Preoperative radiotherapy combined with resection of squamous cell carcinoma of the mid-thoracic oesophagus. Does a histopathological malignancy grading system assess actual survival?

The aim of our study was to assess the reproducibility of the findings of Hambraeus et al. In their group of patients with squamous cell carcinoma of the oesophagus who underwent preoperative radiotherapy and resection, the histopathological malignancy grading score system was found to predict survival. We studied nine patients with squamous cell cancer of the mid-thoracic oesophagus, who had received radiotherapy followed by surgery and survived over 12 months. We did not confirm the prognostic value of the histopathological malignancy grading score system.

Multifocal gastric carcinoma arising from hyperplastic and adenomatous polyps

This paper is a presentation of the unusual case of a 61-yr-old woman operated on for multiple gastric cancers. Two of the cancers were found in the hyperplastic polyps and one in the adenoma. Apart from cancers that arose from these polyps, there were four separate polypoid or flat gastric carcinomas and three other hyperplastic polyps with no signs of malignancy, in this case. The presentation is followed by a detailed discussion focusing on the possible development of carcinoma in gastric hyperplastic polyps in view of the data from the literature.

Congenital fascial dystrophy--a noninflammatory disease of fascia: the stiff skin syndrome

Our patient's disease was similar to the persons with stiff skin syndrome described by Esterly and McKusick (1). Stony-hard indurations of the skin and deeper tissue were generalized but most pronounced in the buttocks, thighs, and legs, with limitation of joint mobility and particularly extensive contractures in the lower limbs. The disease was noticed when the patient was 18 months old, and was nonprogressive within a follow-up period of 12 years. There was no visceral involvement except functional impairment of the lungs, probably due to thickened thoracic fascia. Biochemical, histologic, and electron microscopic studies of the skin and muscle were not remarkable. In skin fibroblasts, collagen synthesis was increased and was accompanied by elevated activity of the prolylhydroxylase and lysylhydroxylase, whereas the transferases were not altered. The fascia was considerably thickened, but contained no inflammatory infiltrates. The significant electron microscopic finding was the presence of amianthoid-like collagen fibers in the fascia.