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Testicular tumour markers in sperimatic vein blood
888
INTERNATIONAL ABSTRACTS
cyst. The others were observed only, and all underwent normal vaginal delivery. Postnatal diagnosis was assessed by clinical examination and ultrasonography. Intrafluid septation seemed to be an important finding in assessing a torsion, either in prenatal or postnatal sonography. Seven babies were operated in the first 2 weeks of life and one in the fourth month. One was lost to follow-up until 3 years of age at which time there was no evidence of a cyst. One patient was only observed. In eight patients an adnexectomy was performed (five for necrosis). Pathologic examination revealed follicular cysts in all cases. The authors favor a conservative operation: cystectomy alone (only one case in their series), leaving a laminated but functional ovary. Nonoperative treatment and/or pereutaneous puncture under ultrasonography should now be considered in small cysts and/or to prevent torsion.--Jean-Michel Guys MUSCULOSKELETAL SYSTEM Interest and Pitfalls of Intraoperative Isotopic Localization of Osteoid O s t e o m a .
P. Nachin, P. Gille, D. Auberl, et aL Chir P~diatr
27:65-68, (March), 1986. Five boys and one girl between 6 and 23 years of age with osteoid osteoma were operated on using intraoperative radioactive localization. In four patients the lesion was in the femoral neck and one each in tibia and scaphoid. A portable P1TMAN-235N with a modified probe was used. Intravenous injection of 10 me tech 99m was done two hours before resection. A bladder catheter was inserted in all cases. The probe had to be oriented perpendicular to the lesion for precise localization, and radioactivity was measured before and after exision on the bone and on the resected specimen. Of these six patients, one reoperation was necessary because this last recommendation was not followed. Precise localization and exision are the two advantages of this technique.--Jean-Michel Guys Ultrasound Measurement of Femoral Anteversion in Children. J.
Fournet-Fayard, R. Kohler, C.R. Michel, et al. Chir P6diatr 27:7983, (March), 1986. This is a preliminary report on the use of ultrasound and a personal method of evaluating femoral anteversion in young children. Nine patients were below 7 years of age. All presented torsion abnormalities of the lower limbs. The authors used a spirit level fixed to a bar probe of 5 MHz. Effective positioning rotation was obtained by placing the feet in fixed but orientable insoles. Successive examinations of the condyles and femoral necks with a similar rotation of the limb was then possible even in young infants. Bilateral measurements were performed in each case and compared with results of CT scan. In the first ten patients, the results were similar. The authors now have an experience with about 40 patients. This method does not allow complete evaluation of the entire limb. However, it is not expensive, easy to perform, and available for routine investigation.--Jean-Michel Guys NEOPLASMS Treatment of Children With Neurogenic Sarcoma. B. Raney, L. Schnaufer. M. Ziegler, et aL Cancer 59:1-5, (January), 1987.
