[Clear cell adenocarcinoma of the cervix uteri and vagina in young women in Norway].
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Adenocarcinoma↗
Biomedical subjects
V Abeler
Publications and source records attributed to V Abeler.
[Intestinal spirochaetosis].
It is well known that spirochetes may be found in the digestive tract of various species, including humans. We describe a homosexual man with long-standing diarrhoea, probably caused by intestinal spirochaetosis. The diagnosis was based upon light microscopic demonstration of a thin haematoxyphilic bandlike layer covering the intestinal surface epithelium, which is an established diagnostic characteristic of intestinal spirochaetosis. The spirochaetosis was further confirmed by electron microscopy. The pathogenetic significance of spirochetes in human intestinal disease is not fully understood. However, intestinal spirochaetosis should be suspected in patients with long-standing diarrhoea. Symptomatic spirochaetosis in the gut responds well to treatment with metronidazole. The spirochetes of the human digestive tract constitute a newly defined genus of the family Treponemataceae.
Adult↗
Alveolar soft-part sarcoma in the uterine cervix.
We describe a case of an alveolar soft-part sarcoma of the cervix in a 35-year-old woman. The light- and electron-microscopic and immunohistochemical findings are described. Periodic acid-Schiff-positive, diastase resistant, intracytoplasmic crystals, pathognomonic for alveolar soft-part sarcoma, were present. The cells expressed immunoreactivity for neuron-specific enolase and protein S100. The results of our own immunohistochemical examinations and those presented in the literature are discussed.
Adult↗
Primary adenocarcinoma localized to the fallopian tubes: report on 33 cases.
Thirty-three cases of primary adenocarcinoma localized to the fallopian tubes were analyzed according to prognostic factors such as depth of infiltration, tumor differentiation, and lymph vessel invasion. Fifteen patients (45, 5%) died of recurrence within 5 years. Only for positive vessel invasion was the survival significance worse. Combination chemotherapy seems promising compared to radiotherapy in these early stages.
Adenocarcinoma↗
Observer variation in histologic classification of malignant and borderline ovarian tumors.
Eight hundred sixty-nine primary malignant or borderline ovarian tumors reported to the Norwegian Cancer Registry were reviewed. The histologic slides were randomly distributed to six observers and classified according to the World Health Organization classification of ovarian tumors. By rotation of slides, each tumor was successively reviewed by three observers. Each observer was given approximately 40 duplicates of slides he or she had typed before, mixed in with the slides for the third review. A contracted version of the classification with 27 entries was used in the analysis. Mean intraobserver reproducibility was 62% (kappa, 0.53), varying from 50% to 75% (kappa, 0.34 to 0.70) for the individual observers. The mean rate of agreement between two observers was 56% (kappa, 0.46), varying from 46% to 65% for the individual pairs of observers. The rate of full agreement among three observers was 41%. The most common disagreements were between different specific types of carcinoma, between undifferentiated and differentiated carcinoma, between borderline and malignant tumors, between unclassified and classified carcinoma, and between mixed and pure types of carcinoma. Very low reproducibility was obtained for mixed and unclassified carcinoma.
Carcinoma↗
Small cell carcinoma of the ovary. A report of six cases.
Six cases of small cell carcinoma of the ovary are presented. The tumors occurred in women with an average age of 27.5 years. According to the International Federation of Gynecology and Obstetrics (FIGO), two patients had Stage I, three Stage II, and one Stage III disease. The tumors behaved highly malignantly, as four of the patients died from disseminated disease within 20 months. Three of the tumors were found to be associated with elevated serum calcium levels. By light microscopy three of the tumors were originally misinterpreted: one as an undifferentiated tumor, probably of stromal origin; one as a germ cell tumor, probably endodermal sinus tumor; and the third as a granulosa cell tumor. In four tumors examined by electron microscopy, the epithelial nature was confirmed, and three of them contained neuroendocrine granules. Immunocytochemical examination in five cases revealed positive staining for neuron-specific enolase (NSE) and negative staining for beta 2-microglobulin, whereas one case was negative for NSE and positive for beta 2-microglobulin. A positive immunoreaction for parathyroid hormone was observed in three cases (all NSE positive). In two of these a raised serum calcium level was documented. This finding possibly gives a clue to the hypercalcemia so frequently found in these patients.
Adolescent↗
Sarcoid reaction of hilar and paratracheal lymph nodes in patients treated for testicular cancer.
Bilateral hilar lymph node enlargement developed in four patients 1 to 8 years after successful radiotherapy for testicular cancer Stage I was performed. Two had additional paratracheal involvement. Biopsy showed sarcoid reaction in all four cases. An increased frequency of sarcoid reaction is assumed in patients treated for testicular cancer. The pathogenesis remains unknown. The clinical and radiologic findings should not be misinterpreted as showing recurrent malignant disease. In an otherwise disease-free patient in whom mediastinal lymph node enlargement develops, a biopsy should always be performed.
