Biomedical subjects
Publications and source records attributed to G W Chapman.
Intracerebral metastatic carcinoma is one of the most common tumors of the central nervous system. Intracerebral choriocarcinoma, however, is rare, but may occur as the initial manifestation of choriocarcinoma. This case report describes the treatment and outcome of a teenager with metastatic intracerebral choriocarcinoma.
Twenty-eight women aged > or = 85 years invasive carcinoma of the cervix were studied retrospectively. Seventy-five percent of the tumors were squamous in origin. Adenocarcinomas constituted 17.9%, and unusual varieties comprised 7.1%. All 5-year survivors are alive with disease and were treated with irradiation therapy. The overall survival rate was 29%.
Gestational trophoblastic disease rarely is reported in early teens. This article describes a 12-year-old black female with molar disease, in which the characteristics and treatment are not dissimilar from adults.
A retrospective study was undertaken to determine the survival of patients with stages I and II serous papillary adenocarcinoma of the endometrium. Twenty-eight patients were evaluable. The patients were treated by a variety of methods that included irradiation only, surgery only, combined irradiation and surgery, and chemotherapy. Eighteen patients had stage I disease and 10 patients had stage II disease. The 2-year survival rate was 16.6% for stage I patients and 40% for stage II patients. The overall 2-year survival rate was 28% for both groups of patients.
A retrospective study was undertaken to evaluate the outcome of elderly females treated for invasive cervical carcinoma. Three hundred three patients were treated for invasive carcinoma of the cervix. More than 45% of patients had advanced stages of disease. Squamous lesions were found in 90.7%, adenocarcinomas in 7.3%, and rare varieties in 1.9% of patients. Among patients with squamous lesions, the overall 5-year survival was 23.2%. Survivals were 26.9% in stage I, 26.3% in stage II, 26.1% in stage III, and 12.5% in stage IV. Advanced age females continue to experience invasive cervical carcinoma in large numbers, and our results indicate grave prognosis.
A retrospective study was undertaken to determine the prevalence of persistent trophoblastic disease among patients with high-risk molar disease. Nineteen patients met the criteria for high-risk molar disease. Fifteen of 19 (71%) patients underwent spontaneous resolution. Four of 19 (21%) developed persistent disease and required chemotherapy.
The patterns, symptomatology, and treatment of molar pregnancy in adolescents are similar to that of adults, and the prognosis is the same.
This retrospective study involved 55 patients, 35 years old or less with invasive carcinoma of the cervix. There were 49 squamous carcinomas, 3 adenocarcinomas, and 3 unusual varieties. Thirty-five patients had stage IB disease; 4 had stage IIA disease; 6 had stage IIB disease; 5 had stage IIIB disease, and 3 had stage IV disease. Treatments employed were either radical hysterectomy and node dissection, irradiation, or irradiation followed by radical surgery. Our overall 5-year disease-free survival among young females with stage IB disease was observed to be only 43%; stage IIA only 25%; stage IIB only 17%, and no survivors in more advanced stages.
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Ovarian cancer represents a formidable challenge to physicians. Early symptoms are nonspecific, and are usually attributed to disorders of the upper gastrointestinal tract. Especially important is suspicion of this neoplasm in its early stage. This article discusses the epidemiology, clinical features, evaluation, and treatment of early carcinomas of the ovary.
A 73-year-old woman manifested recurrent endometrial carcinoma, which presented as multiple nodular lesions in an abdominal scar from previous pelvic surgery.
Meager information exists regarding the morbidity of cancer surgery in obese patients, and it is generally assumed that surgery in the obese patient is attended with increased complications over those found in nonobese patients. A retrospective evaluation was undertaken at the Louisiana State University Medical Center to ascertain the morbidity of cancer surgery among 97 patients. In comparing the obese with the nonobese group of patients, the former was more often found to have complications of postoperative wound disorders that frequently required secondary operations, and a greater incidence of diabetes. The risk of postoperative complications among obese patients undergoing cancer surgery did not otherwise appear to be greater than that of nonobese patients.
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A patient with umbilical metastasis from a primary squamous carcinoma of the cervix is presented and the literature is reviewed.
The presenting symptoms of adenoid cystic carcinoma of the vulva in a 57-year-old woman were a vulvar mass and pain. The mass was excised locally. The disease recurred in the lung four years later. The patient was treated with several regimens of chemotherapy, without significant effect. She died of pulmonary failure six years after diagnosis.
A 26-year-old female with an alveolar soft-part sarcoma of the vagina, manifesting itself during and after pregnancy, is described. The presenting symptoms were pain and an increase in the size of the mass. Local excision, followed by radiotherapy and chemotherapy, was ineffective and the tumor reoccurred within 6 weeks. Reoperation with removal of a portion of the vagina, surrounding tissues, and adjacent periosteum of the pubic bone has resulted in a stabilization of the disease.
The detection and removal of an unusual intravaginal foreign body-a perfume bottle and cap used for sexual gratification-are described.
Proper pulmonary function is a vital part of the physiological adjustment of the patient subjected to radical surgical procedures. The pathophysiology, diagnosis, and treatment of acute respiratory failure are discussed as well as the use of mechanical ventilation, PEEP, CPAP, and IMV and the indications for intubation and extubation.