[The man behind the tumor: Friedrich Krukenberg. He described metastasis to the ovaries].
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Female↗
Biomedical subjects
C Silfverswärd
Publications and source records attributed to C Silfverswärd.
Adjuvant interferon treatment in human osteosarcoma.
An update of the adjuvant trial on osteosarcoma in Sweden comparing patients receiving natural interferon (IFN) alpha with a high-dose chemotherapy group and a nonadjuvant group is presented. The overall survival for the IFN group is 49%, for the chemotherapy group 54%, and for the nonadjuvant group 35%. Trial evaluation was complicated by group differences with respect to various clinicopathologic features of prognostic significance. The role of IFN in the treatment of osteosarcoma can still not be established.
Bone Neoplasms↗
Symptoms and diagnostic difficulties in ovarian epithelial cancer.
OBJECTIVE: To investigate and analyze symptoms in patients with different types of ovarian cancer. METHOD: Records of 160 women with ovarian cancer were studied in detail following the patients from first consultation to operation and diagnosis at Sodersjukhuset, Stockholm. RESULT: No specific group of symptoms could be linked to type or stage of ovarian cancer. Gastrointestinal symptoms were more common in patients with class 1C tumors. Only 21% complained of gynecological symptoms. Women with class 1C cancer had significantly more advanced disease than those with 2C-5C cancer as 77% had a stage III-IV tumor compared with 40% of class 2C-5C patients. CONCLUSION: Diagnosis of ovarian cancer is difficult due to the multitude of symptoms often appearing late in the disease. The majority of women did not experience symptoms in the genital organs. Methods to encourage early consultation should be investigated.
Adult↗
Immunoreactivity with monoclonal antibody A-80 and nuclear DNA content in benign and malignant human breast disease.
Immunohistochemical analysis with the monoclonal antibody (MoAb) A-80, recognizing a tumor-associated cytoplasmic mucin-type glycoprotein, and cytometric nuclear DNA assessment were performed on 314 surgical specimens of the human mammary gland. The series included 36 benign conditions, 34 epithelial hyperplasias, 40 carcinomas in situ, and 204 primary invasive carcinomas. Normal breast parenchyma, benign tumors, and other nonmalignant lesions were all of DNA diploid (euploid) type and rarely expressed the A-80 glycoprotein. Differences in MoAb A-80 immunoreactivity and nuclear DNA content were noted among subtypes of epithelial hyperplasias. Fifteen of 34 epithelial hyperplasias were of DNA aneuploid type and the majority were A-80 immunoreactive. Of these 15 immunoreactive aneuploid epithelial hyperplasias, atypical intraductal hyperplasia was the most common subgroup. None of the 19 epithelial hyperplasias of DNA euploid type immunoreacted. Most of the intraductal (33 of 40) and invasive (180 of 204) carcinomas immunostained with MoAb A-80. The majority of the A-80 immunoreactive malignant tumors were of DNA aneuploid type (26 of 33 carcinomas in situ and 108 of 180 invasive mammary carcinomas). The results suggest that expression of the A-80 glycoprotein occurs at an early stage of malignant transformation. Genetically stable (euploid) mammary tumors seem to immunoreact with MoAb A-80 less frequently than genetically unstable (aneuploid) tumor variants. Combined analysis with MoAb A-80 and of nuclear DNA content in premalignant and malignant mammary lesions could be a useful tool of differential diagnostic and prognostic value.
Antibodies, Monoclonal↗
Benign mixed Müllerian tumor of the ovary.
A case of benign Müllerian tumor of the ovary in a 53-year old woman is reported. The stromal element consisted of rhabdomyoblasts which clearly indicate that this tumor belongs to the Müllerian family. She remains free of disease 12 months following an abdominal hysterectomy and bilateral salpingo-oophorectomy.
Female↗
Prognostic factors in cystosarcoma phyllodes. A clinicopathologic study of 77 patients.
The authors studied prognostic factors in 77 patients with primary cystosarcoma phyllodes (CSP) of the breast. Median patient age was 50 years of age, and the median follow-up time was 8 years. Sixteen patients (21%) had distant metastases and subsequently died of CSP. Clinical variables such as age, symptom duration, clinical tumor size, and type of surgery were not of prognostic value. Local recurrence was more common among patients treated with breast-conserving surgery than among those treated with mastectomy. However, there was no significant difference between these two subgroups in terms of distant metastasis-free survival or overall survival. The prognostic significance of several histopathologic parameters was also assessed, e.g., stromal cellularity, stromal cellular atypism, mitotic activity, atypic mitoses, stromal overgrowth, tumor contour, tumor necrosis, and heterologous stromal elements. In a multivariate Cox analysis, the only features that were found to be independent prognostic factors were tumor necrosis (P less than 0.05) and presence of stromal elements other than fibromyxoid tissue (P less than 0.01). In summary, additional studies of prognostic factors in CSP are warranted because of the conflicting results in published reports.
