, 1 esophagus, 2 bladders, 2 epidermoid carcinomas of the skin, 2 melanomas, 1 chronic lymphatic leukemia, 1 breast cancer, 1 non‐Hodgkin's malignant lymphoma, and 1 stomach cancer. The majority of second malignant tumors were amenable to some form of therapy, ie, surgery, radiation or chemotherapy. However, all of the acute myelogenous leukemias were totally refractory to any therapeutic modalities and rapidly expired.

The majority of second cancers developed in patients receiving adjuvant chemotherapy. This is a patient population with a much longer expected survival time, particularly when compared to patients receiving chemotherapy for advanced disease. Twenty‐five of the 34 second cancers developed in patients who received adjuvant chemotherapy for breast (14) or colorectal (11) cancers.

The etiology of the second malignancies is very difficult to determine. However, alkylating agents appeared to be the possible etiologic agent involved in the development of acute myelogenous leukemia.
Surgery in patients with advanced germ cell malignancy following a clinical partial response to chemotherapy
Authors: Reddel R. R. , Thompson J. F. , Raghavan D. , Tattersall M. H. N. , Levi J. A. , Coupland G. A. E. , Fox R. M. , Coates A. S. , Woods R. L. , Ng A. B. P.
Published: February 2007

Twenty‐one patients with metastatic germ cell tumors achieved only partial clinical tumor regression following chemotherapy, and underwent surgical biopsy or resection of the residual tumor deposits. Sixteen (76%) are at present clinically disease‐free after a median 30+ months (range 17–50 months) from the time of surgery, and five (24%) died after 9–29 months. Adverse prognostic signs were the finding of persistent cancer at histopathological examination of the resected tumor masses, and the presence of elevated serum tumor markers at the time of surgery. Postchemotherapy surgery in this setting provides tissue for the prognostically important histopathological examination on which a decision regarding further chemotherapy may be based. In addition, it provides tumor bulk reduction in the cases of differentiated teratoma and persistent cancer.
Multiple primary cancers in Indian population: Metachronous and synchronous lesions
Authors: Vyas J. J. , Deshpande R. K. , Sharma Sanjay , Desai P. B.
Published: February 2007

A retrospective study of 177 patients attending Tata Memorial Hospital over a period of 40 years from 1942 through 1981 is presented. These patients who had “primary lesions” in the head and neck region, breast, esophagus, lung, and elsewhere as carcinoma or sarcoma developed “second primary” at different sites, after the treatment for the primary lesion after a variable period over years—as “metachronous lesions” (139 patients). Another group of patients presented with “double primary” at initial clinical examination and investigations, and these were “synchronous” lesions (38 patients). The analysis brings out the relationship of these lesions in both groups to each other with reference to habits in Indian population, viz, pan chewing, tobacco smoking, and alcohol consumption and time interval and histological variations among these lesions. An interesting relationship has been observed in certain aerodigestive tract primary lesions developing second cancer due to continued effect of “carcinogens,” as habits are hard to die even after developing cancer. Analysis also brings out an interesting observation of involvement of “physiologically and anatomically” related organs developing second cancer at an interval or concurrently. A solitary pulmonary nodule or an opacity in a patient with extrathoracic cancer should not be considered as “metastatic” unless proved otherwise; metachronous lesions need to be treated energetically, adequately, efficiently, and aggressively in certain clinical situations for better results and salvage.
Mastectomy in the management of patients with inflammatory breast cancer
Authors: Morris Don M.
Published: February 2007

Inflammatory carcinoma of the breast is rare and lethal. Since the early 1940s, operation except for biopsy has been contraindicated in patients with inflammatory breast cancer. Results with radiotherapy alone and with radiotherapy and chemotherapy are reviewed. Results of treating patients with initial chemotherapy and debulking surgery in patients who respond to chemotherapy are presented. Mastectomy may be safely performed in selected patients with inflammatory breast cancer. Local control will improve quality of life. By removing the breast and residual tumor after chemotherapy and/or radiotherapy, fungation, ulceration, and some of the clinical and psychological problems of uncontrolled local disease may be avoided. Mastectomy should be performed only in patients who responded well to preoperative therapy. Patients who do not respond to chemotherapy should be treated with radiotherapy and should not undergo operation. This approach has not been detrimental to survival or to ultimately achieving local control of the disease.
Colon carcinoma metastatic to the ovary
Authors: Tunca Josh C. , Starling James R. , Hafez Gholam R. , Buchler Dolores A.
Published: February 2007

We reviewed 17 patients with colon carcinoma metastatic to the ovary seen from 1970–1980. This represents 2.5% of the total malignant ovarian neoplasms seen during this time period. In 3/17 patients, exploratory celiotomy was performed without preoperative barium enema, stool for occult blood, or colonoscopy. These patients subsequently were found to have a primary colon carcinoma. Colectomy was performed in 8/17 of our patients without prophylactic oophorectomy. All of these patients subsequently developed metastatic ovarian carcinoma. Long‐term survival in our series was dismal. We recommend (1) a compulsary colon examination to include colonoscopy prior to surgery for ovarian masses, and (2) prophylactic bilateral salphingo‐oophorectomy at the time of colectomy for colon carcinoma.
Multiple thoracotomy combined with chemotherapy in metastatic adrenal cortical carcinoma: A case report and review of the literature
Authors: Appelqvist Pertti , Kostiainen Seppo
Published: February 2007