Adult↗
Prevalence of antibodies to herpes simplex virus and frequency of HLA antigens in patients with preinvasive and invasive cervical cancer.
Previous herpes simplex virus type 2 (HSV-2) infections are known to predispose women for the development of cervical cancer, but causal relationship between the virus and the cancer has never been proven. Forty-six patients with cervical carcinoma (13 with preinvasive lesions and 33 with various stages of invasive disease) were selected for the present study. Among the patients 96% were seropositive for the presence of antibodies to herpes simplex virus compared to 87% of the 30 controls. Antibodies specific for HSV-2 were found in the sera from 24% of the patients and 17% of the controls by the use of an immunoblotting test. Patients and controls were typed for HLA-A,B,C and D/DR antigens, but no significant associations were found.
Adult↗
Clinical (stage III) as compared to subclinical intrapelvic extrauterine tumor spread in endometrial carcinoma: a clinical and histopathological study of 175 patients.
One hundred and seventy-five patients with endometrial cancer, seen in the Norwegian Radium Hospital from 1960 to 1977, had tumor extension outside the uterus but not outside the true pelvis. One hundred and eight of these patients had clinical stage III disease and in 67 patients, originally classified as stage I or stage II, the intrapelvic extrauterine tumor spread was first detected at surgery or at histopathological examination of the operation specimen. The 40% 5-year-actuarial survival of the latter group differed significantly from the 16% found in clinical stage III (P less than 0.001). This must be largely contributed to the fact that radical surgery could only be performed in 13% of the clinical stage III group as compared to 70% in the group of patients with subclinical extrauterine disease. Surgical eradication of all macroscopic tumor was of major prognostic importance for patients with clinical stage III, resulting in an actuarial 5-year survival of 41%, nearly identical to 42% for the group of patients with subclinical extrauterine tumor extension. Adjuvant progestagen therapy seemed to be of some benefit, but the need, however, for a more effective systemic treatment, possibly using cytotoxic drugs, is evident.
Adenocarcinoma↗
Stage IV endometrial carcinoma: a clinical and histopathological study of 83 patients.
From 1960 to 1977, eighty-three patients with stage IV endometrial carcinoma were treated in the Norwegian Radium Hospital. The lung was the main site of extrapelvic tumor extension (36%), followed by "multiple sites" (23%), lymph nodes (inguinal, supraclavicular, axillar; 13%), and bladder (13%). The actuarial 5-year-survival rate was 10%. Complete clinical remission was achieved in 5 patients with lung metastases, in 2 with inguinal lymph node metastases, and in 1 patient with ascites with positive cytology. Control of pelvic disease could be achieved in 20 of 72 patients (28%) by radiotherapy alone or combined with surgery and/or progestagens. Progestational agents proved to be of benefit especially for patients with lung metastases. A complete remission of all visible lesions was observed in 8 out of 26 patients (31%). Patients with well- and moderately differentiated primary adenocarcinoma had a response rate of 83% as opposed to 14% for patients with poorly differentiated adenocarcinomas and adenosquamos carcinomas. Extrapelvic tumor localizations, suitable for radiotherapy, were supraclavicular and axillary lymph nodes and bone metastases.
Castration↗
Recurrent adenocarcinoma of the endometrium: a clinical and histopathological study of 379 patients.
Three hundred and seventy-nine patients with recurrent endometrial cancer were seen in the Norwegian Radium Hospital from 1960 to 1976. Local recurrence was found in 190 patients (50%), distant metastases in 108 patients (28%), and in 81 patients (21%) local recurrence and distant metastases were found simultaneously. Thirty-two percent of all patients had no symptoms at the time of diagnosis of the recurrence. The median time interval between primary treatment and detection of recurrence was 14 months for patients with local recurrence and 19 months for those with distant metastases. Thirty-four percent of all recurrences was detected within 1 year and 76% within three years of primary treatment. In 10% recurrence was diagnosed more than 5 years after primary treatment. Twenty-two of the 190 patients (12%) with local recurrence, 5 of the 108 patients (5%) with distant metastases, and 2 of the 81 patients (2%) with local recurrence together with distant metastases survived and were without evidence of disease at the end of the observation period (3-19 years). Radiotherapy alone or in combination with surgery was given in 24 of the 29 "cured" patients; 16 of them received progestagens in addition. Three of the survivors were treated with progestagens alone. The median survival time for patients with lung metastases only, who were treated with progestagens, was considerably longer when compared to those without treatment (9 vs 2 months). The need for nonhormonal cytotoxic chemotherapy in the treatment of recurrent endometrial carcinoma is stressed.
Adenocarcinoma↗
Multi-modality treatment of advanced malignant germ cell tumours in males. I. Experience with cis-platinum-based combination chemotherapy.
