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M J Casey

Publications and source records attributed to M J Casey.

At least 37 records · Page 2Linked to original sources

Malignant melanoma of the vagina--report of 19 cases.

Sixteen previously unreported cases of primary vaginal melanoma were studied, 8 from the Memorial Sloan-Kettering Cancer Center (1935 to 1976) and 8 from the Connecticut Tumor Registry (1934 to 1976). In addition, 3 previously reported cases from the former institution are updated. Local control was obtained by means of primary radical surgery in 5 of 7 patients, 3 of whom are known to have subsequently died of disseminated disease. One patient initially treated with radical surgery had a local recurrence with metastasis to a regional node, but has now survived for more than 14 years following a second radical surgical procedure. Eight patients were treated primarily with radiotherapy, and 6 have died with metastatic melanoma; another died following pelvic exenteration for persistent local disease. Only 1 patient showed evidence of transient control after radiotherapy, but this patient had a local recurrence 36 months later and died with metastases. The overall 5-year survival rate for these 19 patients was 21%.

Adult↗

Ipsilateral concomitant fractures of the hip and femoral shaft.

Fifty-two cases of concomitant ipsilateral fractures of the hip and femoral shaft were reviewed from the literature and twenty-one of our own were added. Thirty-one per cent of the femoral-neck fractures reported in the literature and one of our own were missed on initial evaluation. Examples of non-union and aseptic necrosis were all from the previously reported cases and occurred in the patients in whom there was a delay in diagnosis and treatment of the fracture of the neck. Nine of our patients had associated ipsilateral knee injuries. In nine pulmonary complications developed, all while in skeletal traction. If the patient survived the initial injury, the prognosis was surprisingly good. We concluded that intracapsular hip fractures should be treated by internal fixation. Good long-term results were the rule in the diaphyseal fractures. Internal fixation of both fractures should be considered in patients with severe multisystem trauma, in the very elderly, and in those with ipsilateral knee injuries. Ender pins were useful and were employed in five of our patients.

Adolescent↗

Müllerian adenosarcoma of the uterus. Ultrastructure before and after radiation therapy.

A case of müllerian adenosarcoma arising in the endometrium was studied by light and electron microscopy before and after radiation treatment. The tumor was composed of malignant stroma containing undifferentiated mesenchymal cells admixed with mature fibroblasts and other cell that contained crystalloids. The surface epithelium was lined by epithelial cells with and without cilia, similar to the normal surface epithelium cells of the uterus. High-dose therapeutic irradiation eliminated the undifferentiated mesenchymal cells from the tumor but did not alter the morphology of other epithelial and mesenchymal elements. The immaturity of mesenchymal cells and their radiosensitivity coupled with the ultrasonographic evidence of growth of the tumor point to the probable malignant nature of this neoplasm.

Adult↗

Endometrial screening of asymptomatic women by irrigation technique in the private gynecology office.

A study was made of 201 asymptomatic women over age 40 (range, 40-74 years) who underwent uterine sounding and endometrial screening by the negative-pressure jet irrigation technique, without anesthesia, in private gynecologists' offices. Introduction of the irrigator was accomplished in 88 percent of these patients. In 97 percent of the successful irrigations, the specimens obtained were satisfactory for cytologic and histologic diagnosis of neoplasia. No occult endometrial carcinomas were discovered. The factors which interfered with endometrial screening by these methods are analyzed. Cervical stenosis prevented endometrial irrigation in 13 of the 24 unsuccessful attempts. Acceptance by the patients was high, in that 74.2 percent reported slight or no discomfort and only 4.7 percent complained of severe discomfort. Although 12.5 percent experienced pelvic cramping after irrigation, no other significant side effects were observed. The results of this investigation indicate the feasibility of using the endometrial irrigation technique for massive screening studies of asymptomatic women who are at risk for the development of endometrial carcinoma.

Adult↗