A case is reported in which multiple bilateral pulmonary metastasectiomies for metastatic adrenal cortical carcinoma were performed and which resulted in an unusually long survival of over 25 years from the first thoracotomy and over 28 years from removal of the primary adrenal cortical carcinoma. The patient is alive and free of tumor as of the latest follow‐up. We believe this is the longest survival after pulmonary metastasectomy for carcinoma published to date.
Relationship of the lymphoplasmacytic infiltration of skin tumors to tumor ulceration
Authors: Halter Susan A. , Dellon A. Lee
Published: February 2007

The lymphoplasmacytic infiltrates of 400 bening, borderline, and malignant skin tumors were assessed by light microscopy to determine the relationship between the presence of tumor ulceration and the histologic character of the infiltrate. Squamous cell carcinoma had the highest overall number of infiltrating lymphoplasmacytic cells, while seborrheic keratoses had the lowest. Plasma cells in the infiltrates were related significantly to tumor ulceration (P < .001). This suggests that the plasma cell infiltrates may be more related to tumor ulceration than to a tumorspecific response in these carcinomas. Small lymppocytes were most evident adjacent to areas of irregularity in the peripheral palisade or of squamous differentiation of the basal cell carciomas. This suggests that the presence of small lymphocytes, not plasma cells, is a response by the immunocompetent host to areas of tumor invasion.
A serotonin and βHCG‐producing islet cell carcinoma associated with focal nodular hyperplasia of the liver
Authors: Prinz Richard A. , Bermes Edward W. , Chejfec Gregorio , Fareed Jawed , Klich Janice
Published: February 2007

A 48‐year‐old woman is described with a pancreatic islet cell carcinoma that had no clinical evidence of hormone production. This neoplasm was removed by radical distal pancreatectomy. Immunohistochemical and extraction studies performed on the tumor tissue revealed that it was producing serotonin and βHCG. Circulating levels of these hormones were elevated in preoperative serum samples that had been frozen. βHCG, a known tumor marker, has remained normal following operation, and this mirrors her clinical course since she has no evidence of disease 1.5 yr after operation. This patient also had focal nodular hyperplasia of the liver. It is possible that the trophoblastic hormone, βHCG, which was being produced in excess by the islet cell tumor, may have directly or indirectly caused or facilitated the development of focal nodular hyperplasia.
Surgery following initial treatment of ovarian carcinoma: Restaging (second‐look) and palliative operations
Authors: Jacobs Allan J. , Kubitz Rebecca L. , Scott Joseph C. , Kessinger M. Anne
Published: February 2007

Of 73 patients treated for ovarian carcinoma at the University of Nebraska Medical Center between 1976 and 1982, 37 underwent a second operative procedure following initial surgery. A total of 14 had a second look following complete clinical response, 11 had intestinal diversion, and 12 underwent other procedures. Second‐look surgery proved useful in evaluating patients in clinical remission and directing subsequent management. The majority of patients whose operations were for persistent or recurrent disease had short survival. However, such surgery helps occasional patients and should be considered when circumstances warrant.
Cyclophosphamide activity against B16 melanoma in a rapid in vitro test system
Authors: Hill George J. , Hill Helene Z.
Published: February 2007

An in vitro test system is described for evaluation of the response of tumor cells to chemotherapeutic agents. The test is simple and rapid and does not require the use of sterile technique. The response of B16 melanoma in vivo in C57BL/6 mice to single graded doses of cyclophosphamide is compared to the response of B16 tumor cells in vitro to cyclophosphamide that has been activated in vivo and recovered in plasma. The assay involves preincubating the tumor cells with the activated drug and subsequently measuring the ability of the cells to incorporate [3H]dThd ([3H] thymidine) into acid‐insoluble material. In vivo activated drug is maximally effective in 20 min and the entire test can be completed within 8 hr. This test may be useful as a rapid preliminary screening method to predict the effect of chemotherapy on cancer.
In vitro chemotherapy sensitivity patterns of human colon carcinoma continuous cell lines
Authors: Agrez M. V. , Ames M. M. , Lieber M. M.
Published: February 2007

The cells obtained from four established human colon carcinoma cell lines were cultured in soft agar in the presence of eight chemotherapeutic agents that have been used clinically in patients with metastatic colorectal carcinoma. 5‐Fluorouracil, mitomycin C, adriamycin, and cis‐platinum were highly cytotoxic in vitro at the concentrations employed. These findings were in marked contrast to in vitro chemotherapy sensitivity patterns previously reported by us for a large series of primary human colorectal carcinomas cultured in soft agar. The possible reasons behind these differences are discussed.
Experimental cancer of the bowel in the Nb rat
Authors: Joehl Raymond J. , Drago Joseph R.
Published: February 2007