This report concerns all patients with neurofibrosarcoma, malignant sehwannoma, and malignant neurilemmoma seen at the Chil-
dren's Hospital of Philadelphia (1958 to 1984). Sixteen of the 24 patients in this group had known neurofibromatosis. Twelve of the 24 children had complete resections, five with no known residual and seven with demonstrated microscopic residual following surgery. Some patients from both groups were treated with local irradiation (4,000 to 6,000 rad) plus VAC with or without Adriamycin. Nine of the 12 patients with tumor excision (either complete or with microscopic residual) were tumor-free survivors 3 years following diagnosis. No patient" with gross residual disease survived, despite irradiation and chemotherapy. Complete gross tumor excision was the strongest indicator of prognosis. Tumor mitotic rate was the second most important indicator.--D.M. Hays
Primary Tumors of Testis in Children. Report on a Series of 23 C a s e s . H. Dodal, Y. Chavrier, J.F. D)'on, el al. Chir P~diatr
27:1-13, (January), 1986. Twenty-three cases of primary testicular tumors were observed in six different French divisions of pediatric surgery during a 10-year period. This series, combined with a survey of the literature, serves to stress the rarity of such tumors in boys under the age of 15 years. Yolk sac tumors are the most frequent (40%), followed by teratomas (32.5%), which, in children and in this location, are almost always benign. Tumors of nongerminal origin, in particular rhabdomyosarcomas and tumors of sexual cords, accounted for 22% of the tumors. Testicular tumors are different from what is observed in adults. Most testicular tumors reveal themselves as unilateral testicular masses. High serum alpha-fetoprotein is specific to yolk sac tumors, and its postoperative control is mandatory. Scrotal ultrasonography is the principal means of diagnosis and helps to detect minor tumors in case of precocious puberty and gynecomastia. Since lymphatic invasion is unusual in children, surgical exploration of the retroperitoneal space is no longer considered necessary for staging and is replaced by ultrasonography and CT scan. In case of teratomas and other benign tumors, high inguinal orchiectomy is sufficient. In well-delineated and superficial tumors in single testes, tumor excision alone is possible. In yolk sac tumors, the addition of chemotherapy from the age of 2 years cures more than 90% of stage 1 tumors. Radiotherapy is necessary for tumor grades 1I and 1II. For testicular rhabdomyosarcomas, in which the prognosis is better than in other areas, a combination of surgery, chemotherapy, and radiotherapy can produce cure rates of from 80% to 90%.--Jean-Michel Guys
Testicular Tumour Markers in Spermatic Vain Blood. P.A. Light
and C.J. Tyrrell. Br J Uro159:74-75, (January), 1987. The markers for testicular cancer, alpha-fetoprotein and human chorionic gonadotrophin, were measured in spermatic vein and peripheral blood taken at the time of orchiectomy. In all cases where markers were produced by the tumor, concentrations were found to be higher in spermatic vein than in peripheral blood, presumably because the former drains from the site of the tumor and dilution in the circulation has not yet occurred. Such measurements would be of particular value in patients whose tumors produce such small amounts of marker(s) that they are below the level of detection in peripheral blood.--Prem Puri
INTERNATIONAL ABSTRACTS
cyst. The others were observed only, and all underwent normal vaginal delivery. Postnatal diagnosis was assessed by clinical examination and ultrasonography. Intrafluid septation seemed to be an important finding in assessing a torsion, either in prenatal or postnatal sonography. Seven babies were operated in the first 2 weeks of life and one in the fourth month. One was lost to follow-up until 3 years of age at which time there was no evidence of a cyst. One patient was only observed. In eight patients an adnexectomy was performed (five for necrosis). Pathologic examination revealed follicular cysts in all cases. The authors favor a conservative operation: cystectomy alone (only one case in their series), leaving a laminated but functional ovary. Nonoperative treatment and/or pereutaneous puncture under ultrasonography should now be considered in small cysts and/or to prevent torsion.--Jean-Michel Guys MUSCULOSKELETAL SYSTEM Interest and Pitfalls of Intraoperative Isotopic Localization of Osteoid O s t e o m a .
P. Nachin, P. Gille, D. Auberl, et aL Chir P~diatr
27:65-68, (March), 1986. Five boys and one girl between 6 and 23 years of age with osteoid osteoma were operated on using intraoperative radioactive localization. In four patients the lesion was in the femoral neck and one each in tibia and scaphoid. A portable P1TMAN-235N with a modified probe was used. Intravenous injection of 10 me tech 99m was done two hours before resection. A bladder catheter was inserted in all cases. The probe had to be oriented perpendicular to the lesion for precise localization, and radioactivity was measured before and after exision on the bone and on the resected specimen. Of these six patients, one reoperation was necessary because this last recommendation was not followed. Precise localization and exision are the two advantages of this technique.--Jean-Michel Guys Ultrasound Measurement of Femoral Anteversion in Children. J.
