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Treatment Outcome of Recurrent Cervical Cancer
830
ONCOLOGY AND CHEMOTHERAPY
s.
P. APPLEQVIST AND KOSTIAINEN, Departments of Thoracic Surgery, and Radiotherapy and Oncology, University Central Hospital, Helsinki, Finland
J. Surg. Oncol., 24: 1-4 (Sept.) 1983 The authors report a case in which resection of multiple bilateral pulmonary metastases of adrenal cortical carcinoma were performed, which resulted in an unusually long survival of >25 years from the first thoracotomy and >28 years from removal of the primary adrenal cortical carcinoma. The patient is free of tumor. However, a 1.5 cm. mass was enucleated through a right thoracotomy 24 years after the first pulmonary resection. The authors indicate that adrenal cortical carcinoma is a highly malignant tumor that frequently is large and metastatic at the time of diagnosis. Of the patients 37 per cent present with endocrine syndromes associated with excess tumor steroid production. The diagnosis of carcinoma is based on vascular invasion, although diagnosis by histologic examination only without metastases is always in doubt. H.D.P. 3 figures, 16 references
Massive Intraabdominal Bleeding Due to a Retroperitoneal Leiomyosarcoma B. SHPITZ AND A. DINBAR, Department of Surgery B, Meir General Hospital, Kfar-Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel
M. WITZ,
J. Surg. Oncol., 24: 132-134 (Oct.) 1983 Retroperitoneal leiomyosarcoma is rare, with 9 cases reported previously. This tumor arises from the smooth muscle of the uterus and gastrointestinal tract, and may originate from the wall of various retroperitoneal vessels, prostate, ureter, penis, breast, lung, thyroid, heart and muscles of the extremities. The tumor has the tendency to become large, invade locally and cause necrosis with fistula formation. Because of necrosis and hemorrhage the lesion may rupture and cause free peritoneal bleeding. Leiomyosarcomas are radioresistant and no chemotherapy is available for this tumor. Therefore, the only effective treatment is surgery. The authors have reported on a 60-year-old patient with a ruptured retroperitoneal leiomyosarcoma who presented with massive intra-abdominal bleeding. Immediate resection of the tumor and cessation of bleeding proved to be life-saving for this patient. N.J. 3 figures, 6 references
therapy. There were no significant differences in median survival between the chemotherapy group and the nontreatment group. 3 figures, 8 tables, 18 references Abstracter's comment. The fact that cervical cancer is the second most frequent malignancy of the female genital tract, coupled with the authors' observation that nearly half of the cases are not treated successfully, makes the diagnosis and management of recurrent cervical carcinoma important. The series has confirmed that of others, that the salvage rate in these carefully selected patients is 35 to 40 per cent. H.D.P.
Paravaginal Wolffian Duct (Mesonephros) Adenocarcinoma: A Light and Electron Microscopic Study
w. w. HINCHEY, E. G. SILVA, L. A. GUARDA, N. G. ORDONEZ AND J. T. WHARTON, Departments of Pathology and Gynecology, The University of Texas M. D. Anderson Hospital and Tumor Institute, Houston, Texas
Amer. J. Clin. Path., 80: 539-544 (Oct.) 1983 Tumors of presumed mesonephric (wolffian) origin arising in the female genital tract are rare. Such tumors have been described in the leaves of the broad ligament and, occasionally, in the cervix. However, some of the lesions in the cervix were clear cell tumors and since have been proved to be of miillerian origin. This study documents an adenocarcinoma of mesonephric origin studied by light and electron microscopy, and immunocytochemistry. Unlike previous reports, this lesion was located paravaginally and not in the leaves of the broad ligament or in the cervix. The light microscopic features were similar to those of previous cases in the literature. Although not specific, the ultrastructural features of the tumor were similar to those of mesonephric structures and different from those of miillerian structures. The diagnosis always should be considered when a tumor occurs at the site where mesonephric remnants may be found and after exclusion of a carcinoma of other pelvic organs or a metastasis from a primary neoplasm elsewhere. W. W.H. 7 figures, 14 references
Hemangioma of the Urinary Bladder
P. SARMA AND M. WEINER, Department of Pathology, Louisiana State University Medical School, Department of Urology, Tulane School of Medicine and Veterans Administration Medical Center, New Orleans, Louisiana
D.