An animal model of bowel cancer, induced by 1,2‐dimethyl hydrazine, has been developed in the Nb rat. Invasive polypoid carcinomas of the colon were noted in nine rats surviving 29 weeks after the carcinogen was first administered. Two of these nine rats also developed duodenal carcinomas. Because dosage schedules are known from previous experiments with the Nb rat, this animal model may be useful for evaluating the effects of cytotoxic drugs on experimental bowel cancer.
Enhanced tumor growth in experimental whole body hyperthermia
Authors: Wile Alan G. , Nahabedian Maurice Y. , Mason G. Robert
Published: February 2007

The purpose of this study was to investigate the interaction of heat and chemotherapy in experimental whole body hyperthermia (WBH). A vascular technique of extracorporeal perfusion was employed to rapidly elevate body temperature in rabbits carrying the transplantable VX‐2 carcinoma. Hyperthermia (> 41°C) was achieved in a mean time of 28 minutes. Tumor‐bearing rabbits receiving WBH alone exhibited poor mean survival (14 days) relative to untreated tumor‐bearing animals (32 days) and the group receiving IV Cis‐platinum alone (50 days) (NS, p < .05 respectively). WBH with Cis‐platinum was intermediate in terms of mean survival (30 days, NS) between the WBH alone and Cis‐platinum alone groups. In this experimental model we have determined WBH to be a detrimental form of cancer therapy. Its action appears to enhance tumor proliferation, resulting in rapid animal demise. In light of these findings a reevaluation of clinical WBH may be warranted.
Massive intraabdominal bleeding due to a retroperitoneal leiomyosarcoma
Authors: Witz Misha , Shpitz Baruch , Dinbar Alex
Published: February 2007

Retroperitoneal leiomyosarcomas are rare and show a tendency toward large size, cystic degeneration, bleeding, and extensions by infiltration to the adjacent structures. An unusual case of a retroperitoneal cystic leiomyosarcoma with massive intraabdominal bleeding is presented.
Computerized tomography in malignant tumors
Authors: Karakousis C. P. , Jennings E.
Published: February 2007

Computerized tomography (CT) was used in the evaluation or follow‐up of 89 patients with malignant tumors. Excellent correlation was found between the preoperative CT findings and those at surgical resection of the tumor in 52 patients. CT scan was the only test demonstrating the tumor mass in 18% and was superior to other tests in 67% of patients. When used as a follow‐up test to detect recurrence in 74 patients, it was the first test to reveal recurrence in 30.5% of 36 patients who developed recurrence. It was false negative in one patient, and gave rise to false positive interpretations in seven patients. Overall, the CT scan was superior to conventional readiologic techniques, but the latter are not replaced completely and remain essential in the pertinent anatomical situations.
The distribution of acidic coomassie blue‐stained proteins from uninvolved human liver, hepatoma, normal colon, primary colon cancer, and colon metastases to the liver, determined by two‐dimensional protein electrophoresis
Authors: Anderson K. M. , Baranowski J. , Olson L. , Economou S. G.
Published: February 2007

The distribution of Coomassie blue‐stained proteins from uninvolved regions of 4 human livers, from 1 hepatocellular carcinoma, and from 4 samples each of uninvolved colon, primary adenocarcinoma of the colon, and colon cancer metastatic to the liver was analyzed by two‐dimensional protein electrophoresis. From a comparison of acidic proteins between pI 3.5 and 6.5, we conclude (1) that the majority (66 of 82) of denoted acidic proteins from 4 normal liver samples were represented in the hepatocellular carcinoma. Fifty‐one of 58 proteins denoted in the 4 colon samples were detected in each of the 4 primary colon cancers; (2) that the “normograms” of proteins from normal colon and normal liver differed in many details, and their dissimilar patterns identified the source of the sample; (3) that hepatoma and primary adenocarcinoma of the colon were easily distinguished by their distribution of proteins; (4) that colon cancer metastatic to the liver contained a majority (50/58) of acidic proteins enumerated in primary colon cancer. These results indicate that uninvolved liver and colon and their primary or secondary cancers can be identified by their distribution of electrophoresed acidic proteins.
Superficial lymph node infarction
Authors: Pietrafitta Joseph J. , Grasberger Robert C. , Deckers Peter J. , Giampaolo Casimiro M. , Kondi Edward S.
Published: February 2007

Suerficial lymph node necrosis is an unusual pathologic diagnosis encountered in clinical practice. When seen it is usually indicative of involvement of the affected lymph nodes with either metastatic cancer or lymphoma. Occasionally it has been associated with hypersensitivity phenomena with arteriolar involvement. The underlying etiology in all of these instances is extensive occlusion of the rich vascular supply to the node. Rarely cases are seen where no clear‐cut etiology can be found. Ten such cases have been reported in the medical literature including the case published in this report. Its occurrence, however, may be more common than previously recognized. Preoperatively it is usually not possible to distinguish this entity from the other diagnoses for which it is generally mistaken. These other diagnoses most commonly include femoral hernia and mass in the axillary tail of the breast. The patient reported here is unusual in regard to the size of the lesion encountered. In other published reports very few lymph nodes were involved. In this case extensive involvement of a large mass of nodes was noted. Once the diagnosis is made limited work‐up as well as further close observation is important since it may herald the occurrence of a lymphoproliferative disorder.
The Nb rat prostatic adenocarcinoma's dose response to methotrexate and adriamycin
Authors: Drago Joseph R. , Palmer John
Published: February 2007

