Biomedical subjects
M D Staunton
Publications and source records attributed to M D Staunton.
Malignant thyroid tumours 1932 to 1972: the outcome in 492 patients.
We report on 492 patients treated for thyroid cancer at the Royal Marsden Hospital between 1932 and 1972: 380 of the patients are now dead. Eighty-three per cent (n = 410) are tumours of follicular cell origin. We found the crude 20-year probability of survival to be 54% in papillary carcinoma, 29% in follicular carcinoma and 1% in anaplastic carcinoma. Considering solely cancer deaths, the survival in papillary cases was 68%. Age, histology (tumour type), extent of primary tumour (T stage), haematogenous metastases (M1 stage) and, to a lesser extent, sex exercised a significant influence on survival. We support the use of these five factors to produce a prognostic index for estimating the level of risk for tumours of follicular cell origin. We add our experience in the non-follicular cell tumours of medullary carcinoma (3%), lymphoma (7%) and fibrosarcoma (1%).
Sclerosing lymphocytic lobulitis of the breast--evidence for an autoimmune pathogenesis.
We describe 13 cases of inflammatory lesion of breast lobules in young and middle-aged women, presenting as breast lumps, with, in five cases, associated breast pain. The patient with the most florid bilateral disease subsequently developed Hashimoto's thyroiditis. This prompted us to consider an autoimmune pathogenesis for all the breast lesions. We confirm a previously documented association of such breast lesions with diabetes mellitus and review the evidence for a possible HLA association. Increased HLA-DR expression by breast epithelial cells was observed in cases available for study. Of the seven patients screened for circulating autoantibodies, three had none, one had smooth muscle antibodies, one parietal cell, one parietal cell and thyroid microsomal, and the seventh had the thyroid autoantibodies expected in Hashimoto's disease. Five of seven patients whose HLA-status was determined were HLA-DR3, 4 or 5 positive, either singly or in combination. Immunophenotypic analysis of the mammary lymphoid infiltrate showed that the majority of infiltrating lymphocytes were B-cells.
Liposarcoma of the spermatic cord.
Explore the source record for details and available documents.
Brachial plexopathy in breast carcinoma--an unsolved problem.
Brachial plexus involvement from carcinoma of the breast produces a severe disability which presents difficulties in diagnosis and treatment. Five patients who suffered this complication are described and the problems they present are discussed.
Chondrosarcoma--local recurrence and systemic embolization.
Explore the source record for details and available documents.
The birth of retropubic prostatectomy--Millin.
Explore the source record for details and available documents.
Spontaneous expulsion of a large submucosal colonic lipoma.
Explore the source record for details and available documents.
Stab injury--the experience of an East London Hospital 1978-1983.
A retrospective review of 201 patients with stab wounds admitted to an East London Hospital over a period of six years was performed. There was no striking increase in the annual incidence of these injuries over the period reviewed. The majority of patients were young males who arrived at the Accident and Emergency Department after 1800 h on a Friday, Saturday, or Sunday and had consumed alcohol prior to admission. There were 47 abdominal injuries (23%), 69 thoracic (34%), 51 limb injuries (25%) and 34 injuries involving the head and neck (17%). Forty patients (20%) had injuries involving more than one site. Abdominal stabbings were managed by a selective approach resulting in 28 laparotomies of which only 2 (7%) were negative. Evisceration of small bowel or omentum was always associated with significant intraperitoneal injury.
Thyroid cancer: prognosis in 469 patients.
Explore the source record for details and available documents.
Treatment of thyroid cancer in 293 patients.
Two hundred and ninety-three patients with thyroid cancer were treated at The Royal Marsden Hospital, London, between 1931 and 1963. Thirty-six per cent of the tumours were papillary, 21 per cent follicular, 1 per cent medullary and 42 per cent anaplastic. Surgery combined with radiotherapy formed the commonest treatment regime. Thirty-six per cent of the patients with papillary carcinoma survived for 20 years, 20 per cent with follicular tumour and 4 per cent with anaplastic carcinoma. The present series indicates that treatment influences the survival time, confirms the prognostic value of histology and age and shows that papillary node metastases do not prejudice survival.
Malignant adenoma of the thyroid: hail or farewell?
Explore the source record for details and available documents.