Adolescent↗
Paragangliomas: neuroendocrine features and cytometric DNA distribution patterns. A clinico-pathological study of 22 cases.
Paragangliomas from 22 patients with extraadrenal tumours of this type were studied. Neuroendocrine features were examined using immunohistochemical techniques. Twenty-two antisera raised against neuroendocrine "markers", regulatory peptides, serotonin and intermediate filament proteins were studied in this group and cytometric DNA assessments were made by means of image cytometry. One normal and 5 hyperplastic carotid bodies were used as controls in the DNA cytometric investigations. Clinical and/or histopathological evidence of "malignancy" was present in 5 cases. The tumour cells showed heterogeneity with regard to their expression of different peptides, and the immunohistochemical analyses did not permit differentiation between benign and malignant paragangliomas. An euploid nuclear DNA distribution pattern was found in all controls and in 17 of the tumours; all except 1 were clinico-pathologically benign. An aneuploid DNA pattern was observed in 5 of the cases and some malignant features were present in 4 of these cases. DNA data may give further information apart from that obtained from the histopathological findings which may be of value in predicting the biological behaviour of this tumour type.
Adult↗
Prognostic factors in invasive squamous cell carcinoma of the vulva.
Histological malignancy grading and its correlation to prognosis were retrospectively investigated in 303 cases of squamous cell carcinoma of the vulva. A scoring system based on several variables is suggested. The scores and the individual histological variables were tested along with clinical factors with a view to predicting survival. Various histological variables including mode of invasion, depth of invasion and nuclear polymorphism, as well as the sum of the scores were good predictors of survival. The study revealed a significantly better survival rate in stage III if no metastases were suspected. An age factor was also found showing that cancer of the vulva has a worse prognosis in older women.
Adult↗
Grading of human urothelial carcinoma based on nuclear atypia and mitotic frequency. I. Histological description.
The World Health Organization (WHO) grade II bladder tumors constitute a clinically and histologically heterogeneous group due to imprecise histological definitions. In an attempt to improve this problem 124 transitional cell carcinomas of the bladder were histologically reviewed using a modified Bergkvist system. The grade II tumors were divided into 2 groups, grades IIa and IIb, mainly with reference to the degree of nuclear atypia and number of mitoses. Using definitions possible to express by numerical means, the separation was easy and reproducible. Due to great histological resemblance between certain close grades we propose a new grading system with 3 grades combining I and IIa (grade A), IIb and III (grade B), and a third group (grade C) for the anaplastic tumors.
Carcinoma, Transitional Cell↗
Grading of human urothelial carcinoma based on nuclear atypia and mitotic frequency. II. Prognostic importance.
A grading system was applied in a retrospective study of 124 patients with transitional cell carcinoma of the bladder using a modified Bergkvist system. The intermediate World Health Organization (WHO) grade II tumors were divided into supposedly benign and malignant forms of grades IIa and IIb, respectively. The 5-year survival was 92% for patients with grade IIa urothelial carcinoma, compared to 43% for patients with grade IIb tumors. The corresponding figures for grades I and III tumors were 100 and 44%, respectively. When excluding carcinoma in situ (5-year survival 50%) no patient with a noninvasive tumor (stage Ta) died of bladder carcinoma within 5 years, compared to 50% of those with invasive cancers (stages T1 to T4). We propose a new grading system in which grades I and IIa are embraced as grade A, grades IIb and III as grade B, and grade IV as grade C. The 5-year survival rate in the 3 grades was 94, 44 and 27%, respectively. Grade A seems to represent a type of tumor with universally favorable prognosis, in contrast to grades B and C. This offers practical advantages, since the former can be treated conservatively, whereas the latter need more urgent radical intervention, especially in patients in whom invasive growth is recorded.
Carcinoma, Transitional Cell↗
Dysgerminoma. The Radiumhemmet series 1927-1984.
Dysgerminoma is a rare, highly radiosensitive, malignant germ cell tumor occurring in young females. At Radiumhemmet, Stockholm, Sweden, from 1927 to 1984, 60 patients with histologically confirmed pure dysgerminoma were treated. Primary treatment was surgery followed by radiotherapy. Recurrences were irradiated. The mean age was 23.2 years. Sixty-seven percent were in International Federation of Gynecology and Obstetrics (FIGO) Stage I, 6% Stage II, 22% Stage III, 3% Stage IV, and 2% were not staged. The median follow-up time was 19 years (range, 1-53). Generally, women with Stage IA disease had unilateral oophorectomy and unilateral external irradiation. Fourteen have borne 22 children after treatment. Seventeen women in the series have died, 11 from dysgerminoma. Actuarial survival, only counting deaths from dysgerminoma, was 83% at 5 years. No patient has died of dysgerminoma since 1963 when radiotherapy with megavoltage x-rays was introduced. The authors consider external irradiation to be an effective treatment as a complement to surgery in dysgerminoma of the ovary.
