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Biomedical subjects

G M Farrow

Publications and source records attributed to G M Farrow.

At least 91 records · Page 5Linked to original sources
PubMed1985

Spindle cell lipoma of the orbit.

A spindle cell lipoma was partially removed from the left orbit of a 27-year-old man. Computed tomography showed a large, mildly enhancing, primarily intraconal mass. The circumscribed, nonencapsulated mass was composed of mature adult lipocytes, spindle cells, and capillaries. The spindle cells lacked a basal lamina and contained a single elongated nucleus. Cells containing osmiophilic material were rounded with nucleus displaced to one margin. Because of the tumor's size and proximity to vital structures, total excision was not possible. Such tumors are more frequent in the subcutaneous tissue of the shoulder and posterior aspect of the neck. This benign lesion may be mistaken for other spindle cell tumors, including liposarcoma, angiolipoma, neurilemmoma, and hemangiopericytoma.

Adult↗
PubMed1985

Expression of blood-group-related antigens in carcinoma in situ of the urinary bladder.

Expression of epithelial ABH blood group antigens and the T (Thomsen-Friedenreich)-antigen was quantitatively studied by immunoperoxidase techniques in nine cystectomy specimens containing extensive carcinoma in situ (CIS), and also histologically benign epithelium. CIS areas typically showed abnormal expression of both ABH and T-antigens and a distinctive vascular architecture, revealed by endothelial ABH staining. Histologically normal epithelium generally was antigenically normal, but occasionally showed abnormalities of either ABH or T-antigens. Antigen expression was variable in histologically atypical epithelium, with significant segments showing abnormalities of either ABH or T-antigen, and sometimes of both antigenic markers. It is postulated that histologically benign, but antigenically abnormal, epithelium may represent low-grade CIS of the urinary bladder. Assessment of blood-group-related antigen expression in flat atypical epithelium of the urinary bladder may be useful for predicting the biologic potential of these lesions.

ABO Blood-Group System↗
PubMed1985

Sarcoma and carcinosarcoma of the bladder in adults.

Sarcomas of the bladder occur rarely in adults. As a result, the natural history of these unusual tumors and the best methods of treatment are uncertain. We reviewed our experience with 13 patients presenting between 1970 and 1980 (5 had leiomyosarcoma, 5 had carcinosarcoma and 3 had rhabdomyosarcoma). Gross hematuria nearly always was the presenting symptom. Patients treated by partial cystectomy fared poorly, while 7 treated by radical cystectomy and supravesical urinary diversion had an excellent prognosis: 6 (86 per cent) have been free of disease for more than 1 year, including 4 who have survived more than 45 months without evidence of recurrence or metastasis.

Adult↗
PubMed1985

Radiotherapy as initial treatment for bulky stage II testicular seminomas.

Sixteen consecutive patients with bulky stage II seminoma were treated with primary radiotherapy from 1971 to 1982. Bulky stage II seminoma was defined as either Union Internationale Contre le Cancer (UICC) stage IIC (retroperitoneal metastases greater than 5 cm) or IID (palpable retroperitoneal metastases) with no evidence of visceral or supradiaphragmatic disease. The median age was 38 years (range, 26 to 52) and the median size of retroperitoneal disease was 11.5 cm (range, 5 to 25 cm). Patients were treated with generous radiation ports (such as wide hockey-stick or whole abdomen) often followed by boosts to the sites of bulky disease. Median tumor dose was 3,235 cGy (range, 2,700 to 5,668 cGy). Mediastinal (with or without supraclavicular) prophylactic radiation was administered to 15 of the 16 patients with a median dose of 2,590 cGy (range, 1,200 to 3,700 cGy). Treatment toxicity was mild. All 16 patients achieved a complete remission (CR) with radiotherapy. Median follow-up from the time of diagnosis was 60 months, and all patients are currently disease-free. Two patients recurred after therapy but were rendered disease-free with further radiation. These two relapsing patients have remained disease-free, following initial recurrence, for 8 years. The excellent results obtained with modern imaging and radiotherapeutic techniques justify radiotherapy as the initial treatment of choice for bulky stage II seminomas.

Adult↗
PubMed1985

Malignant germ cell tumors of the mediastinum.

