Angiosarcoma following therapeutic irradiation

This paper reports a case of angiosarcoma of the terminal ileum in a 66-year-old female. This angiosarcoma developed 8 years after postoperative irradiation for ovarian carcinoma. This case appears to be the sixth case of angiosarcoma arising at the site of therapeutic irradiation thus far reported in the literature. The fact that the angiosarcomas in these cases developed in anatomic sites, which are unusual for angiosarcomas in general, suggests that there is a cause-and-effect relationship between irradiation and angiosarcoma. Apart from the direct carcinogenic effect of irradiation, prolonged stimulation for tissue repair resulting from tissue damage secondary to irradiation-induced vascular changes may also play an etiologic role in the development of angiosarcomas in these cases.

Fibroxanthosarcoma of kidney

The clinicopathologic features of a case of fibroxanthosarcoma of the kidney are reported. This case represents the third reported case in the literature. The nine-year disease-free survival following nephrectomy in this case suggests that this tumor may have a prognosis different from that of the renal cell adenocarcinoma and that reporting of additional cases should be encouraged.

Angiosarcoma of the spleen: a report of two cases and review of the literature

Results of the ultrastructural study of one of two cases of splenic angiosarcoma established the blood vessel origin of this tumor. Fifty-three previously reported cases were reviewed. None of the 55 patients had a history of exposure to thorium dioxide, vinyl chloride, or arsenic, which are known to be associated with hepatic angiosarcoma and other tumors. A comparison of the splenic and hepatic angiosarcomas showed that tumors not associated with exogenous material frequently involve the spleen and liver simultaneously, and that tumors associated with thorium dioxide, vinyl chloride, or arsenic commonly involve the liver with sparing of the spleen.

Angiosarcoma complicating generalized lymphangiectasia

Multifocal angiosarcoma of the lower extremities developed in a 23-year-old patient with generalized lymphangiectasia. Eighteen cases of angiosarcoma complicating congenital or idiopathic lymphedema have previously been reported. The ages of the patients ranged from 13 to 65 years, with an average age of 40 years. There was an equal sex ratio. The extremities were the principal sites of involvement. No conclusion can be made regarding blood vessel or lymphatic origin of these tumors.

Metastasizing pleomorphic adenoma of the salivary gland

A case of metastasizing pleomorphic adenoma in which both the primary tumor and metastasis were composed of benign pleomorphic structures is reported and previously reported cases reviewed. The metastasis commonly developed many years after the excision of the primary tumor and was usually preceded by local recurrences. The most common sites of metastasis were the bone and lung. Mitotic activity and infiltrative growth pattern are the histologic features in the primary tumor important in predicting the metastasizing potential. The treatment of choice for the metastatic tumor appears to be surgical excision. Radiotherapy seems to have a limited role other than providing temporary palliation.

Multiple fibroxanthosarcoma of bone

A case of multiple fibroxanthrosarcoma of bone is described. Clinically, the patient presented with multiple osteolytic lesions involving the skull, ribs, vertebral body, pelvic bones and proximal femur simulating multiple myeloma or metastatic carcinoma. The histologic features of the lesion fulfilled the criteria established for the recently delineated fibroxanthosarcoma. Three similar cases reported as multiple diffuse fibrosarcoma of bone are reviewed and the terminology for these lesions discussed.

Primary tumors of the external and middle ear. III. A clinicopathologic study of embryonal rhabdomyosarcoma

Embryonal rhabdomyosarcoma of the middle ear-mastoid is a highly lethal neoplasm of childhood in most cases, which clinically simulates a chronic infection. Extensive hemorrhage and necrosis in the biopsy specimen may obscure and often delay the diagnosis. Two of the six embryonal rhabdomyosarcomas in this study showed histologic evidence of differentiation. These same two patients were the only long-term survivors. Similar examples of "differentiated" embryonal rhabdomyosarcomas of the middle ear-mastoid with prolonged survival have been recorded individually in the literature. Therapeutic implications of this finding have been discussed.

Acute myelogenous leukaemia in Hurler's syndrome

The occurrence of the Hurler syndrome and acute myelogenous leukaemia in a 2 1/2-year-old girl is described. This represents the first published report of the concurrence of these two diseases.

Primary tumors of the external and middle ear. II. A clinicopathologic study of 14 paragangliomas and three meningiomas

Paragangliomas (chemodectomas, glomus jugulare tumors) represented 15% of all neoplasms of the ear in the period from 1964 to 1975 at the University of Minnesota, Minneapolis. Women in the fifth to sixthe decades of life were mainly affected, and hearing loss and tinnitus were the principal symptoms. Although most tumors had the typical histopathologic appearance, two neoplasms that were initially diagnosed as paragangliomas illustrated the problems in differential diagnosis. One of these latter two tumors had metastasized and was thought to represent a malignant paraganglioma. Retrospectively, both neoplasms were adenomatous tumors of the middle ear. For the remaining patients with typical jugular paragangliomas, surgery and/or irradiation therapy controlled the local tumor in 12 cases. Two of the three meningiomas occurring in the middle ear were preceded by or associated with an intracranial component. There were only four prior examples in the literature, excluding our one case, of primary meningiomas of the ear-mastoid region. Histologically, the features were virtually identical to the usual intracranial meningioma.

Primary tumors of the external and middle ear. I. Introduction and clinicopathologic study of squamous cell carcinoma

Squamous cell carcinoma (41 cases) represented 45% of all neoplasms of the ear that were treated in the study period from 1964 to 1975. The auricle was the primary site in 17 cases, and the external auditory canal was the primary site in the remaining 24 cases. Although the overall histologic appearance and differentiation were similar in both sites, there were important age, six, and prognostic differences. Tumor-related deaths occurred in only 6% (1/17) of patients with auricular neoplasms, in contrast with 52% (11/21) of those with carcinomas of the external auditory canal. Actinic damage of the epidermis was uniformly associated with squamous cell carcinomas of the auricle, but no such relationship existed for the lesions of the auditory canal.

Peritoneal foreign body granulomas to keratin in uterine adenocanthoma

Four cases of well-differentiated adenocarcinoma with squamous metaplasia (so-called adenocanthoma) of the uterus were associated with granulomatous inflammation of the pelvic peritoneum. The inflammation was the result of a foreign-body response to keratin that desquamated from the surface of the tumor and was carried to the peritoneal cavity through the lumen of the Fallopian tubes. The absence of viable neoplastic cells and favorable follow-up examinations in these patients indicate that the presence of peritoneal keratin granulomas in association with endometrial adenoacanthoma should not be regarded as an indicator of metastatic spread.

Abdominal form of lymphomatoid granulomatosis

A 54 year old white male died three months after hospitalization for hematemesis and melena due to a duodenal ulcer and two monthos after the subsequent onset of progressive ascites and edema. At necropsy, lesions characteristic of "lympomatoid granulomatosis" as delineated by Liebow et al. were found in the liver, retroperitoneal lymph nodes, and mesenteric and retroperitoneal adipose tissue. This case appears to be the first case of "lymphomatoid granulomatosis" confined to the abdomen. This report further broadens the clinical spectrum of the newly delineated "lymphomatoid granulomatosis" and adds another situation to the differential diagnosis of space occupying lesions of the liver.