Adult sacrococcygeal teratomas.

We report a rare case of a benign adult sacrococcygeal teratoma discovered during pregnancy. The cystic mass was confirmed on CT scan and magnetic resonance imaging. In the fifth postpartum month, three cysts (1, 2.5, and 6 cm) were excised. Pathologically, the specimens contained differentiated tissue from all three germ layers, including endocrine tissue within the ectopic exocrine pancreas.

Primary leiomyosarcoma of the greater omentum: case report and review of the literature.

Omental leiomyosarcomas are rare intra-abdominal tumors. This report describes a case of primary leiomyosarcoma of the greater omentum discovered on abdominal CT scan. The mass was removed via laparotomy and an omentectomy performed. At 2 years postoperatively there is no sign of tumor recurrence or metastasis.

Melanoma within a southwestern Hispanic population.

The New Mexico Melanoma Registry and New Mexico Tumor Registry identified 81 cases of melanoma involving the skin and mucous membranes of Hispanics. The clinical and pathologic characteristics of these tumors were compared with those observed in whites. The frequency of melanoma in Hispanics appears to be no more than a sixth of that observed in whites. Female patients were more prevalent within the Hispanic population. The median patient age at diagnosis was similar in Hispanics and whites. A much larger proportion of melanomas in Hispanics occurred on the palms, soles, and in subungual regions. Acral lentiginous melanomas were correspondingly more frequent among Hispanics, as was mucous membrane melanoma. Melanomas arising from the palms, soles, subungual regions, and mucous membranes tended to be advanced in stage, to occur in older individuals, and to metastasize. These cases explain the generally poorer prognosis for Hispanic patients compared with whites. The epidemiology of melanoma relevant to these findings is discussed.

Renal cortical necrosis and Purtscher's retinopathy in hemorrhagic pancreatitis.

A patient presented with acute hemorrhagic pancreatitis complicated by both renal cortical necrosis and Purtscher's retinopathy. Either of these two complications is rare and never before have both been reported in the same patient. The patient's renal insufficiency required hemodialysis; it gradually improved over two years when dialysis could be discontinued. The patient's retinopathy included bilateral hemorrhages and cotton wool spots; visual fields and acuity remained normal. Funduscopic lesions disappeared by three months after the acute event. These two rare vasculo-occlusive complications of pancreatitis simultaneously occurring in one individual might suggest complement-mediated leukostatic mechanisms.

Scuba diving deaths: a review and approach for the pathologist.

A series of 34 cases of SCUBA-related fatalities in military personnel from the files of the Armed Forces Institute of Pathology has been presented. It may be concluded that the potential problems that can occur in the hyperbaric aquatic milieu while using scuba are not completely appreciated by pathologists. The resulting investigations of such fatalities give little hard data relevant to such entities as true incidence of barotraumatic injuries, aseptic bone necrosis, and contaminated air supply, the interrelationship of human, environmental, and life support system factors in such fatalities, and the pathophysiologic sequences leading to drowning or death due to causes other than drowning. Hyperbaric pathophysiology is reviewed with the hope that more reasonable interpretations of cause and mechanisms of death will be possible, and the entities air embolism and decompression sickness are differentiated in a similar light. The importance of the type of SCUBA is discussed, through analysis of ten operational diving fatalities, and the possibility of anoxia, hyperoxic convulsions, and hypercapnia existing with the use of rebreather SCUBA is emphasized. A general approach to the medical investigation of a SCUBA fatality is given, under broad headings including on-the-scene investigation, clothing and equipment examination, external and internal examinations, and toxicologic examination.