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Biomedical subjects

G M Farrow

Publications and source records attributed to G M Farrow.

At least 109 records · Page 6Linked to original sources
PubMed1983

Well differentiated (grade 1) clear cell renal carcinoma.

We reviewed the experience at this clinic from 1950 to 1980 with cases of grade 1 clear cell renal carcinoma. We wanted to determine whether patients with well differentiated clear cell renal tumors had the favorable clinical course that has been demonstrated for those with well differentiated oncocytic renal tumors. Of the 46 patients identified with pure grade 1 clear cell renal carcinoma two-thirds were discovered incidentally during diagnostic tests for unrelated complaints. These tumors generally were small, with 67 per cent being 6 cm. in diameter or smaller. Of all tumors 83 per cent were pathologic stage 1 (confined within the renal capsule). However, 10 patients have died of metastatic renal carcinoma and 3 are alive with disease. Actuarial survival curves show a significantly poorer prognosis for patients with grade 1 clear cell renal tumors compared to patients with grade 1 oncocytic renal tumors or to an age and sex-matched control group. We conclude that whereas well differentiated oncocytic renal tumors behave like benign renal tumors, well differentiated clear cell renal tumors can behave like aggressively malignant renal carcinomas and should be treated as such.

Adenocarcinoma↗
PubMed1983

Benign teratomas of the mediastinum.

Approximately 8% of all mediastinal tumors are benign teratomas. We reviewed 86 cases of benign teratoma seen at the Mayo Clinic from 1930 through 1981. The mean age of the patients was 28 years and the sex distribution was approximately equal. The most common symptoms were chest, back, or shoulder pain, dyspnea, and cough, but 36% were asymptomatic at the time of presentation. Chest roentgenograms showed a well-circumscribed anterior mediastinal mass which often protruded into one lung field. Detectable calcification was observed in 22 patients: a calcified tumor wall in seven, bone or teeth in the mediastinum of seven, and nonspecific calcifications in eight. Surgical excision remains the best means of diagnosing and treating this benign tumor. Though the tumors are histologically benign, they may present difficult surgical problems because of the vital structures involved. Since 1952 there has been a change in the clinical presentation of patients with this entity: More patients are asymptomatic and have smaller tumors and fewer complications than prior to 1952.

Adolescent↗
PubMed1982

Primary retroperitoneal seminoma.

In a retrospective review (1950-1975) of the Mayo Clinic experience with seminomas (483 cases), twelve patients (2.5%) were found to have a retroperitoneal seminoma without evidence of testicular involvement. The mean age was 47 years (range, 31-67). Eleven patients were treated by radiation alone, with doses ranging from less than 2,000-5,800 rads. Seven patients are alive with a median follow-up of six years. The median survival of the five that died is ten months. Good prognostic factors are typical histopathology and an encapsulated tumor. Poor prognostic factors are atypical histopathology, a nonencapsulated tumor, a symptomatic abdominal mass and a nonfunctioning kidney at the time of diagnosis. Although the review includes few patients, it seems reasonable to suggest irradiation of the tumor bed and para-aortic lymph nodes to a minimum dose of 2,000 rads. Prophylactic treatment of the mediastinum and supraclavicular lymph nodes should be considered if one or more of the poor prognostic factors are present.

Adult↗
PubMed1982

Primary anterior mediastinal seminoma.

A review of the Mayo Clinic experience with primary anterior mediastinal seminomas involved 17 patients who had pure anterior mediastinal seminomas and four who had mixed germ-cell tumors containing seminomas. At follow-up, of the 17 patients with pure anterior mediastinal seminoma, nine had no evidence of disease and eight had died of metastatic disease. Of the four patients with mixed germ-cell tumor containing seminoma, two were alive at follow-up and two had died of metastatic disease. In the group with pure anterior mediastinal seminoma, these factors seemed to have been associated with a greater potential for progression of disease: older than 35 years of age, presentation with fever, superior vena caval syndrome, supraclavicular or cervical adenopathy, and roentgenographic evidence of hilar disease.

Adolescent↗
PubMed1982

Nucleolar grading of prostatic adenocarcinoma: light microscopic correlation with disease progression.

Thirteen patients who had adenocarcinoma of the prostate with micrometastasis to pelvic lymph nodes were treated with radical retropubic prostatectomy and pelvic lymphadenectomy, but no adjuvant hormonal therapy, and were followed until the documented appearance of metastasis to bone or soft tissue. Sections from the initial lesion, stained with hematoxylin and eosin and examined under the light microscope, revealed that the nucleoli in the primary Gleason pattern were "prominent" or "intermediate" (regardless of the Gleason grade) in nine cases; and the mean interval to progression was shorter in this group than in the group of four in whom nucleoli were judged to be "not prominent" (P = 0.015). Since the number of cases is small, the findings should be considered preliminary and their interpretation speculative; but the study is continuing.

