ABSTRACT
A 62-year-old man developed a malignant melanoma in his left eye that had been blind due to trauma for 35 years. This case illustrates the difficulties in detection and early diagnosis of occult malignant melanoma of the uveal tract in phthistic globes. The necessity for long-term follow-up of posttraumatic eyes is stressed.
Subject(s)
Blindness/complications , Choroid Neoplasms/complications , Eye Injuries/complications , Melanoma/complications , Uveal Neoplasms/complications , Choroid Neoplasms/pathology , Choroid Neoplasms/therapy , Humans , Male , Melanoma/pathology , Melanoma/therapy , Middle Aged , Neoplasm Invasiveness , Prognosis , Uveal Neoplasms/pathology , Uveal Neoplasms/therapyABSTRACT
A logical, systematic approach to the interpretation of diagnostic biochemical profiles in patients with hypercalcemia has been attempted through the use of algorithms (decision trees). A tentative algorithm (ALG-I) and an expanded and modified version (ALG-II) were compared for effectiveness in tests of 80 patients with hypercalcemia at Charity Hospital in New Orleans. The overwhelming majority (69%) of these patients had malignant disease. Comparative performance indicated that the modified algorithm (ALG-II) assigned the correct diagnostic categories in 66% of cases, compared with 53% for ALG-I, but the clinical performance of ALG-I improved (agreement rate of 60%) when it was assumed that patients with malignancy could have coexisting hyperparathyroidism or pseudohyperparathyroidism. The clinical trial indicated that both algorithms were fairly comparable and that their primary use would be as teaching aids for medical students and residents to suggest various diagnostic possibilities for hypercalcemia in patients.
Subject(s)
Hypercalcemia/diagnosis , Mathematics , Adolescent , Adult , Aged , Calcium/blood , Child , Female , Humans , Hypercalcemia/etiology , Hyperparathyroidism/complications , Lung Neoplasms/complications , Male , Middle Aged , Tuberculosis, Pulmonary/complications , Uterine Cervical Neoplasms/complicationsABSTRACT
Two cases of squamous cell carcinoma with sarcomatoid stroma are presented. One tumor was located in the soft palate that metastasized to a neck lymph node; the epithelial and the spindle cell component of the tumor at the primary as well as at the metastatic site showed ultrastructural features of squamous cell carcinoma. The other case, a laryngeal tumor with spindle cell stroma, was shown by ultrastructural studies to be composed of proliferating fibroblasts. The diagnostic problems and the controversies regarding classification and behavior of these rare tumors of upper respiratory tract and upper gastrointestinal tract are discussed.