The Noble rat prostatic adenocarcinoma, Nb‐Pr‐A.I.‐II, an androgen‐insensitive tumor, is the subject of this experiment. Dose responses were carried out with treatment of these tumors with three doses of adriamycin and two doses of methotrexate. Adriamycin treatment resulted in decreased tumor volume and decreased number of metastases in the higher dosage. Methotrexate also decreased metastasis and tumor volume. No animal treated with either of these agents in this protocol had the tumor undergo complete tumor regression, a criteria used in evaluation of chemotherapies with this animal model.
Immunity in esophageal carcinoma
Authors: Advani S. H. , Kutty P. M. , Gopal R. , Swaroop S. , Nair C. N. , Dinshaw K. A. , Damle S. R. , Nadkarni J. S. , Akolkar P. N. , Gothaskar B. P. , Vyas J. J. , Desai P. B.
Published: February 2007

In carcinoma of the esophagus, response to in vivo sensitization with recall antigens and DNCB was markedly depressed with 13% and 16% positivity respectively. Similarly, the number of T‐cells was found to be significantly low (24 ± 14) as compared to normal control (61 ± 23). Blastogenesis index with PHA was only 1.75 ± 1.04 in contrast to normal of 6.79 ± 2.57. This depression was independent of serum albumin level and body weight. Cell‐mediated immunity was further depressed following radiotherapy and did not improve following enteral alimentation for 3 weeks. In untreated patients, there was a significant rise in levels of IgA (298 ± 184 mg/100 ml) as compared to normal (154 ± 54 mg/100 ml). Levels of IgA did show a downward trend following enteral hyperalimentation. Circulating immune complexes and serum CEA level were elevated in almost 50% of patients. These data confirm the influence of tumor‐related impairment of cell‐mediated immunity while nutrition appears to affect IgA levels.
Submucous lipoma of the transverse colon: Report of one case
Authors: Mauriziodi P. Di , Bracci F. , Colizza S. , Cianconi C. , Crisci E.
Published: February 2007

A case of submucous lipoma of the transverse colon is reported. The patient, a man aged 61, complained of recurrent crampy periumbilical pain. A plain x‐ray of the abdomen was negative, while a barium enema showed an intramural filling defect of the transverse colon which was interpreted as a probably degenerated colonic polyp. Laparotomy did not clarify the diagnosis which was readily clear when the lesion was cut, and confirmed by histology.
Tumor specific reactivity during development of N‐methyl‐N‐nitrosourea‐induced rat colon cancer
Authors: Weese James L. , Starling James R. , Syrjala Steven
Published: February 2007

Invasive colon adenocarcinomas with lymph node metastases can be induced in Sprague‐Dawley rats by 15 weekly intrarectal injections of 2 mg N‐methyl‐N‐nitrosourea (NMU). Extracts were prepared from invasive adenocarcinomas and normal rat colon mucosa by a 2 phase gradient. Mixed leukocyte tumor interaction (MLTI) assays stimulating lymphocytes from tumor‐bearing and normal rats were performed using these extracts. Quadruplicate cultures were established with 2 × 105 lymphocytes and tumor or normal colon extract. Cultures were pulsed with H3 thymidine at 7 days and harvested 6 hours later. Results were expressed as net counts (experimental CPM minus background CPM). Reactivity in tumor‐bearing animals was first seen when rat colons showed intraepithelial dysplasia histologically and was maximal when early invasive colon tumor were present. No difference in stimulation was seen between tumor‐bearing and normal animal lymphocyte reactivity with normal colon extract. In conclusion, animals with NMU‐induced rat colon cancer show specific tumor reactivity in MLTI assays. Immune reactivity in these animals may provide clues to clinical tumor status by immunologic assay.
Management of osteoradionecrosis of the mandible with myocutaneous flaps
Authors: Baker Shan R.
Published: February 2007

Involvement of large areas of the mandible or the entire mandible with osteoradionecrosis may result in severe functional disability and cosmetic deformity. The use of a well‐vascularized pectoralis major myocutaneous flap from outside the original field of irradiation has been successful in obtaining functional and cosmetic goals. Myocutaneous flaps provide bulk for contour and tissue support, and their rich vascular supply promotes healing of the heavily irradiated soft tissue and bone. Successful bone grafting for mandibular reconstruction may follow control of the osteoradionecrosis.
Hepatic leiomyosarcoma
Authors: Chen Karl T. K.
Published: February 2007

A case of hepatic leiomyosarcoma is reported and the literature on smooth muscle tumors of the liver is reviewed. All 15 patients with hepatic leiomyosarcoma presented initially with hepatic or abdominal mass. About half of these patients also had abdominal pain or weight loss or both. Elevated levels of serum alkaline phosphatase, SGOT, and lactic dehydrogenase were frequent but inconsistent findings. The prognoses appeared grave, but potentially curable. All but four patients died in less than 3 years. One patient was not followed. The three patients who were alive in follow‐ups survived 8 months, 1 year, and 6.5 years, respectively, with no evidence of disease. All three surviving patients had resectable tumor and were surgically treated.
Bowel obstruction in cancer patients: Performance status as a predictor of survival
Authors: Weiss Stephen M. , Skibber John M. , Rosato Francis E.
Published: February 2007