Adenocarcinoma↗
PubMed1982

Bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for adenocarcinoma of prostate with regional lymph node involvement.

Ninety-nine patients with adenocarcinoma of the prostate and regional lymph node involvement underwent pelvic lymphadenectomy. Therapeutic results were analyzed in 70 patients who subsequently underwent radical retropubic prostatectomy with or without concomitant therapy (usually hormonal) and in 29 patients who received radiation or hormonal treatment only but without prostatectomy. Follow-up ranged from one to fourteen and one-half years. The over-all projected survival rates (Kaplan-Meier) at five and ten years (88 per cent and 71 per cent, respectively) in the prostatectomy series were comparable to those of an age-matched control group. Concomitant bilateral orchiectomy provided a high projected (76 per cent at ten years) nonprogression rate. Over-all survival rates in the nonprostatectomy series were poor. Only the number of nodes involved was associated with survival and time to disease progression. Patient age, tumor bulk, seminal vesicle involvement, and tumor grade (Mayo and Gleason scores) had no definite relationship to survival. Pelvic lymphadenectomy and radical retropubic prostatectomy for prostatic adenocarcinoma may be therapeutic in some patients with limited (less than or equal to two positive nodes) nodal disease.

Adenocarcinoma↗
PubMed1982

Relationship between grade and stage of adenocarcinoma of the prostate and regional pelvic lymph node metastases.

The relationship of grade and local tumor extent to pelvic nodal involvement was assessed surgically in 469 patients who underwent pelvic lymphadenectomy and radical retropubic prostatectomy for adenocarcinoma of the prostate. Grade and local stage alone and combined score were associated in a linear fashion with nodal involvement. Gleason sum and Mayo grade alone were not predictive of nodal metastases. Some patients with a Gleason score of 4 had positive nodes and some with a score of 8 to 10 had negative nodes. Mayo sum (grade plus stage) consistently was related to negative nodal involvement.

Adenocarcinoma↗
PubMed1982

Detection and localization of In situ carcinoma of the bladder with hematoporphyrin derivative.

The extent and localization of in situ carcinoma of the urinary bladder are frequently difficult to assess. We have studied this problem by employing intravenous hematoporphyrin derivative, an endoscopic detection device, and complete pathologic bladder mapping. These preliminary investigations indicate that hematoporphyrin derivative localizes in dysplastic and neoplastic transitional cell epithelium and that these abnormal areas can be detected during a cytoscopic examination with the use of our detection device.

Carcinoma in Situ↗
PubMed1981

Scanning electron microscopic features of human urinary bladder cancer.

Biopsies from 17 cases of transitional cell carcinoma of the urinary bladder were examined by scanning electron microscopy to evaluate surface features of the luminal cells. Pleomorphic microvilli were observed on cells in all cases regardless of tumor grade. Several types of cell surface patterns were observed but variability in appearance increased with grade as did the degree of pleomorphism of the microvilli. Pleomorphic microvilli were not observed in biopsies from two patients without bladder lesions.

Biopsy↗
PubMed1981

Renal adenocarcinoma in young adults: survival and variables affecting prognosis.

Survival rates and various prognostic factors were studied in 89 patients between 20 and 40 years old who underwent nephrectomy for renal adenocarcinoma between 1950 and 1978. Although rare, renal carcinoma in young adults seems to follow a course similar to the disease seen in older patients. Among 18 suspected prognostic factors 2 are strongly and independently associated with survival. These are the pathologic stage of the tumor and preoperative weight loss. Several other prognostic variables show a statistically significant association with survival. These include the presence of preoperative fever, duration of symptoms, tumor cell type, microhematuria on admission to the hospital, tumor grade and sex. However, advanced statistical techniques demonstrate that the association of these variables with survival can be accounted for mostly by their close correlation with the stage of the tumor. Certain variables show no prognostic significance. These included the diameter of the tumor, age of the patient, presence or absence of gross hematuria, flank pain, palpable mass, arterial hypertension, sedimentation rate and side or site of the tumor.

Adenocarcinoma↗
PubMed1981

Renal oncocytoma.

Review of the Mayo Clinic tissue registry for the years 1950 to 1979 identified 90 cases of pure, well differentiated eosinophilic granular cell renal tumors. The clinical, laboratory, pathologic and survival features of these patients were analyzed. Fifty-nine per cent of these tumors were discovered incidentally during an examination for other problems and 91 per cent were confined within the renal capsule, with no evidence of local invasion. Sixty-two patients had grade 1 and 28 had graded 2 tumors. None of the patients with grade 1 tumors developed metastases. Four of the patients with grade 2 tumors died of metastatic disease. Survival curves show no difference in survival between patients with these renal tumors, and an age and sex matched cohort. If the term renal oncocytoma is used to signify a very well differentiated (grade 1) eosinophilic granular cell renal parenchymal tumor then this study demonstrates that renal oncocytomas are non-aggressive tumors with a highly favorable prognosis.

