四肢周围神经鞘瘤40例临床回顾

目的：分析40例周围神经鞘瘤的临床特点，诊断和手术要点。方法：40例神经鞘瘤，其中臂丛神经5例，上肢神经21例，下肢神经14例，单发者38例，多发者2例（同一肢体2个肿瘤），8例肿块位于颈部及上臂近端者术前作MRI检查，证实5例的肿瘤起源于臂丛神经，2例为颈部肿瘤，1例为肺尖部肿瘤。33例行肿瘤完整切除；1例C8神经根肿瘤因邻近胸膜顶及锁骨下动静脉，很难分离，故只能行肿瘤包膜内切除，6例曾在其它医院误将肿瘤与神经干一同切除，行神经修复术。结果：33例术后神经功能正常，随访6个月，－28年未见复发。1例包膜内切除者术后出现手内肌功能部队障碍，出院时已有大部分恢复，仍在随访中，结论：神经鞘瘤能够完整切除者疗效满意。对起源于神经根的肿瘤可行包膜内切除。     

Renal abscesses: Classification and review of 40 cases

Renal abscesses are misdiagnosed often and, consequently, mistreated or treated too late. Forty cases of renal abscesses divided into anatomic categories — perinephric, renal cortical, and corticomedullary — are reviewed. Various conditions seem to predispose to renal abscesses: urinary tract infections, vesicoureteral reflux, calculi, or other medical problems. This retrospective study discloses that a high correlation exists between organisms found in the patients' urine cultures and those organisms cultured from all 3 categories of abscesses. Accurate and complete urine bacteriologic study is therefore an essential tool for diagnosis.     

Agenesis of the gallbladder--a case report.

Agenesis of the gallbladder, which is an extremely rare anomaly, may present with biliary symptoms but is virtually impossible to diagnose by such conventional investigations as oral cholecystogram or ultrasonography. We report herein a case of a young man presenting with episodic epigastric pain on whom an ultrasonographic diagnosis of gallstones was made. A gallbladder was not visualized on oral cholecystogram, however, he was subsequently found to have agenesis of the gallbladder, the diagnosis of which was confirmed by intra-operative cholangiography and a postoperative N-2,6-dimethylphenylcarbamoyle methyl iminodiacetic acid scan (HIDA scan). His symptoms responded to antiulcer treatment with upper gastrointestinal endoscopic findings suggestive of oesophagitis and duodenitis.     

Carcinoma of the penis: a review of 42 cases.

A retrospective survey was made of 42 cases of carcinoma of the penis presenting over 14 years. Cases for attempted cure of the primary lesion were treated by either radiotherapy or surgery. It is recommended that radiotherapy should be the primary treatment as it is non-mutilative, allows secondary surgical salvage where necessary and has no greater occurrence of post-treatment lymph node metastases than surgery.     

Neurinomas of the cauda equina clinical analysis of 40 surgical cases

Summary We report a retrospective study conducted on 40 patients with neurinoma of the cauda equina, assessing the clinical features and treatment. Neurinomas are clinically indistinguishable from other tumours localized in the same region. It is possible, but not simple, to differentiate neurinoma of the cauda equina from more common lumbar disc herniations. In the early stage, neurinomas provoke sciatic pain that is unilateral and monoradicular, worsened in decubitus and hard to define, whereas in the later stage pain becomes bilateral, polyradicular and is mostly accompanied by motor and sensory disturbances. Moreover, Lasegue's sign was often absent. Therapeutically, total removal of the tumour seems to be the most appropriate form of treatment given that even the sacrifice of a root does not worsen any pre-existing neurological deficit.     

Carcinoma of the papilla of Vater. A review of fifty-seven cases

Fifty-seven cases of carcinoma of the papilla of Vater are reviewed. Clinical and pathologic features as well as results of various surgical treatments are summarized. The Whipple operation may be the operation of choice for cancer of the papilla of Vater, offering a chance for cure and obviating further surgery.     

Carcinoma of the male breast: A review of 200 cases.

Two hundred cases of male breast carcinoma were treated at the Christie Hospital, Manchester, between 1942 and 1971. The survival rate of the group following curative treatment is presented; the response to palliative treatment is also discussed. The survival rate was particularly good for stage I cases, with 79 per cent surviving for 5 years and 56-3 per cent surviving for 10 years. However, the later stages did less well, particularly when compared with female patients of the same age and stage. With such a rare disease it would be of help to centralize the treatment of these patients as much as possible.     

Carcinoma of penis: report of 59 cases and review of literature

PURPOSE: To analyze the characteristics and prognostic factor of penile cancer, we retrospectively reviewed the clinicopathological data of patients with a diagnosis of penile cancer treated. PATIENTS AND METHODS: The records of 59 patients (median age 66, ranged from 47 to 91) with squamous cell carcinoma of the penis reffered between April 1988 and January 2006 were reviewed. The importance of tumor size and stage, differentiation, type of infiltration, vascular invasion, patient age, lymph node metastasis, distant metastasis and type of therapy were assessed using univariate and multivariate analyses. RESULTS: After a mean follow up of 37.7 months, 13 cases (22.0%) died of cancer and 5-year survival was 67.4%. Multivariate analysis demonstrated that, type of operation (p = 0.0471, Hazard ratio 3.364), vascular invasion (p = 0.0014, Hazard ratio 5.921) were associated with survival. CONCLUSION: Vascular invasion and type of operation were related to survival. Our findings indicate that correct pathological diagnosis and appropriate treatment may lead to prolonged survival.