Two cases of recurrent squamous cell carcinoma of the cervix within pelvic-abdominal lymphocysts are presented. The majority of symptomatic lymphocysts after radical pelvic surgery present in the early postoperative period. When lymphocysts become clinically apparent many months after surgery, differentiating the usual benign cystic masses from those involving the recurrent tumor may be difficult. The diagnosis and management of the late-occurring lymphocysts are discussed. From the authors' experience and a review of the literature, it can be concluded that a lymphocyst occurring six months after surgery is unusual, and this should be highly suspect of harboring recurrent tumor. Adequate excision of the lymphocyst wall for histologic study is the most accurate method to rule out recurrent carcinoma.

Abdomen↗

PubMed1982

Microinvasive carcinoma of the vulva.

Thirty cases of microinvasive squamous cell carcinoma of the vulva were seen from 1972 to 1978 inclusive. They comprised 37.7% of 77 cases of squamous carcinoma of the vulva seen during this period of time. The results of analysis of multiple factors, including tumor depth and pattern of invasion, nuclear and histologic grade, volume, inflammatory response, presence of vascular invasion, and depth of invasion as compared to the depth of adjacent skin appendages and rete ridges are presented. Two patients were found to have inguinal lymph node metastasis: in one of these patients the tumor was deeper than the adjacent deepest skin appendages while in the second patient skin appendages were not adjacent to the tumor. These tumors measured 2.25 and 1.8 mm in depth, respectively. In both patients the tumor was of high nuclear grade and had a diffuse pattern of infiltration. No nodal metastases were found in patients whose tumors did not invade deeper than 1.5 mm or deeper than the adjacent deepest skin appendage. Tumors measuring 1.5 mm in depth had tumor volumes under 1,000 mm3. The only death from tumor that occurred in this series occurred in a woman who had a second primary tumor of the vulva following a local excision for her microinvasive carcinoma. The definition and measurements of microinvasive carcinoma of the vulva are discussed and an improved method of measurement is proposed.

Adult↗

PubMed1982

Condylomata acuminata of the cervix: histopathology and association with cervical neoplasia.

Cervical specimens from 531 consecutive cases were reviewed to determine the frequency of cervical condylomata acuminata (CLA) and their association with cervical intraepithelial neoplasia (CIN). CLA and CIN were subclassified into three groups based on the criteria previously established in the literature. Our data indicate that CLA was present in 103 (19%) cases and that 44 (43%) of these had CIN as well. The total number of cases of CIN in this series was 146 (27%) with 44 of these (30%) having associated CLA. Of the eight CIN cases in women under 20 years of age, seven (99.6%) had associated CLA. The mean age of patients with CIN alone was 31 years; patients with CIN and CLA were younger, with a mean age of 24 years. These findings indicate that cervical CLA is a common lesion affecting young women and that there is a significant association of CLA with CIN. Women with CLA appear to be at significant risk for development of CIN.

Adolescent↗

PubMed1982

Occult axillary lymph node metastases in invasive breast carcinoma: characteristics of the primary tumor and significance of the metastases.

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Adult↗

PubMed1981

Multicentric nature of vulvar carcinoma in situ.

A detailed histologic and DNA-microspectrophotometric study is presented of 31 lesions selected from 12 of 65 patients with vulvar carcinoma in situ whom the authors have seen. In 6 patients the lesions were multicentric and in 6 they were confluent. The purpose of the study was to determine whether or not there was a measurable biologic difference between these 2 distinctly different clinical lesions that would justify separating them into different categories. A hypothesis as to the clonal evolution of multicentric and confluent vulvar carcinoma is presented based on the authors' findings.

Carcinoma in Situ↗

PubMed1980

Carcinoma in situ of the vulva: a continuing challenge.

The epidemiologic data, clinical features, associated diseases, and histologic characteristics present in 50 cases of carcinoma in situ of the vulva are analyzed. A comparison of follow-up results obtained with various treatment methods is presented. With primary surgery the recurrence rate is dependent on the presence or absence of tumor at the surgical margins. Deoxyribonucleic acid patterns, determined by microspectrophotometry, were aneuploid in 92% of the cases studied. Five patients (10%) with aneuploid lesions, observed without therapy, experienced spontaneous regression of tumor and replacement of abnormal areas by euploid epithelium.

Adolescent↗

PubMed1980

Carcinoembryonic antigen and L-fucose in malignant and benign mammary disease.

A prospective study of 123 patients was undertaken to determine whether carcinoembryonic antigen (CEA) or L-fucose could be used as "tumor markers" to distinguish patients who had mammary cancer (41) from patients who had benign mammary disease (41) and patients who did not have mammary cancer (41). The predictive value of positive test results for both L-fucose and CEA was lower for patients who smoked than for those who did not. The sensitivities of CEA and L-fucose indicators are both below 55%. There were frequent false-positive and false-negative results. A substantial overlap in the levels of CEA and L-fucose was found for the patients who had mammary cancer and those who had benign mammary disease. CEA and L-fucose performed similarly in distinguishing cancer from benign disease. For patients who smoked, however, the predictive value of L-fucose was only 44%. The effect of smoking on L-fucose levels may account for discrepancies in L-fucose data reported in previous studies of mammary cancer. Neither CEA nor L-fucose were found to be of value in screening for mammary cancer.

