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Biomedical subjects

D Heberling

Publications and source records attributed to D Heberling.

35 records · Page 2Linked to original sources
PubMed1982

[Conditions of metastatic spread of endometrial cancer: analysis of autopsy findings and clinical data].

Among 263 patients who suffered from endometrial carcinoma and died of their disease or unrelated causes autopsies showed metastases or recurrences in 165 cases. The conditions for metastatic spread were analysed from the morphological parameters of the tumour. The incidence and localization of above all the lymph node metastases are closely correlated to the grading and the depth of invasion (I 0 to I 3/3) of the primary tumour. The incidence of pelvic lymph node metastases is 8.7% at an invasion depth I 1/3,33% at an invasion depth of I 3/3 of the myometrium. Tumours with the invasion depth I 1/3 show metastases in the para-aortic lymph nodes in 17.3% and at the invasion depth I 3/3 in 50% of the cases. At an invasion depth of I 3/3 17% had exclusively para-aortic lymph node metastases. Pelvic lymph node metastases were found in tumours of the grading G 1 in 5.7% of the cases, in grading G3 in 26% of the cases. The tumour grading and primary extent of the endometrial carcinoma area are closely correlated. At a grading G1 90% of the cases were in stage I/II and only 10% in stage III/or IV. At a grading G3 23.8% of the cases were stage I/II and 76.2% of the cases stage III/IV. Based on the presented analysis it is recommended to supplement the conventional treatment at an invasion depth I 2/3 of I 3/3 with radiotherapy of the para-aortic lymph nodes since 27.3 to 50% of these cases show para-aortic metastases. In 17% of the endometrial carcinomas with an invasion depth I 3/3 exclusively para-aortic lymph node metastases were found which do not respond to conventional treatment.

Adult↗
PubMed1982

[Morphology and clinical aspects of malignant mixed müllerian tumors of the corpus uteri].

Mixed muellerian tumours of the uterus are more common today than uterine leiomyosarcomata. There is a world wide increase in the incidence in the last few years. In the past 15 years we observed 20 mixed muellerian tumours of the uterine body. The patients are usually 10 years older than women with endometrial carcinoma or leiomyosarcoma of the uterus. Morphologically homologous and heterologous tumours must be differentiated. Characteristic is the marked polypoid growth. There is a close correlation between tumour stage and microscopic tumour grading. Tumours with high malignancy are usually in stage I or II. The prognosis correlates well with the grade and stage of the tumour, therefore the elaboration of a prognostic index is necessary. The survival rates are low. Mixed muellerian tumours are not at all or very little influenced by radiotherapy. The single or combined chemotherapies in use o date have not shown satisfactory success. As complete as possible surgical removal is therefore important. It cannot as yet be predicted whether our present combined treatment in stage III and stage IV by operation and post-operative combined chemotherapy with CYVADIC is liable to increase the survival rates.

Aged↗
PubMed1982

[Morphology and clinic of ovarial teratomas (author's transl)].

This analysis covers 170 patients with teratomas from 1965-1978 in the Department of Obstetrics and Gynaecology of Heidelberg University. Malignant teratomas were found in two patients; in a special case, a "gliomatosis peritonei" was identified. The histological composition, the degree of maturity, grading and clinical staging were compared with regard to the prognosis and for obtaining an optimal therapeutic approach and procedure. Under the condition that an accurate and extensive histological diagnosis is obtained, "conservative surgery" seems to be the optimal therapy in fertile patients. In case of malignant teratoma, radical surgery followed by chemotherapy is imperative.

Adolescent↗
PubMed1981

[Morphological and clinical aspects of the so-called sinus tumours of the ovary (author's transl)].

Data from literature as well as our own studies are used in the discussion of differential diagnosis of the so-called endodermal sinus tumours. Clinical and paraclinical aspects of this once lethal tumour species are reported. New therapeutic strategies are presented consisting of the introduction of new, effective combinations with adjuvant chemotherapy. Thus at early stages a conservative surgical approach seems to allow the preservation of fertility in these generally young women. But even in more advanced cases the administration of a modern adjuvant polychemotherapy is likely to result in higher survival rates.

Adolescent↗
PubMed1981

[Diagnosis of siamese twins at 12 weeks gestation (author's transl)].

Double monsters are a rare obstetric event. The mean incidence is approximately 1:50,000 deliveries. The early diagnosis of siamese twins with the aid of routine ultra-sound investigation is described. Typical ultrasound findings and procedures to verify the diagnosis are described in detail.

