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Biomedical subjects

L J Geisse

Publications and source records attributed to L J Geisse.

3 recordsLinked to original sources

Iris melanomas.

Most iris tumors behave benignly, reflecting their small size and the high proportion of nevi and spindle A melanomas. Of 1,043 reported iris melanomas, 31 metastasized (3%). Metastasis from a spindle A melanoma is not known to occur despite documented growth and local recurrence after excision. If known spindle A melanomas are excluded from all reported spindle cell tumors of the iris, the rate of metastasis for spindle cell tumors is 2.6%. Mixed-cell melanomas have a metastasis rate of 10.5% and epithelioid melanomas a rate of 6.9%. The interval between the histologic diagnosis and death from metastases ranged from three months to 12 years, with an average of 6.5 years. Five- and ten-year mortality rates for different cell types cannot be ascertained. Iris angiography may be useful in defining the limits of tumor involvement but is of uncertain value in differentiating benignancy from malignancy. Of the 31 cases with metastases, 21 included information on the type of surgical procedure used to obtain the histologic diagnosis. In 13 of the 21 cases (62%), the tumors were initially involved with either incomplete excision or inadvertent transection before enucleation.

Adolescent

Pre-clinical cytological diagnosis of bladder cancer.

The records of 100 recent urology service patients with bladder neoplasms were evaluated for correlation of cytological findings with clinical and histological diagnoses. At the time of diagnosis 83 patients had synchronous positive biopsies and cytologies, 3 had negative cytologies (even though urothelial cancer was present) and the remaining 14 had abnormal cytologies but clinical examination was negative. Of these 14 patients invasive cancer has been identified subsequently in 11, while 3 have not yet returned for clinical followup. Analysis of the 11 patients in whom cancer was proved eventually reveals 14 distinct periods, ranging from 1 to 37 months, in which cytologies were abnormal and concurrent clinical examinations and histological diagnoses were negative. Ten of these periods preceded tumor recurrence and the other 4 antedated the first occurrence of cancer. A relationship was found between a cytological diagnosis of carcinoma in situ or severe dysplasia and the presence or future appearance of low grade clinical cancer. Cytologies containing overtly malignant cells more commonly were associated with or preceded the appearance of high grade cancers. In these 11 patients the sensitivity of a single spontaneously voided urine specimen was 97 per cent but the sensitivity was 100 per cent when 2 or more specimens were submitted per patient. Bladder barbotages were 100 per cent sensitive.

Carcinoma in Situ