Adenoma↗
PubMed1981

Elevated levels of the eosinophil granule major basic protein in the sputum of patients with bronchial asthma.

The eosinophil granule major basic protein (MBP) is toxic to parasites and mammalian cells. Because eosinophilia is characteristic of asthma, we tested the effect of MBP on bronchi and assayed sputa for this protein. We found that MBP damaged bronchial epithelium in vitro and produced changes that mimicked those in asthma. Radioimmunoassay of sputa from 100 consecutive patients with respiratory diseases revealed MBP levels above 0.1 mug/ml in 13 patients, and 11 of these had asthma. In 15 patient hospitalized for asthma, MBP levels of sputum were markedly elevated. Treatment with bronchodilators and glucocorticoids caused an increase peak expiratory flow rate, a reduction in blood eosinophils, and a decrease in the serum and sputum levels of MBP. The results indicate that eosinophil granule constituents are released into the bronchi in asthma and that measurement of sputum MBP may be useful in identifying asthma. The possibility that the eosinophil damages bronchial epithelium in asthma is discussed.

Asthma↗
PubMed1980

Radical prostatectomy after radiotherapy for prostatic cancer.

We report on 18 patients with clinical stages B and C carcinoma of the prostate who underwent radiotherapy to the prostate, followed by radical retropubic prostatectomy and pelvic lymphadenectomy. Of the 18 patients only 2 (1 with grade 1 and 1 with grade 4 disease) had no residual local cancer at operation. Surgical morbidity was minimal in the 18 patients and only 3 patients had spread of the disease after the combined treatment. Radical retropubic prostatectomy after radiation therapy appears to be safe and effective treatment.

Adenocarcinoma↗
PubMed1980

Primary malignant mixed tumors of the lacrimal gland. Report of 10 cases.

Ten consecutive cases of malignant mixed tumor (pleomorphic adenocarcinoma) primary in the lacrimal gland were studied for clinical features, pathology, course and prognosis and surgical management. Long-term follow-up data were available on all patients and emphasized the varied nature of the neoplasm. Survival intervals after the initial operation varied and seemed dependent on whether the neoplasm was initially histologically malignant or became malignant during the recurrence of a benign mixed tumor. An en bloc, one-stage removal of neoplasm with attached periorbita and underlying bone is recommended to minimize early dissemination via bone.

Adenocarcinoma↗
PubMed1980

Management of carcinoma in situ of the bladder: the case for surgical management.

In view of the foregoing observations of the distinctive characteristics of in situ cancer of the bladder, our position on this disease is as follows. The variability in the biologic activity and in the chronicity of carcinoma in situ of the bladder is acknowledged. However, it is clear that most, if not all, cases of invasive bladder cancer represent a progression of the in situ stage, which is usually currently detectable in an undifferentiated or anaplastic cellular state. Until the advent of biochemical predictors of unqualified reliability for the identification of the crucial time of invasion, we recommend radical cystectomy for cure of in situ carcinoma provided the patient is a reasonable surgical risk, is severely symptomatic, has histologic evidence of extension of the lesion into the vesical neck, urethra, or terminal ureter, and has either histologic or cytologic persistence of cancer after a 6 to 12 month course of intravesical chemotherapy. Most patients with incidentally discovered or asymptomatic in situ carcinoma seem to have a more focal variety of the disease. Under these circumstances, a 6 to 12 month trial of intravesical chemotherapy would be reasonable if scrupulous assessment of the progress of the cancer were possible.

Carcinoma in Situ↗
PubMed1979

Blood group isoantigen deletion in carcinoma in situ of the urinary bladder.

Blood group isoantigens A and H (O) were measured by the Secific Red Cell Adherence (SRCA) Test in nine radical cystectomy specimens removed from patients with extensive carcinoma in situ of the urinary bladder. All bladders had areas of histologically normal epithelium and areas of epithelial atypia in addition to the carcinoma in situ. In eight cases, tissue-associated blood group isoantigens were deleted in areas showing either atypia or carcinoma in situ. Isoantigens were present in these areas in the ninth case. Blood group isoantigens were absent in approximately half of the sections of histologically normal epithelium. We propose that areas of epithelium which appear benign according to conventional histological criteria but in which the blood group isoantigens are absent may represent areas of low grade carcinoma in situ.

ABO Blood-Group System↗
PubMed1979

Prostatic adenocarcinoma of ductal origin.

Adenocarcinomas that arise from primary or secondary prostatic ducts have distinctive histopathologic features. The age of patients, symptoms, findings on digital rectal examination and determinations of serum acid and alkaline phosphatase are similar to those of patients with acinic carcinomas. Carcinomas of secondary ducts may be less responsive to endocrine manipulation and of greater malignancy than carcinomas of primary ducts. The course and survival of patients with ductal carcinomas treated conservatively are poor.

Acid Phosphatase↗