Adolescent↗
Mixed müllerian tumours of the uterus--prognostic factors: a clinical and histopathologic study of 147 cases.
One hundred and forty-seven women with uterine mixed Müllerian tumours (UMMT) treated at Radiumhemmet from 1936 through 1981 were reviewed. The prognostic value of clinical and histopathologic data was analysed with bivariate and multivariate techniques. Stage, age and abdominal pain were found to be significant predictors of survival. Surgery and combined radiotherapy (intracavitary + external irradiation) gave in stage I, a lower local failure rate (p = 0.006) and better overall survival (p = 0.001) than surgery in combination with either intracavitary or external irradiation.
Adult↗
Vascular tumours in occlusive disease of the iliac-femoral vessels.
Two cases of intraluminal tumours of the iliac-femoral vessels are presented. One was a benign haemangioendothelioma of the common femoral vein and the other a leiomyosarcoma of the iliac artery. Their clinical features were similar to those of patients having venous thrombosis and atherosclerotic occlusive disease respectively. Consequently every physician specialized in vascular disease should be aware of intraluminal tumours as an uncommon explanation of these common clinical pictures.
Adult↗
Reappraisal of uterine sarcoma diagnosis in the Swedish Cancer Registry.
An investigation of over- and under-registration of uterine sarcomas in the Swedish Cancer Registry during the period 1958-1980 was carried out. A histopathologic review of a 10% sample (159 cases) revealed that 18% of the cases, the majority of which were benign leiomyomas, could not be reclassified as sarcomas. All 186 cases of uterine sarcoma treated at Radiumhemmet during the period 1958-1980 were found in the Cancer Registry, but only 90% as sarcomas. As a consequence of over- and under-registration of the sarcoma tumors, the estimated incidences will be affected. In this study, however, we could not find any time trend in the erroneous registration, which implies that comparisons in incidence over time would still be valid.
Diagnostic Errors↗
The age of osteosarcoma patients is increasing. An epidemiological study of osteosarcoma in Sweden 1971 to 1984.
We conducted an epidemiological study of osteosarcoma in Sweden from 1971 to 1984 to investigate whether the typical features of the disease had changed. Of 294 osteosarcoma patients reviewed, 249 had primary skeletal tumours, and for these the mean annual incidence was 2.1 per million, without any clear trend over time. The mean male/female ratio for the period was 1.6 again with no consistent pattern over time; nor was there any significant change in the distribution of tumours according to location. The only feature which showed a significant change over the 14-year period was the mean age of the patients, being at its lowest (19 years) in 1972 and at its highest (40 years) in 1981. Excluding the 22 patients with craniofacial tumours, the remaining 227 also showed a significant increase in mean age. Analysis of the annual age distribution disclosed an increasing fraction of patients older than those in the classical age peak between 10 and 29 years. A large number of trials have shown improved survival in osteosarcoma over the last 15 years, which has been attributed mainly to adjuvant chemotherapy. The change we have observed in age distribution should also be taken into account in the evaluation of the results of treatment; it may be that older patients have a better prognosis.
Adolescent↗
Prognostic factors in uterine leiomyosarcoma. A clinical and histopathological study of 143 cases. The Radiumhemmet series 1936-1981.
One hundred and forty-three patients with uterine leiomyosarcomas treated at Radiumhemmet from 1936 through 1981 were reviewed. Clinical and histopathological findings were analysed by bivariate and multivariate analyses to assign prognostic factors. Mitotic count, menopausal status and stage showed to be significant predictors of survival. The series was divided into two periods of time and a significantly higher survival rate in the second period was noted for patients with stage I disease. Thirty-seven patients with tumors showing less than 10 mitotic figures per 10 high power fields had a 5-year survival rate of 65% compared with 17% for 106 patients with 10 or more mitotic figures per 10 high power field. No significant predictor of a bad outcome for these low mitotic count tumors was found.
Female↗
Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers.
The frequency of new primary cancers was studied in 1846 postmenopausal patients included in a randomised trial of tamoxifen as an adjunct to primary surgery for early breast cancer. The median follow-up was 4.5 years (range 0.5-10.5 years). The number of new cancers in the tamoxifen group (n = 57) did not differ significantly from that in the control group (n = 70). However, in tamoxifen patients second breast cancers occurred less often and endometrial cancer occurred more often than in the controls. The increase in endometrial cancers was probably related to the agonistic oestrogenic effects of tamoxifen and was most pronounced in those treated for over 2 years.
Adenocarcinoma↗
Choriocarcinoma of the fallopian tube associated with induced superovulation in an IVF program; a case report.
The authors present a case of choriocarcinoma of the fallopian tube. The patient was enrolled in an IVF program and to our knowledge this is the first report of a choriocarcinoma following treatment with clomiphene citrate and hMG. The possible role of superovulation in inducing the tumour is discussed. The patient was treated by conservative surgery only and is in remission 1.5 years after the event.
Adult↗