Fournet-Fayard, R. Kohler, C.R. Michel, et al. Chir P6diatr 27:7983, (March), 1986. This is a preliminary report on the use of ultrasound and a personal method of evaluating femoral anteversion in young children. Nine patients were below 7 years of age. All presented torsion abnormalities of the lower limbs. The authors used a spirit level fixed to a bar probe of 5 MHz. Effective positioning rotation was obtained by placing the feet in fixed but orientable insoles. Successive examinations of the condyles and femoral necks with a similar rotation of the limb was then possible even in young infants. Bilateral measurements were performed in each case and compared with results of CT scan. In the first ten patients, the results were similar. The authors now have an experience with about 40 patients. This method does not allow complete evaluation of the entire limb. However, it is not expensive, easy to perform, and available for routine investigation.--Jean-Michel Guys NEOPLASMS Treatment of Children With Neurogenic Sarcoma. B. Raney, L. Schnaufer. M. Ziegler, et aL Cancer 59:1-5, (January), 1987.
This report concerns all patients with neurofibrosarcoma, malignant sehwannoma, and malignant neurilemmoma seen at the Chil-
dren's Hospital of Philadelphia (1958 to 1984). Sixteen of the 24 patients in this group had known neurofibromatosis. Twelve of the 24 children had complete resections, five with no known residual and seven with demonstrated microscopic residual following surgery. Some patients from both groups were treated with local irradiation (4,000 to 6,000 rad) plus VAC with or without Adriamycin. Nine of the 12 patients with tumor excision (either complete or with microscopic residual) were tumor-free survivors 3 years following diagnosis. No patient" with gross residual disease survived, despite irradiation and chemotherapy. Complete gross tumor excision was the strongest indicator of prognosis. Tumor mitotic rate was the second most important indicator.--D.M. Hays
Primary Tumors of Testis in Children. Report on a Series of 23 C a s e s . H. Dodal, Y. Chavrier, J.F. D)'on, el al. Chir P~diatr
27:1-13, (January), 1986. Twenty-three cases of primary testicular tumors were observed in six different French divisions of pediatric surgery during a 10-year period. This series, combined with a survey of the literature, serves to stress the rarity of such tumors in boys under the age of 15 years. Yolk sac tumors are the most frequent (40%), followed by teratomas (32.5%), which, in children and in this location, are almost always benign. Tumors of nongerminal origin, in particular rhabdomyosarcomas and tumors of sexual cords, accounted for 22% of the tumors. Testicular tumors are different from what is observed in adults. Most testicular tumors reveal themselves as unilateral testicular masses. High serum alpha-fetoprotein is specific to yolk sac tumors, and its postoperative control is mandatory. Scrotal ultrasonography is the principal means of diagnosis and helps to detect minor tumors in case of precocious puberty and gynecomastia. Since lymphatic invasion is unusual in children, surgical exploration of the retroperitoneal space is no longer considered necessary for staging and is replaced by ultrasonography and CT scan. In case of teratomas and other benign tumors, high inguinal orchiectomy is sufficient. In well-delineated and superficial tumors in single testes, tumor excision alone is possible. In yolk sac tumors, the addition of chemotherapy from the age of 2 years cures more than 90% of stage 1 tumors. Radiotherapy is necessary for tumor grades 1I and 1II. For testicular rhabdomyosarcomas, in which the prognosis is better than in other areas, a combination of surgery, chemotherapy, and radiotherapy can produce cure rates of from 80% to 90%.--Jean-Michel Guys
Testicular Tumour Markers in Spermatic Vain Blood. P.A. Light
and C.J. Tyrrell. Br J Uro159:74-75, (January), 1987. The markers for testicular cancer, alpha-fetoprotein and human chorionic gonadotrophin, were measured in spermatic vein and peripheral blood taken at the time of orchiectomy. In all cases where markers were produced by the tumor, concentrations were found to be higher in spermatic vein than in peripheral blood, presumably because the former drains from the site of the tumor and dilution in the circulation has not yet occurred. Such measurements would be of particular value in patients whose tumors produce such small amounts of marker(s) that they are below the level of detection in peripheral blood.--Prem Puri