Three-weekly cis-platinum-based combination chemotherapy with or without subsequent surgery and/or radiotherapy resulted in a 58% 3-year-survival in 79 patients with advanced malignant germ cell tumours. Poor risk factors were relapse after previous chemotherapy, retroperitoneal bulky disease, liver metastases and extremely high serum levels of AFP, beta-HCG, and LDH. Patients with pure seminoma had a high curation rate. The overall toxicity was acceptable. Cis-platinum-based chemotherapy is at present the most effective cytotoxic treatment for patients with advanced malignant germ cell tumours. The relatively low survival rate in poor-risk patients necessitates more aggressive primary chemotherapy in this subgroup of patients.
Antineoplastic Combined Chemotherapy Protocols↗
Multi-modality treatment in males with advanced malignant germ cell tumours. II. Experience with surgery and radiotherapy following cis-platinum-based chemotherapy.
After chemotherapy with cis-platinum, vinblastine and bleomycin, 33 surgical procedures were performed in 29 patients with advanced malignant germ-cell tumours. The tumour masses could be completely resected macroscopically in 26 patients. Histology of the operation specimens showed fibrosis/necrosis (9 specimens), mature teratome (13 specimens) and vital malignant tumour (11 specimens). Patients with fibrosis/necrosis or completely resected mature teratoma had an excellent prognosis, whereas only 5 of the 11 patients with vital malignant tumour survived in spite of second-line treatment with chemotherapy/radiotherapy. Preoperatively elevated serum levels of AFP, beta-HCG and/or LDH indicated the presence of residual vital malignant germ cell tumour. Eight of 14 patients were rendered tumour-free by radiotherapy given as second- or third-line treatment. In general, tumour masses, remaining after cis-platinum-based induction chemotherapy should be resected as completely as possible even in the case of mature teratoma or fibrosis/necrosis. Radiotherapy should be considered as second- and third-line treatment in selected patients.
Antineoplastic Combined Chemotherapy Protocols↗
Granulocytic sarcoma (chloroma) of the uterine cervix: report of two cases.
Two cases of granulocytic sarcoma in the cervix are described, adding to the six previously reported cases. Both our cases were primarily misdiagnosed as other types of small-cell malignant tumors. Misdiagnosis often occurs in granulocytic sarcomas, especially for those in extraskeletal sites or when the tumor precedes development of frank leukemia. A conclusive diagnosis of granulocytic sarcoma depends upon the demonstration of granulocytic differentiation of the tumor cells. For this purpose, special staining methods like the Leder stain and the antilysozyme immunoperoxidase stain are particularly useful.
Adult↗
Endometrial carcinoma with cervical involvement (stage II): prognostic factors and value of combined radiological-surgical treatment.
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Brachytherapy↗
Squamous cell carcinoma in situ of the vulva. A clinical and histopathological study.
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Adult↗
Individualized treatment of stage I carcinoma of the vulva.
A series of 117 patients with stage I squamous cell carcinoma of the vulva was followed for 3 to 21 years. Twenty recurrences (17.1%) were found, 12 in the vulva or vagina, 7 in the groin, and 1 in a patient who developed distant metastases. Invasion of tumor cells in lymph or blood vessels was found in operative specimens from 19 patients (16.2%), 8 of whom (42.1%) developed local recurrences of metastases. Of 76 patients who underwent lymphadenectomy, 7 had ipsilateral and 1 had bilateral metastases to the inguinal lymph nodes. Five-year crude survival rate for the whole series was 79%, but only 52% for the group of patients with vessel invasion. Treatment should in most cases be hemivulvectomy with ipsilateral inguinal lymphadenectomy.
Female↗
Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients.
From 1968 to 1974, 540 patients with stage I adenocarcinoma of the corpus uteri entered a prospective clinical trial to evaluate the effect of postoperative external pelvic irradiation. After primary surgery all patients received intravaginal radium irradiation; 6000 rads was delivered to the surface of the vaginal mucosa. At the time vaginal radium was given, randomization was performed: Group A received no further treatment (controls); group B received additional high-voltage irradiation to the pelvic field with a dose of 4000 rads to the pelvic lymph nodes. During the follow-up period of 3 to 10 years a significant reduction in vaginal and pelvic recurrences was found in group B as compared with group A (1.9 versus 6.9%, P < .01). On the other hand, more patients in group B developed distant metastases than those in group A (9.9 versus 5.4%). Thus, the 5-year survival rate was not improved by external irradiation. A more detailed analysis of the series led to the conclusion that only patients with poorly differentiated tumors (grade 3), which infiltrate more than half the myometrial thickness, might benefit from additional external radiotherapy. In almost 20% of 151 consecutive patients, tumor cells were found in endothelial lined spaces. Significantly more deaths and recurrences were found among these patients compared to those without vessel invasion (26.7 versus 9.1%, P < .01).
Adenocarcinoma↗