A review of 56 cases of primary malignant germ cell tumors of the mediastinum revealed that, as with benign teratomas, the tumors occurred in young adults (mean age 29 years) but that the sex distribution differed (86% male and 14% female). A single germ cell element was found in 37 (66%) of the tumors, and various combinations were present in the remaining 19 (34%). The tumors were classified among five recognized types of germ cell tissues. There were 24 seminomas (22 pure and two with mature teratomas), 17 embryonal carcinomas (nine pure and eight with mixtures), five teratomas, seven choriocarcinomas (three pure and four with mixtures), and three pure yolk sac tumors. Most (86%) of the patients were symptomatic at the initial examination, with chest pain, cough, and loss of weight being the most frequent presenting symptoms. The standard posteroanterior and lateral roentgenograms were the most helpful diagnostic tool, showing evidence of an anterior mediastinal mass in 53 patients. The diagnosis was established by surgical exploration of the mediastinum or by biopsy of a lymph node in 55 patients. Of the 55, 24 (43.6%) had complete resection of the tumor and 31 (56.4%) had incomplete resection or biopsy alone. The overall prognosis for mediastinal germ cell tumors is poor, partly because the tumors are far advanced at the time of diagnosis but also because some of the tumors that contain embryonal cell carcinoma, choriocarcinoma, and yolk sac elements are very aggressive. Factors that were prognostic in patients with seminoma--such as age, presence of the superior vena caval syndrome, lymphadenopathy, evidence of hilar disease on the chest roentgenogram, and resectability--were not predictive in patients with other types of malignant germ cell tumors. Although aggressive combination chemotherapy may represent a significant treatment modality for nonseminomatous mediastinal tumors, the present study spanned many years in which no chemotherapy was available. Patients in the later years of the study received combination chemotherapy with various treatment regimens. No conclusions concerning specific chemotherapy, therefore, can be derived from this study.

Adolescent↗
PubMed1985

Review of Mayo Clinic experience with carcinoma in situ.

Experience with carcinoma in situ (CIS) of the urinary bladder during a twenty-year period at the Mayo Clinic is reviewed. The most important clinical clues for diagnosis of this disease continue to be irritative bladder symptoms in the absence of infection in elderly men and a history of transurethral resection of the prostate. The most reliable method of diagnosis is urinary cytology. When not modified by treatment, CIS is the precursor of most invasive cancers, originating probably from an area of atypical hyperplasia into CIS and, finally, into invasion. Among patients considered to have CIS who undergo cystectomy, 34 per cent may already have microinvasion. CIS has the potential to involve the entire urothelium. Prudence should guide the use of intravesical chemotherapy (mitomycin or thiotepa or doxorubicin), which may control the disease for extended periods in many patients. If primary treatment fails, immediate second-line treatment should include BCG or hematoporphyrin derivative (HpD) phototherapy or both. If such therapy fails, delay of radical cystectomy seems inadvisable. Monitoring of the prostatic urethra during intravesical treatment is mandatory; a radical surgical procedure should be performed once the prostatic urethra is involved. Results of treatment for secondary prostatic and upper urinary tract cancer are dismal. Conversely, secondary urethral disease, although it occurs frequently beyond five years, may be associated with a good prognosis.

Administration, Topical↗
PubMed1985

Studies of the human testis. XIX. Preparation of an antibody to human testosterone-oestradiol-binding globulin and its application to the study of testicular androgen-binding protein.

Human testosterone-oestradiol-binding globulin (hTeBG) was purified from pregnancy serum by ammonium sulphate precipitation, preparative flatbed electrofocusing, Concanavalin A-Sepharose affinity chromatography, Sephadex G-150 gel filtration, DEAE-Sephadex chromatography and preparative polyacrylamide gel electrophoresis. The yield was 0.3 mg of hTeBG with a specific acitivity of 1.1 nmoles DHT bound per mg. An antiserum to TeBG was raised in rabbits. Anti-hTeBG IgG was separated from rabbit TeBG by DEAE-Affi-Gel-Blue chromatography. Anti-hTeBG was titrated using protein A-Sepharose which quantitatively binds IgG and therefore bound [3H]DHT-hTeBG-anti-TeBG complexes. The androgen binding components from human testis were separated on Concanavalin A-Sepharose columns into excluded and retained fractions. The antibody bound both testis fractions with titration curves which paralleled that of TeBG, indicating that these androphilic proteins share common immunodeterminants with hTe-BG. The possibility that these testicular proteins are identical in amino acid sequence to TeBG and differ only in carbohydrate content will require further verification. Finally, these results indicate that antibodies to TeBG can be used to study human testicular androgen-binding protein.

Androgen-Binding Protein↗
PubMed1984

Carcinoma of the seminal vesicle.

Strict criteria were applied to 12 cases of carcinoma of the seminal vesicle in the Mayo Clinic tumor registry. Diagnosis was carcinoma of the seminal vesicle if the neoplasm was a papillary or anaplastic carcinoma localized primarily to the seminal vesicle and no other primary tumors were demonstrated. In addition, some degree of mucin production was required, especially when prostatic involvement was present. Only 2 of our cases and 35 cases reported previously were judged acceptable or probable cases of carcinoma of the seminal vesicle. Prognosis for patients with this tumor is poor. A combination of extirpative surgery and hormonal therapy appears to provide the best opportunity for extended survival, although this remains to be proved.

Adenocarcinoma↗
PubMed1984

Relationship of leukoplakia to urothelial malignancy.

The records of 108 patients presenting with leukoplakia of the urinary tract during the last 35 years were reviewed to define the natural history of this disease, with emphasis upon its association with urothelial cancer. Of the 108 patients 24 had upper urinary tract, 78 bladder and 10 urethral leukoplakia (1 with renal and bladder involvement, 3 with bladder and urethral involvement, and 1 with ureteral and renal involvement). Presenting complaints were primarily irritative. To date, 41 patients (37 per cent) have had associated carcinoma of the urothelium: 23 (21 per cent) presented with a concomitant or previous carcinoma and 18 of 85 (21 per cent) presenting without a concomitant or previous neoplasm have had documented progression to cancer. These figures support the concept that leukoplakia is a premalignant disease and that patients with this diagnosis deserve careful and frequent followup.

