Soft-tissue sarcoma of the head and neck after puberty

The most frequent soft-tissue sarcomas in the head and neck are are embryonal rhabdomyosarcomas and neurofibrosarcomas. Histological grading and the staging of the lesions bear on the prognosis of the disease. The use of sequential surgical resection plus postoperative radiation therapy has considerably improved the local control of these sarcomas. The use of multiple-drug systemic chemotherapy as an adjuvant to radiation therapy is fraught with considerate complications in this seris of patients. Studies are ongoing for a better understanding of the immunologic changes that occur in patients with sarcoma.

Parosteal osteosarcoma of the maxilla

Parosteal osteosarcoma is a low-grade form of osteosarcoma that rarely affects the jaws. A case involving the maxilla of a 25-year-old man is presented, and four previously reported cases are reviewed.

Diagnosis of lymphoma from a cholecystectomy specimen: case report and review of the literature

A 31-year-old woman had cholecystectomy for recurrent acute cholecystitis. Pathologic examination of the resected gallbladder revealed unsuspected histiocytic lymphoma. A staging laparotomy seven weeks after cholecystectomy revealed disseminated disease. Lymphomatous involvement of the gallbladder is rarely diagnosed antemortem and indicates disseminated disease until proved otherwise.

Histologic factors affecting prognosis of pure seminoma of the testis

The histologic features of 92 cases of pure seminoma of the testis were reviewed in relation to the presence and degree of fibrosis, necrosis, granulomatous and lymphocytic reactions, interstitial cell hyperplasia, and lymphatic and/or vascular invasion associated with the primary tumor. No relationship between any of the histologic factors studied and survival was established.

Primary carcinoma of the female urethra

The clinical and morphological features in 81 cases of carcinoma of the female urethra were reviewed. The over-all 5 and 10-year survival rate for the entire group was 32 per cent. Survival expectations for patients with squamous carcinoma, transitional cell carcinoma and adenocarcinoma were similar when analyzed according to stage and all cell types appeared to respond equally to irradiation. Prognosis was related directly to the clinical stage of the disease. A plea is made for more accurate assessment of the disease status. The high incidence of local recurrence noted for all forms of single modality therapy (46 to 64 per cent) suggests the need for clinical trials with combination preoperative irradiation followed by definitive surgical procedures.

Retroperitoneal lymphadenectomy as adjunctive therapy in selected cases of advanced testicular carcinoma

The findings in 10 patients with advanced non-seminomatous testicular malignant disease in whom either complete remission or reduction in clinical stage was achieved with chemotherapy and later retroperitoneal lymphadenectomy are presented. The procedure in these selected instances allowed for a more accurate assessment of the disease status. The operative findings served as an accurate guide to determine the need for further drug therapy.

Squamous cell carcinoma of the bladder

Clinical and morphological features of 90 cases of squamous cell carcinoma of the bladder have been reviewed. The lesions were solitary in 90 per cent of the patients, developed without a history of vesical malignant disease in 82 per cent and were invasive at the time of diagnosis in all cases. Ureteral obstruction was demonstrated in 42 per cent of the group. The over-all survival rate at 5 years was only 10.6 per cent. There were 17 patients who received no therapy, all of whom were dead before 2 years. Unassisted supervoltage radiation therapy for patients with stages B2 and C lesions yielded a 5-year survival rate only 17.7 per cent. However, preoperative radiotherapy followed by simple total cystectomy and urinary diversion in a small number of patients with stages B2 and C lesions resulted in a 5-year survival rate in excess of 34 per cent. We are encouraged by this finding and believe that combination therapy warrants further clinical trial.

Mucinous adenocarcinomas of nose and paranasal sinuses

This study concerns the Clinicopathologic findings for 18 patients with mucinous adenocarcinomas of nose and/or paranasal sinuses. Males in the 5th decade of life predominated in the series. Nasal obstruction, a growing mass in a sinus, or epistaxis were the most frequent complaints. Ten patients had tumors in the maxillary antrum, and the nasal cavity was the site in 5 patients. Histopathologically, the tumors were moderately to well differentiated, with a few poorly differentiated types. Tumor with the solid pattern of growth were anaplastic; these patients had poorer prognoses. For most patients, treatment consisted of radical surgery alone or in combination with radiotherapy. Of 13 patients for whom survival could be adequately evaluated, 7 died from the tumors, 5 are alive and free of disease more than 4 years, and 1 is living with recurrent tumor 14 months after diagnosis.

Anaplastic seminoma

The clinical and morphological features of 7 cases of anaplastic seminoma are reviewed. Although this tumor appears to behave more aggressively than classical seminoma, presenting with earlier metastases, it has the same prognosis when staging is taken into consideration. Radiotherapy remains the treatment of choice.

Percutaneous transfemoral renal artery occlusion in patients with renal carcinoma. Preliminary report

Twenty-four patients have undergone percutaneous transfemoral selective renal artery occlusion as part of their management for renal carcinoma. Preoperative infarction was performed in 7 cases. This facilitated surgery by eliminating the major blood supply to the tumor and resulted in collapse of the large collateral veins and created edema within the perirenal tissue. In 17 patients with visceral metastases, tumor infarction was performed in lieu of nephrectomy for control of the primary lesion and in hopes of stimulating an autoimmune response. The current status of this procedure s discussed in light of its indications, complications, and preliminary results.

Neurofibrosarcoma of spermatic cord

The first report of a neurofibrosarcoma arising within the spermatic cord is presented. The light and electron microscopic features are discussed.

Megestrol acetate for treatment of advanced carcinoma of the prostate

Thirteen men, ranging in age from 53 to 73 years and with previously untreated metastatic carcinoma of the prostate, received megestrol acetate (a synthetic progestin) in doses of 120 mg daily. A beneficial clinical response with a mean duration of 47 weeks was achieved in 12 patients (92%). When relapse developed in 8 patients, a secondary response was readily obtained by orchiectomy. The results suggest that a staged hormonal approach, using progestin therapy initially, may offer additional palliation in treating patients with metastatic prostatic carcinoma.