Ninety‐five patients with known cancer who developed bowel obstruction were reviewed in an effort to evaluate the reliability of preadmission performance status as a predictor of outcome of therapy. Based on the review, a number of conclusions can be reached. Performance status, which is more easily measured than stage of disease at admission, is correlated with successful resolution of obstruction and survival. Many patients with known cancer who develop bowel obstruction have a non‐malignant cause of obstruction. Prolonged nonoperative treatment of cancer patients with bowel obstruction is unlikely to be successful and is fraught with complications.
Ewing sarcoma of the hand: Literature review and a case report of nonsurgical management
Authors: Kedar Amos , Bialik Viktor , Fishman Joseph
Published: February 2007

A case of a 12‐year‐old girl with Ewing sarcoma of the third metacarpal bone is described. Following an incisional biopsy, radiation therapy and adjuvant chemotherapy were given. The girl is now 34 months postdiagnosis and 25 months off therapy in sustained complete remission and functionally normal right hand. Of the seven previously published cases only two are long‐term survivors (one had disarticulation, and the other resection of the fourth and fifth rays).
Ossified skeletal muscle angioma: Report of two cases
Authors: Hoag Gordon N. , Murphy Maurice M. , Major Paul A.
Published: February 2007

Ossifying skeletal muscle angiomas are relatively rare occurrences. The preoperative diagnosis is exceedingly difficult, although ossification may be reflected radiologically as a “Swiss cheese” appearance. Two patients are described whose skeletal muscle angiomas contained osseous tissue. The osseus tissue varied from microscopic foci to an abundant amount which was readily recognizable radiologically. The pathologic and radiological features are discussed and these appearances to hemangioma and lymphangioma are presented.
Primary head and neck reconstruction with a simultaneous ipsilateral pectoralis major myocutaneous flap and a deltopectoral flap
Authors: Morris Don M. , Reed William , Cunningham Marshall
Published: February 2007

Patients with large advanced tumors of the head and neck that are resectable may be reconstructed by using the combination of an ipsilateral pectoralis major myocutaneous flap and an ipsilateral deltopectoral flap. Preoperative planning is necessary. The PM flap must be elevated and care taken not to interfere with the internal mammary perforating arteries. The lateral chest incision must be made low enough to provide adequate skin and soft tissue in the DP flap. These two flaps provide adequate tissue with a reliable blood supply to reconstruct these large defects.
Observations on the inadequately excised basal cell carcinomas
Authors: Sarma Deba P. , Griffing Craig C. , Weilbaecher Thomas G.
Published: February 2007

We studied 43 cases of reexcised skin where a diagnosis of “inadequately excised basal cell carcinoma” was made at the initial excision. Only 3 cases (7%) revealed microscopic residual tumor. Prior studies have shown a recurrence rate as high as 35% for “inadequately excised basal cell cancers.” Possible reasons for relatively low incidence of residual tumor in the reexcised specimens are discussed.
Extrarenal angiomyolipoma
Authors: Chen Karl T. K. , Bauer Vija
Published: February 2007

A case of angiomyolipoma arising in the anterior abdominal wall is reported and compared with other reported cases of extrarenal angiomyolipoma. None of the patients had tuberous sclerosis and no recurrence was noted following simple excision.
Impairment of thymus‐derived lymphoid cell function in patients with basal cell carcinoma
Authors: Dellon A. Lee , Elfenbein Gerald J. , Orlando Joseph C.
Published: February 2007

The host‐tumor relationships in 34 patients with basal cell carcinoma was investigated by characterizing thymus‐derived (T) and bone marrow‐derived (B) lymphoid subpopulations in the blood by cell surface markers and lymphoid function in vitro by proliferative responses to mitogenic and antigenic stimulation. Results were correlated with tumor stage. In patients with tumor present, the data demonstrate significantly (P < .02) decreased responsiveness of T cells to the lectin mitogens phytohemagglutinin and concanavalin A, and further demonstrate significantly decreased responsiveness of T cells to antigens (P < .001 for Candida antigen, P < .05 for Staphylococcal filtrate and Streptococcal varidase). In patients who were grossly disease free after resection of tumors, there was no significant difference in these responses from normal. These results document, for the first time, impaired T‐cell function in patients with basal cell carcinoma and suggest that the functional impairment is tumor induced.
Surgical treatment of carcinoma of the breast: III. Pathological finding and probability of relapse
Authors: Lee YEU‐TSU N. (Margaret)
Published: February 2007

