Solitary cerebral metastases from ovarian epithelial carcinoma: 11 cases

Ovarian cancer is quite common in women, but brain metastases from ovarian cancer are considered rare. Eleven patients with solitary cerebral metastasis from ovarian epithelial carcinoma were treated at the Neurosurgical Department of University of Rome La Sapienza, between 1980 and 2000. We treated all of the 11 patients by surgical en bloc removal and by postoperative radiotherapy and chemotherapy. Mean survival was 28 months, and the cause of death was recurrence of the systemic disease in all cases. Multimodal treatment by surgery, radiation and chemotherapy is the best choice of treatment and leads to a median survival of about 20 months.     

Adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma of minor salivary glands: a comparative immunohistochemical study using the epithelial membrane and carcinoembryonic antibodies

OBJECTIVE: The purpose of this study was to investigate immunohistochemically the expression of epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) in adenoid cystic carcinoma (AdCC) and polymorphous low-grade adenocarcinoma (PLGA) in an attempt to assess the ability of these markers to distinguish AdCC from PLGA when the histological features on routine hematoxylin and eosin are equivocal. MATERIALS AND METHODS: Fourteen specimens of AdCC, 10 PLGA, and five normal minor salivary glands fixed in 10% formalin and embedded in paraffin, were retrieved from the files of our department and were retrospectively studied with the streptavidin-biotin complex method using the epithelial membrane and carcinoembryonic antibodies. RESULTS: The immunoreactivities and the expression patterns of EMA and CEA in AdCC and PLGA were similar. CONCLUSIONS: The results of this study suggest that the immunostaining of AdCC and PLGA with EMA and CEA could not offer an adjunctive aid in differential diagnosis between these two tumors.     

Solitary plasmacytoma

A Retrospective Review Is Presented Of Nine Patients Presenting With Solitary Plasmacytoma. Between 1963 And 1980, These Patients Were Treated With Radiation At The Department Of Radiation Oncology, University Of Louisville. Criteria For Admission To This Particular Study Include (1) A Solitary Focus Of Plasmacytoma Proven By Biopsy, (2) Normal Bone Marrow Findings (Less Than 10% Plasma Cells), And (3) No Evidence Of Disseminated Disease. In Six Patients The Primary Site Was Osseous, And In Three Extramedullary, Two Of Which Were Located In The Nasopharynx And Nasal Cavity And The Third In The Stomach. All Of The Extramedullary Plasmacytomas Are Disease Free For Periods Ranging From 4 To 10 Years. Of The Six Patients With Osseous Lesions, Two Developed Multiple Myeloma In 2 And 3 Years, Two Are Ned (No Evidence Of Disorder) After 9 Years, One Died Of Intercurrent Disease, And The Remaining Patient Was Ned For 2 Years, After Which He Was Lost To Follow-Up. These Results Suggest The More Favorable Prognosis Of Extramedullary Plasmacytoma And Support The Theory That The Solitary Plasmacytoma Of Bone And Extramedullary Plasmacytoma Are Distinct Disease Entities.     

Surface ultrastructure of human endometrium. Effect of hormonal status and neoplastic progression

The structure, size and number of uterine endometrial surface epithelial cells and specialized structures, cilia and microvilli were analyzed by light microscopy, transmission and scanning electron microscopy. The purpose was to further our understanding of the biological, morphological and prognostical implications of change in hormonal status and neoplastic progression. The results of this study showed that the quantitative and qualitative alterations followed a similar pattern: the cilia and microvilli were minimally developed in atrophic endometrium, and gradually progressed in size and number in relation to the hormonal cycle and hyperplastic endometrium, unless associated with cellular atypia. Lesions with atypical adenomatous hyperplasia showed irregular and disorganized surface structure, progressively more apparent in specimens from adenocarcinomas. Decreasing degree of differentiation of the tumor and radiation treatment caused a reduction in number and size, as well as derangement in the structure of cilia and microvilli. The results showed the sensitivity of the uterine lining to hormonal changes, the distinction between different types of endometrial hyperplasia and the close interrelationship between atypical adenomatous hyperplasia and early adenocarcinoma, as well as the extent and severity of different clinical entities, including radiation treatment.     

Alpha-fetoprotein, prealbumin, albumin, alpha-1-antitrypsin and transferrin as diagnostic and therapeutic markers for endodermal sinus tumors.

According to Gitlin, alpha-fetoprotein (AFP), albumin, prealbumin, alpha-1-antitrypsin and transferrin are normal products of the human yolk sac. They are expected to reappear in human endodermal sinus tumor (yolk sac tumor). The synthesis of alpha-fetoprotein and other serum proteins by human endodermal sinus tumor was studied in the culture cells and in the tumor tissue transplanted into nude mice. The results gave evidences of synthesis of some of these proteins including alpha-fetoprotein and alpha-1-antitrypsin. Serum concentrations of these proteins were studied in eight children having endodermal sinus tumors. Serum AFP levels were abnormally high in all cases, whereas concentrations of other serum proteins were almost within normal ranges. This might be simply reflected by the fact that pre-albumin, albumin, alpha-1-antitrypsin, and transferrin are already present in large quantities in sera of normal subjects while alpha-fetoprotein is present only in a negligible quantity. Alpha-fetoprotein, as a diagnostic and therapeutic marker of endodermal sinus tumor, showed good correlation to the tumor growth. Serum AFP concentrations declined almost to 0 ng/ml with a half-life of 4 days when surgical removal was complete, whereas serum AFP decreased only to 100-200 ng/ml with radiation and chemotherapy alone.     

Evaluation of giant cell tumor by computerized tomography

The use and value of computerized tomography in giant cell tumor is demonstrated. The usefulness of computerized tomography, in the evaluation of giant cell tumor, rests upon its ability to demonstrate the presence and extent of its soft tissue component, as well as its intraosseous extent, more accurately than conventional methods. Computerized tomography is a non-invasive procedure, and in the postoperative state can demonstrate more accurately the presence and extent of residual or recurrent disease.     

CT of the paranasal sinuses

Summary CT scanning has allowed the radiologist to image paranasal sinus disease with an accuracy and detail never before attainable. This information has made the imager an important member of the physician team that evaluates the operability and treatment planning of these patients. The protocol of the CT examination is discussed, the normal CT anatomy is reviewed and an approach to evaluating both inflammatory and malignant disease is presented.