Breast Diseases↗

PubMed1980

Endometrial involvement by cervical intraepithelial neoplasia.

Two cases of cervical intraepithelial neoplasia (CIN) with superficial extension to the endometrium are presented, and the English literature is reviewed. The concept of the radial growth phase of CIN is presented and discussed. The radial growth phase may precede the vertical or invasive phase of neoplastic growth. The possibility of endometrial involvement in CIN points to the potential hazard of not evaluating the endocervix and endometrium before treatment of cervical CIN.

Aged↗

PubMed1980

Videotaped vs traditional lectures for medical students.

Closed-circuit television (CCTV) provides medical departments with alternatives in instructional formats. Concern, however, has been voiced about teaching via TV because the medium itself might cause inattention. This study investigated whether TV will lower the test scores of medical students. Sixty-one students were randomly divided into two groups. The lecture (control) group received the information via traditional lectures, including use of 2" X 2" transparencies. The video group received concurrently the same information via CCTV. Multiple-choice examinations were given after each of the six sessions. The cumulative mean scores were similar: lecture group=87.56%, video group=87.99%, i.e., no significant difference (P=0.77). To detect attitudinal differences toward the two formats, the students were surveyed at the end of the series and intragroup agreement on specific questions was calculated. The students rated the lecture format more highly. In response to the question 'Did the audiovisual materials used by the instructor aid your learning?', the mean rating from the lecture group was 7.37 (scale of 0-9) compared to a mean rating of 5.93 from the video group (P < 0.0003).

Education, Medical, Undergraduate↗

PubMed1980

Clinical delineation of trisomy 9 syndrome.

A rare but typical case of trisomy 9 mosaicism is reported. The infant showed the characteristic phenotype of this syndrome: low-set malformed ears, micrognathia, broad nose with bulbous tip, abnormal brain, congenital heart disease, abnormal hands and feet, cryptorchidism, micropenis, and early death. This infant, however, did not have dislocation of joints or microcephaly; the head was larger than normal and had almost a cloverleaf shape.

Abnormalities, Multiple↗

PubMed1979

Paramagnetic changes in cancer: DMBA-induced tumours studied in non-lyophilized and lyophilized tissues.

Electron spin resonance (ESR) studies were made on frozen samples of 7,12 dimethylbenzanthracene (DMBA)-induced rat breast tumours both before and after lyophilization. The primary purpose of these studies was to determine the relationship between ESR spectra under these two conditions and thereby hopefully resolve an apparent conflict as to the experimental findings and clinical implications of these findings. In contrast to the other system (Walker 256 carcinosarcoma) which we studied by a similar method, in the DMBA-induced tumours we found a close parallel between the ESR spectra before and after lyophilization. In both cases free-radical levels were elevated about two-fold in all tumours and showed little dependence on the age of the tumour. Studies of blood and liver before the development of tumours showed no change in free radicals levels in either nonlyophilized or lyophilized samples. In animals with tumours, the level of free radicals in the liver increased approximately 17%. Manganese (2+) levels were increased in breast tumours but the changes did not closely follow those of free radicals and were much more variable in the lyophilized samples. We conclude that: (1) there seems to be no general relationship between ESR spectra of tumours before and after lyophilization; (2) there appears to be no general pattern of ESR changes in lyophilized samples of tumours.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed1978

Lymph-node identification by specimen radiography and xerography.

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Humans↗

PubMed1978

Borderline microinvasive carcinoma of the cervix.

This study identifies borderline microinvasive carcinoma of the cervix as a subgroup of microinvasive carcinoma. We define borderline microinvasive carcinoma of the cervix as the infiltration of neoplastic squamous epithelial cells into the stroma where the depth of infiltration is 1 mm or less from the basement membrane of the epithelial surface immediately adjacent to the site of infiltration without capillary-like or lymphatic-like space involvement. In a 20-year review of cervical neoplasia in our institution, 29 cases of borderline microinvasion were identified. None of these 29 patients had recurrent carcinoma. Of our in situ carcinomas, 4.8% were found to be borderline lesions on review. Of our cases initially interpreted as microinvasion, 27.1% were, in fact, borderline lesions. There are better data to establish the criteria for borderline microinvasive carcinoma than there are to establish the absolute depths of invasion that would be unequivocally acceptable as "microinvasion." Borderline microinvasive carcinoma of the cervix is a lesion which is not metastatic and can be treated by nonradical methods.

Carcinoma in Situ↗

PubMed1978

Breast biopsy evaluation by paraffin-block radiography.

The presence of occult breast carcinoma in breast biopsy specimens originally interpreted pathologically as benign has been reported in up to 2.4% of cases. Paraffin-block radiography of 658 blocks from 119 breast biopsies obtained prior to the use of mammography and initially interpreted as benign was performed to determine the frequency and relevance of "significant" calcifications. Of all cases 87.4% demonstrated some calcifications within the breast tissue; 19.3% contained calcifications considered significant. Step sections of the original blocks containing significant calcifications did not demonstrate malignant neoplasms.

Biopsy↗