This is a retrospective review of pathological findings of 462 patients who had mastectomy for carcinoma of the breast during 1971–1980. There is a positive correlation of size of the primary tumor and histological subtypes with the incidence of axillary nodal metastasis. Infiltrating ductal and lobular carcinoma, although less likely than medullary or colloid carcinoma to be 4 cm or greater in size, had a significantly higher incidence of nodal metastasis (and greater chance of having four or more positive nodes). Colloid carcinoma smaller than 4 cm and the less common histological subtypes (comedo, tubular, and papillary carcinomas) rarely metastasizes. Considering only carcinoma of infiltrating ductal, lobular, and medullary types, there is a progressively worsening prognosis with increasing sizes and number of positive axillary lymph nodes. In our series, dividing tumors into three arbitrary subgroups either by size (⩽ 2 cm, 2–6 cm, ⩾ 6 cm) or number of positive nodes (0–3, 4–9, ⩾ 10) gave the most significant separation of prognosis.
Cutaneous adnexal squamous carcinoma
Authors: Chen Karl T. K.
Published: February 2007

A 46‐year‐old woman developed a squamous carcinoma of the skin that was treated with surgical excision followed by irradiation. The excised tumor showed no epidermal involvement; therefore, it was diagnosed as metastatic squamous carcinoma. However, a 4‐year disease‐free follow‐up indicates that it represents a primary skin tumor. Since the exact histogenesis is unclear, this tumor is tentatively designated “cutaneous adnexal squamous carcinoma.”
Primary pedunculated fibrosarcoma of the peritoneum: A case report
Authors: Delpero J. R. , Lieutaud R. , Dominguez C. , Guerinel G. , Carcassonne Y.
Published: February 2007

Fibrosarcoma is a primitive, mesenchymal tumor frequently arising from superficially located soft tissues. A case of a primary intraperitoneal, pedunculated fibrosarcoma is reported, initially presenting as an abdominal mass protruding into a large incisional hernia of the anterior abdominal wall. Despite total tumor resection, multiple intraperitoneal tumor nodules of varying sizes were found and resected six months and one year later. The patient died 18 months after the first surgical intervention. This case illustrates the highly malignant behavior and poor prognosis of fibrosarcomas of the peritoneum.
Non‐spore‐forming clostridial bacteremia
Authors: Grasberger Robert C. , Pietrafitta Joseph J. , Deckers Peter J.
Published: February 2007

The significance of the non‐spore‐forming clostridium as a blood‐borne pathogen has been underemphasized. Over a 7‐year period, these bacteria were cultured 40 times in 30 patients. Overall mortality rate for non‐spore‐forming clostridial bacteremia was 39%. Patients with polymicrobial infections had a 58% mortality rate, while those with only clostridium in their blood had a mortality of 23%. Mortality increased as the number of positive cultures. Patients who were clinically septic at the time of their cultures fared poorly. Advanced age and underlying malignant disease were associated with increased mortality. Patients who have positive blood cultures for non‐spore‐forming clostridium are at a significant risk and should be treated aggressively.
Prognosis of skin melanoma with regional node metastases (stage II)
Authors: Cascinelli Natale , Vaglini Maurizio , Nava Maurizio , Santinami Mario , Marolda Raffaele , Rovini Dario , Clemente Claudio , Bufalino Rossaria , Morabito Alberto
Published: February 2007

566 stage‐II melanoma patients treated at the National Cancer Institute of Milan, Italy, were analyzed to evaluate the prognosis. Among the criteria considered, four were significantly associated with survival when considered as single factors: growth pattern, levels of invasion, the number of involved lymph nodes, and the extent of metastatic growth. As regards growth pattern, the observed 5‐year survival rates were 41.9% for superficial spreading melanoma and 20.5% for nodular melanoma (P = 10−3). As regards levels, the 5‐year survival rates were as follows: level II, 20.9%; level III, 33.1%; level IV, 43.2%; level V, 10.2% (P = 10−3). Patients with a partial node metastasis had 64.5% 10‐year survival, while those with extension beyond the capsule had 32.6% 10‐year survival (P = 10−9). Patients with one metastatic node had 43.4% 10‐year survival, and patients with three or more positive nodes had 26.0% 10‐year survival (P = 10−9). Multifactorial analysis shows that growth pattern and extent of node metastases significantly affect survival (P =10−2 and P = 10−4, respectively) while the number of involved nodes turns to borderline P‐value (0.051) and the levels are no longer significant (P = 0.4).
Is mediastinal irradiation necessary for stage I testicular seminoma?
Authors: Jose Baby , Perkins Lee P. , Kays Howard , Chu Ann M. , Sharma Subhash C.
Published: February 2007

This study is a review of 39 patients with testicular seminoma, Stage I, treated at the Department of Radiation Oncology, James Graham Brown Cancer Center from 1959 to 1978. The age of the patients ranged from 16 to 70 years with a median of 37. Thirty‐two (82%) patients presented with swelling or mass in the testis, four patients with pain, and three patients had seminoma diagnosed incidentally. Twenty (51%) patients had the tumor on the right side and 19 (49%) patients had the tumor on the left side. All patients received irradiation to the ipsilateral inguinal, iliac, and bilateral para‐aortic nodes with “hockey stick” type fields. The majority of the patients received a midplane dose of 3,200 to 3,600 rad in 3–4 weeks time. None of the patients received prophylactic irradiation to the mediastinum and supraclavicular region. The 5‐year actuarial survival rate is 96%. There is no additional benefit in giving prophylactic irradiation to the mediastinum and supraclavicular regions in Stage I testicular seminoma. A brief review of the literature regarding the, role of prophylactic irradiation in this group of patients is done.
Seminoma in undescended testes
Authors: Jose Baby , Perkins P. Lee , Kays Howard
Published: February 2007