Abortion, Induced↗
PubMed1981

[Ultrasonographic diagnosis of a combined malformation syndrome - hydrocephalus - evisceration and dysplasia of the extremities (author's transl)].

The article reports on the ultrasonographic criteria in a complex malformation syndrome (hydrocephalus, evisceration and phocomelia of the lower extremities). Additional examination methods which are suggested whenever there is a suspicion of foetal malformation, are described. The majority of severe congenital malformations can be discovered antenatally via thorough sonographic examination of the foetus in the longitudinal and transverse axes.

Abnormalities, Multiple↗
PubMed1980

[Gliomatosis peritonei--a contribution to the biology of metastasising (author's transl)].

A rare case of "gliomatosis peritonei" is reported in a 16 year-old girl suffering from an adult ovarian teratoma with high-differentiated glia structures without malignancy. The histological grading of the primary tumor and its metastasis in the omentum majus seems to be contradictory to the ovarian-tumor-staging recommended by FIGO. The biological dignity of high-differentiated gliametastasis of an adult teratoma evidently allows a minimum of treatment because of good prognosis of this disease.

Adolescent↗
PubMed1979

[Carcinoma of the apocrine glands of the vulva with intraepidermal spreading under the picture of invasive Paget's disease (author's transl)].

The histological findings of Paget's disease of the nipple and of extramammary localisation are well known. The relationship to the so called "adnexal carcinoma" has not become clear to this moment. We report a case of combination of invasive vulva Paget's disease and adnexal carcinoma of the apocrine vulvar glands. Our findings are discussed with the statements of literature about aetiology and pathogenes.

Aged↗
PubMed1978

[Diagnosis, therapy, and prognosis of primary reticulum cell sarcoma of the cervix uteri (author's transl)].

Until now 12 cases of primary reticulum cell sarcoma of the cervix uteri have been described in the literature. Two more cases are reported. Diagnosis is only possible after exclusion of a systemic disease. Principle rules for therapy cannot be given by these few cases. However it seems that combined surgical and radiological treatment provides the best chances for longer surviving. Experiences in chemotherapeutical treatment of reticulum cell sarcoma of the cervix uteri are not yet published. Four of the 14 patients mentioned in this study died from relapse. The prognosis of this type of cervical tumor seems to be rather good.

Adult↗
PubMed1977

[Placental metastases from a maternal angioblastic sarcoma of the vagina (author's transl)].

Metastasizing maternal tumors during pregnancy with spread to the placenta are spontaneous attempts of malignant tumor transplantation to the Fetus. Because of the resistance of the Syncytiotrophoblast to metastases, carcinomas do not appear to transgress the placental barrier wheras malignant melanomas and sarcomas may do so in some cases. In the described case of maternal angioblastic sarcoma the lack of resistance to tumor spread of the epithelial trophoblast was compensated by resistance of the fetal stroma of the chorionic villi against invasive spread of the tumor. The infant was delivered by Caesarean Section and showed no evidence of a malignant tumor acquired by transplacental spread at the age of 2 1/2 months.

Adult↗
PubMed1977

[Cytologic follow-up examination of patients with a suspicious Papanicoaou type 3D smear (author's transl)].

The cytological differential diagnosis "dysplasia" was made in 176 cases between January 1968 and June 1975. An immediate microscopic diagnosis was possible in 18 cases (10.22%). 14 cases eluded further follow-up. In 144 cases, long term observation was carried out. In some cases up to 6 years. Cytological regression to a permanently negative smear occurred in 57 patients (39.58%). A microscopic confirmation of the diagnosis was not obtained in these patients. In cytologically persistent cases microscopic confirmation was obtained after varying times of observation. The cytological differential diagnosis was correct in comparison to the histologic findings in 82.6% of the cases. 62 cases of the total (43.05%) showed cytological persistence of the suspicious smear. A cytological progression became apparent in 25 cases (17.36%) and was always subjected to microscopic confirmation by cone biopsy or primary hysterectomy. In 71 cases with microscopic confirmation persistent dysplasia was found in 64.78% of the cases and a progression occurred in 30.98% of the cases. 21.12% showed carcinoma in situ, 7.04% (5) cases showed a microinvasive carcinoma and 2 cases (2.82%) showed an invasive carcinoma. Cervical dysplasias are apparently capable of regression in a large number of cases. However about 10% of the cases will show progression to a micro-invasive or invasive carcinoma after varying lengths of time. In order to avoid unnecessary operations and to improve our knowledge on the biology of dysplasias, observation with cytological diagnosis dysplasia (Papanicolaou 3D) is justified.

Carcinoma in Situ↗