Aged↗
PubMed1984

Testicular yolk sac and embryonal carcinomas in pediatric patients: comparative immunohistochemical and clinicopathologic study.

Twelve Mayo Clinic patients less than 17 years of age were identified who had yolk sac tumors of the testis. Seven additional pediatric patients were identified who had embryonal carcinoma of the testis. These 19 patients form the basis for this study correlating histopathology and immunocytochemical patterns with clinical outcome. Immunoperoxidase studies were done with antibodies to alpha-fetoprotein, beta-subunit of human chorionic gonadotropin, alpha-1-antitrypsin, and human albumin. The immunocytochemical staining pattern in these neoplasms did not appear to correlate with prognosis.

Adolescent↗
PubMed1984

Carcinoma in situ of the urinary tract.

The identification and description of carcinoma in situ by pathologists and the recognition of its clinical features and diagnostic clues by clinicians represent a significant advancement in the struggle to conquer invasive epithelial cancer in recent times. The authors discuss symptoms, diagnosis, pathologic features, and treatment.

Carcinoma in Situ↗
PubMed1984

An assessment of the impact of urine cytology screening using a computer-based model of bladder cancer.

Utilizing a computer-based model of bladder cancer, the applications of various urine cytology screening strategies are assessed. Outcomes for patients diagnosed by screening with respect to numbers of cases diagnosed, mean length of life, and numbers of cancer deaths are compared with a similar population of patients diagnosed after the development of symptoms. Diagnostic and treatment modality costs can be used to predict the cost per man-year of life extension afforded by a screening program.

Adult↗
PubMed1983

Hormonal treatment at time of radical retropubic prostatectomy for stage D1 prostate cancer.

We classified 70 prostatic cancers as stage D1 at the time of pelvic lymphadenectomy and radical prostatectomy. For retrospective analysis after 1 to 14 years of followup, the patients were divided into 32 in whom endocrine therapy had been given immediately postoperatively and 38 in whom it had not. These 2 groups did not differ substantially in patient age, Gleason grade, pathologic stage, tumor volume or seminal vesicle involvement. The mean number of involved nodes per patient was higher in the hormone-treated group (2.9 versus 1.8). According to Kaplan-Meier projections 88 per cent of such patients without hormonal treatment will have progression within 5 years, compared to only 14 per cent of those given hormonal treatment immediately. However, projected survival differed little between the groups, most likely since 17 of the 18 patients with progression in the nontreated group were given hormonal treatment as soon as progression was substantiated. Definitive assessment of the impact of the timing of endocrine therapy on patient survival and time to disease progression awaits a randomized trial with long-term followup.

Adenocarcinoma↗
PubMed1983

Sarcomatoid renal carcinoma.

Sarcomatoid renal carcinoma made up 1 per cent of renal parenchymal tumors resected from 1967 to 1980. The majority of patients with this aggressive type of renal carcinoma were symptomatic and had a palpable renal mass at the time of diagnosis. Only 2 of 13 patients had tumor confined within the renal capsule at the time of operation. One of these patients survived and 12 of 13 died rapidly of metastatic renal carcinoma, with a median survival of 6.3 months from the time of diagnosis. This distinctive histologic variant of renal carcinoma has a highly malignant biological behavior and, as effective adjuvant treatment for renal carcinoma becomes available, should be one of the tumor types treated vigorously.

Adenocarcinoma↗
PubMed1983

Treatment of transitional cell carcinoma of the bladder with hematoporphyrin derivative phototherapy.

The demonstration that intravenously administered hematoporphyrin derivative concentrates preferentially in dysplastic and neoplastic transitional cells in the human bladder prompted a trial of hematoporphyrin derivative phototherapy in patients with transitional cell cancer of the bladder. A dose of 2.5 mg. per kg. was given intravenously 3 to 48 hours before treatment with light of a wavelength of 630 nm. from an argon ion pumped dye laser. Total light dose approximated 150 joules per cm.2. Four patients with resistant carcinoma in situ have been treated and all have had disappearance of the tumors proved by biopsy. Although there are many technical problems we believe that hematoporphyrin derivative phototherapy holds promise as an effective treatment modality, primarily for patients with resistant, recurrent in situ transitional cell carcinoma of the bladder.

Aged↗
PubMed1983

Villous adenocarcinoma of the male urethra.

We report on 2 men with multifocal papillary adenocarcinoma arising in the bulbous urethra proximal to a urethral stricture. Histologically, the tumors appeared similar to villous adenocarcinomas of the colon and rectum. Both patients were treated with segmental urethrectomy. Villous adenocarcinoma of the male urethra is a distinctive clinicopathologic entity. Although uncommon it should be added to squamous cell carcinoma and transitional cell carcinoma on the list of tumor types causing cancer of the male urethra.

Adenocarcinoma↗