The role of cryptorchidism in testicular carcinogenesis has been of concern for many physicians for quite a long time. The probability of a malignant neoplasm developing in an undescended testicle is about 20 to 48 times greater than a normally descended testicle. In a review of 74 patients treated with a diagnosis of testicular seminoma at the Department of Radiation Oncology, University of Louisville, Louisville, Kentucky, from 1959 to 1978, six cases were identified with a history of cryptorchidism. A detailed review of these patients along with literature review is done in this paper. The different etiologic factors for tumorigenesis in this group of patients is also discussed. The importance of periodic follow‐up of these patients is also stressed in this paper.
Prolonged survival following six pulmonary resections for metastatic adrenal cortical carcinoma: A case report
Authors: Potter Dorothy A. , Strott Charles A. , Javadpour Nasser , Roth Jack A.
Published: February 2007

A case is presented of prolonged survival following multiple thoracotomies performed for metastatic adrenal cortical carcinoma that was refractory to other treatment modalities. In selected patients with isolated metastases to the lungs, repeated surgical resection may offer the only possibility for cure or extended palliation.
Leiomyo(sarco)ma of the oesophagus
Authors: Hoekstra Harald J. , Vermey Albert , Edens Enje Th.
Published: February 2007

Leiomy(sarco)mas of the oesophagus are rare tumours, which often cause ill‐defined disturbances in the passage of solid food. The diagnosis can be established by simple radiological examination and endoscopy. There is no infiltration of the mucosa and it is undesirable to take biopsy specimens from such tumours through intact mucosa. The treatment of choice of leiomyoma is enucleation; that of leiomyosarcoma is resection.
A case report of pancreatic metastasis of an intracranial angioblastic meningioma (Hemangiopericytoma) and a review of metastatic tumor to the pancreas
Authors: Tanabe Shun‐Ichi , Soeda Shuji , Mukai Toshikazu , Oki Shuichi , Yun Kankatsu , Miyahara Shin‐Ichi
Published: February 2007

The authors report a case of solitary metastasis to the pancreas from an intracranial angioblastic meningioma (hemangiopericytoma) and discuss secondary (metastatic) tumors of the pancreas. A 65‐year‐old man developed a pancreatic tumor 15 years after the craniotomy was performed for a parasagittal meningioma. Histological investigation of the pancreatic tumor excised as a biopsy on exploratory laparotomy revealed a tumor identical to the intracranial meningioma. It was concluded that the intracranial angioblastic meningioma had recurred and metastasized to the pancreas.
Surgical treatment of cavernous hemangioma of the liver
Authors: Takagi Hiroshi , Kido Choichiro , Morimoto Takeshi , Yasue Mitsumori , Kato Hisashi
Published: February 2007

This report describes our experiences with 12 cases of cavernous hemangioma of the liver. Eight patients were submitted to surgical procedures. Five out of eight underwent liver resections that ranged from simple excision to hepatic lobectomy. Three patients underwent hepatic artery ligation. There were no surgical deaths or any late deaths. Four more asymptomatic patients have been observed for up to 11 years (mean 4.0 years). None of the patients in this group has evidenced intensification of symptoms or any remarkable change of the size of lesions.
Primary lymphoma of the brain: A case report and review of the literature
Authors: Alic Linda , Haid Max
Published: February 2007

A case of primary lymphoma of the brain is presented. The disease is rare and thus firm guidelines for therapy are lacking. Whole‐brain irradiation therapy, the accepted treatment of choice, when given to a dose of 5000 rads, is associated with improved survival. However, the overall prognosis is poor due to local recurrence in the central nervous system and the tumor's ability to diffusely infiltrate the meninges. Twenty‐six percent of the cases may have positive cerebrospinal fluid cytology. Whether the addition of intrathecal chemotherapy with agents such as methotrexate will improve upon the results obtained with irradiation therapy alone would be an appropriate subject for a cooperative prospective randomized study.
The significance of bone scan abnormalities in patients with primary osteogenic sarcoma
Authors: Keller Steven M. , Rosenbaum Richard C. , Rosenberg Steven A.
Published: February 2007

The radionuclide bone scans and medical records of 62 patients with osteogenic sarcoma were reviewed to determine the significance of abnormalities demonstrated by the initial scintigraph at sites other than the primary lesion. 94% (58/62) of patients had abnormally increased tracer uptake at sites other than the primary tumor location. Eighty percent (49/62) of patients had abnormal bone scans at the ipsilateral proximal weight bearing joints. Only two of these patients later demonstrated metastatic tumor. Sixty‐one percent (38/62) of patients had abnormal bone scans at joints distal to the primary tumor and none were due to tumor. Five patients ultimately developed osseous metastases at sites that were normal in the original scan. The majority of radionuclide bone scan abnormalities occurring at the time of diagnosis of osteogenic sarcoma at locations distant from the primary tumor site do not represent metastatic disease.
Tubular adenoma with squamous metaplasia of the sigmoid colon: A case report
Authors: Hayashi Itsuro , Katsuda Yasaburo , Muto Yukiro , Fujii Yoshio , Morimatsu Minoru
Published: February 2007

