ABSTRACT
The case of bilateral ovarian fibromas occurring in an 8-year-old black girl is reported. These lesions occur rarely in premenarchal females and may be a manifestation of Nevoid Basal Cell Syndrome. Calcifications are reported to occur rarely in ovarian fibromas but seem to occur frequently in fibromas in children. Management is guided by the benignity of the lesion and consists of surgical excision of the fibroma. Preservation of normal ovarian tissue is recommended with the acknowledged risk of recurrence of the fibroma.
Subject(s)
Fibroma/diagnosis , Neoplasms, Multiple Primary/diagnosis , Ovarian Neoplasms/diagnosis , Child , Female , Fibroma/surgery , Humans , Neoplasms, Multiple Primary/surgery , Ovarian Neoplasms/surgeryABSTRACT
From 1972 through 1987, 40 patients at the Medical College of Georgia were assessed with a diagnosis of mixed müllerian tumors which constituted 3.5% of all female genital tract malignancies. The mean patient age was 65.3 years; 60% of the patients had stage I disease. Of those patients with clinical stage I disease, more advanced disease was found at celiotomy in 33%. Retroperitoneal nodes were positive for malignancy in 35% of 20 patients who underwent node sampling. Cell washings were positive in 12%, and 9% had omental metastases. Forty-seven percent had homologous tumors; 53% of tumors were heterologous. Relatively poor prognosis was associated with large tumor volume, vascular invasion, nodal metastases, and disease outside the uterus. The overall survival rate was 32%; 14 of 24 patients with stage I disease are dead of disease. Of patients dead of disease, 92.5% had distant metastases. Adjuvant therapy with a combination of VP-16, cisplatin, and irradiation was beneficial in four high-risk patients.
Subject(s)
Neoplasms, Germ Cell and Embryonal/pathology , Uterine Neoplasms/pathology , Aged , Aged, 80 and over , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Lymphatic Metastasis , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Neoplasm Staging , Neoplasms, Multiple Primary/epidemiology , Parity , Retrospective Studies , Uterine Hemorrhage/etiology , Uterine Neoplasms/mortality , Uterine Neoplasms/therapyABSTRACT
Exsanguination in a case of esophageal carcinoma resulted from an aortoesophageal fistula. The squamous carcinoma was undiagnosed clinically and was untreated. Ulceration of the carcinoma gave rise to mediastinitis and an abscess containing necrotic tumor and bacteria. Infection spread from the abscess to the adjacent aorta, producing focal bacterial aortitis, necrosis of the aortic media, and aortic perforation. A fistula was thus established between the aorta, the abscess cavity, and the esophagus. Terminally, the patient had a large hematemesis, and massive hemorrhage acutely distended the stomach which ruptured to produce a large hemoperitoneum.