J. Surg. Oncol., 24: 142-144 (Oct.) 1983 Treatment Outcome of Recurrent Cervical Cancer C.
K. CHUNG, W. A. NAHHAS, J. A. STRYKER AND R. MORTEL, Division of Radiation Oncology, Department of Radiology and Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, Pennsylvania
J. Surg. Oncol., 24: 5-10 (Sept.) 1983 Of 85 patients with recurrent cervical cancer followed for ~24 months .17 were treated by surgery, 18 by radiotherapy (14 for cure), 29 by chell).otherapy and 21 received no further treatment. Only 14 per cent of this group are alive without evidence of disease. Of 17 patients treated for cure with radical surgery 6 (35 per cent) are alive and have no evidence of disease, compared to 6 of 14 (43 per cent) treated for cure with radiation
Hemangioma of the bladder is extremely rare. Hemangiomas have been rl:lported to involve many parts of the body. Melicow reported 6 cases of bladder hemangiomas while studying 954 cases of primary bladder cancer. There are >85 additional cases reported. Gross painless hematuria has been the most common presenting symptom. Of the patients >50 per cent were <20 years old at the time of presentation. About 25 per cent of the cases may have cutaneous hemangiomas over the abdomen, perineum and thighs. In the bladder the location generally is the lateral or posterior walls. Generally, there is a single sessile lesion with bluish-red overlying mucosa. Microscopically, >50 per cent of the lesions are cavernous hemangioma and the remaining are of the capillary type. Intermittent gross painless hematuria in young patients, especially with hemangioma of the skin, is highly suggestive of such lesions in the bladder.
ONCOLOGY AND CHEMOTHERAPY
s.
P. APPLEQVIST AND KOSTIAINEN, Departments of Thoracic Surgery, and Radiotherapy and Oncology, University Central Hospital, Helsinki, Finland
J. Surg. Oncol., 24: 1-4 (Sept.) 1983 The authors report a case in which resection of multiple bilateral pulmonary metastases of adrenal cortical carcinoma were performed, which resulted in an unusually long survival of >25 years from the first thoracotomy and >28 years from removal of the primary adrenal cortical carcinoma. The patient is free of tumor. However, a 1.5 cm. mass was enucleated through a right thoracotomy 24 years after the first pulmonary resection. The authors indicate that adrenal cortical carcinoma is a highly malignant tumor that frequently is large and metastatic at the time of diagnosis. Of the patients 37 per cent present with endocrine syndromes associated with excess tumor steroid production. The diagnosis of carcinoma is based on vascular invasion, although diagnosis by histologic examination only without metastases is always in doubt. H.D.P. 3 figures, 16 references
Massive Intraabdominal Bleeding Due to a Retroperitoneal Leiomyosarcoma B. SHPITZ AND A. DINBAR, Department of Surgery B, Meir General Hospital, Kfar-Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel
M. WITZ,
J. Surg. Oncol., 24: 132-134 (Oct.) 1983 Retroperitoneal leiomyosarcoma is rare, with 9 cases reported previously. This tumor arises from the smooth muscle of the uterus and gastrointestinal tract, and may originate from the wall of various retroperitoneal vessels, prostate, ureter, penis, breast, lung, thyroid, heart and muscles of the extremities. The tumor has the tendency to become large, invade locally and cause necrosis with fistula formation. Because of necrosis and hemorrhage the lesion may rupture and cause free peritoneal bleeding. Leiomyosarcomas are radioresistant and no chemotherapy is available for this tumor. Therefore, the only effective treatment is surgery. The authors have reported on a 60-year-old patient with a ruptured retroperitoneal leiomyosarcoma who presented with massive intra-abdominal bleeding. Immediate resection of the tumor and cessation of bleeding proved to be life-saving for this patient. N.J. 3 figures, 6 references
therapy. There were no significant differences in median survival between the chemotherapy group and the nontreatment group. 3 figures, 8 tables, 18 references Abstracter's comment. The fact that cervical cancer is the second most frequent malignancy of the female genital tract, coupled with the authors' observation that nearly half of the cases are not treated successfully, makes the diagnosis and management of recurrent cervical carcinoma important. The series has confirmed that of others, that the salvage rate in these carefully selected patients is 35 to 40 per cent. H.D.P.