A case of tubular adenoma with squamous metaplasia of the sigmoid colon in a 44‐year‐old female is reported. The tumor was a pedunculated polyp with a size of 1.2 × 1.7 × 1.7 cm. Histologically, the tumor showed tubular adenoma with focal squamous metaplasia. Borderline atypia was noted in a part of adenoma without squamous metaplasia and squamous component. It is supposed that squamous epithelial polyp, squamous cell carcinoma, adenosquamous carcinoma, and mucoepidermoid carcinoma may be derived from colonic adenoma with squamous metaplasia. Only six cases of the adenoma with squamous metaplasia of the large intestine have been reported previously in the literature.
Treatment of advanced invasive cervical cancer: Changing times and trends
Authors: Yoonessi Mahmood
Published: February 2007

A retrospective analysis of the treatment results and complications in 140 patients with advanced (Stage IIB or more) invasive cervical cancer treated at the Albert Einstein College of Medicine (AECOM) from 1962–1970 and the State University of New York at Buffalo (SUNYAB) from 1974–1982 is the subject of this report. All patients were clinically staged and received external pelvic radiotherapy followed by one to two intracavitary radium insertions, and those with histologically proven positive para‐aortic nodes received on additional 4,500 to 5,000 rads to the para‐aortic areas. Forty‐four patients had pretherapy surgical staging (26 transperitoneal, 18 extraperitoneal). In the clinical staging group, a survival time of 5 years or longer was attained in 22 of 39 patients (56%); with Stage IIB, 11 of 30 patients (37%) with Stage IIIA, two of 13 patients with Stage IIIB and two of 12 patients with Stage IVA disease. Of 26 patients staged via transperitoneal approach, two survived more than 5 years and three others were alive at last contact (after more than 3 years follow‐up). The last 18 patients have been subjected to laparoscopy and retroperitoneal pelvic and para‐aortic node biopsies followed by tailored radiotherapy with [12] or without [6] chemotherapy. Chemotherapy consisted of alternating weekly courses of vincristine and bleomycin and hydroxyurea. Mitomycin‐C was added to this regimen at the conclusion of the course of radiotherapy. Only one patient developed a vesicovaginal fistula. At last contact, seven patients in the combined therapy group were alive and free of disease. Combined therapy following extraperitoneal surgical staging appears to be feasible and justifiable. It deserves further trials in larger series.
In vitro activation of cyclophosphamide for an in vitro chemosensitivity assay
Authors: Hill Helene Z. , Hill George J.
Published: February 2007

The problem of activation of cyclophosphamide (CY) for an in vitro chemosensitivity assay was studied using the B16 melanoma. The efficacy of the S9 hepatic microsomal fraction in vitro was compared with activation by passage of drug in vivo. The effect of CY was assayed by inhibition of tritiated thymidine (3HdThd) uptake by B16 tumor cells in vitro, and by its effect in single dose in vivo on the life span of syngeneic C57BL/6 mice injected with B16 tumor cells. In vivo activation of CY that was achieved by injecting 20 mg of CY intraperitoneally (i.p.) into mice and obtaining plasma 20 minutes later was more rapid and more reproducible, while in vitro activation provided a more potent preparation and a better quantitative correlation with the in vivo effect of CY. The activation activity of different preparations of S9 microsomal fractions was found to be directly related to the activity of aminopyrine demethylase, a mixed function oxidase enzyme, in the S9 fraction, rather than to total protein concentration. The S9‐activated drug required 2 1/2 to 3 hours to achieve maximum inhibition of subsequent tumor cell tritiated thymidine (3HdThd) incorporation compared with 20 minutes to achieve maximum inhibition by in vivo activated drug. We conclude that rapid qualitative screening for effectiveness of CY may best be done with in vivo activated drug, whereas quantitative prediction of effective concentration appears to be best achieved with drug activated in vitro by the hepatic S9 fraction.
Malignant histiocytosis in the oropharynx
Authors: Ogasawara Hiroshi , Toda Fuki , Kumoi Takeo , Sawada Yukio , Mitsunobu Masao , Uematsu Kunio
Published: February 2007

Malignant histiocytosis is characterized by systemic, progressive, and invasive proliferation of malignant histiocytes. The disorder is typically accompanied by fever, general fatigue, lymphadenopathy, and hepatosplenomegaly. A case of a 21‐year‐old woman with primary malignant histiocytosis of the oropharynx is reported. Histologic diagnosis from the biopsy specimen was confused by infiltration of normal‐appearing histiocytes and inflammatory cells. The titers of Epstein‐Barr virus and the Paul‐Bunnell test were elevated without atypical lymphocytes. The patient died 3.5 months after the onset of symptoms. Autopsy revealed systemic neoplastic proliferation of malignant histiocytes. A review of literature on this subject revealed no cases of malignant histiocytosis primarily involving the oropharynx.