Paravaginal Wolffian Duct (Mesonephros) Adenocarcinoma: A Light and Electron Microscopic Study
w. w. HINCHEY, E. G. SILVA, L. A. GUARDA, N. G. ORDONEZ AND J. T. WHARTON, Departments of Pathology and Gynecology, The University of Texas M. D. Anderson Hospital and Tumor Institute, Houston, Texas
Amer. J. Clin. Path., 80: 539-544 (Oct.) 1983 Tumors of presumed mesonephric (wolffian) origin arising in the female genital tract are rare. Such tumors have been described in the leaves of the broad ligament and, occasionally, in the cervix. However, some of the lesions in the cervix were clear cell tumors and since have been proved to be of miillerian origin. This study documents an adenocarcinoma of mesonephric origin studied by light and electron microscopy, and immunocytochemistry. Unlike previous reports, this lesion was located paravaginally and not in the leaves of the broad ligament or in the cervix. The light microscopic features were similar to those of previous cases in the literature. Although not specific, the ultrastructural features of the tumor were similar to those of mesonephric structures and different from those of miillerian structures. The diagnosis always should be considered when a tumor occurs at the site where mesonephric remnants may be found and after exclusion of a carcinoma of other pelvic organs or a metastasis from a primary neoplasm elsewhere. W. W.H. 7 figures, 14 references
Hemangioma of the Urinary Bladder
P. SARMA AND M. WEINER, Department of Pathology, Louisiana State University Medical School, Department of Urology, Tulane School of Medicine and Veterans Administration Medical Center, New Orleans, Louisiana
D.
J. Surg. Oncol., 24: 142-144 (Oct.) 1983 Treatment Outcome of Recurrent Cervical Cancer C.
K. CHUNG, W. A. NAHHAS, J. A. STRYKER AND R. MORTEL, Division of Radiation Oncology, Department of Radiology and Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, Pennsylvania
J. Surg. Oncol., 24: 5-10 (Sept.) 1983 Of 85 patients with recurrent cervical cancer followed for ~24 months .17 were treated by surgery, 18 by radiotherapy (14 for cure), 29 by chell).otherapy and 21 received no further treatment. Only 14 per cent of this group are alive without evidence of disease. Of 17 patients treated for cure with radical surgery 6 (35 per cent) are alive and have no evidence of disease, compared to 6 of 14 (43 per cent) treated for cure with radiation
Hemangioma of the bladder is extremely rare. Hemangiomas have been rl:lported to involve many parts of the body. Melicow reported 6 cases of bladder hemangiomas while studying 954 cases of primary bladder cancer. There are >85 additional cases reported. Gross painless hematuria has been the most common presenting symptom. Of the patients >50 per cent were <20 years old at the time of presentation. About 25 per cent of the cases may have cutaneous hemangiomas over the abdomen, perineum and thighs. In the bladder the location generally is the lateral or posterior walls. Generally, there is a single sessile lesion with bluish-red overlying mucosa. Microscopically, >50 per cent of the lesions are cavernous hemangioma and the remaining are of the capillary type. Intermittent gross painless hematuria in young patients, especially with hemangioma of the skin, is highly suggestive of such lesions in the bladder.