Germ cell tumors in Indian children.

The present paper is a retrospective study of one hundred and thirty five germ cell tumors seen in children at the University Hospital, Varanasi during a period of 21 years. These tumors constituted 7.5% of all solid tumors in the pediatric age group. Histologically 89 tumors (65.9%) were benign and 46 (34.1%) were malignant. Eighty percent of ovarian and all the testicular germ cell tumors were malignant. Thirty per cent of the tumors were located in the sacrococcyx. The ovaries were the next common site. There were 80 girls, 53 boys, and 2 cases in which the sex was not recorded. The predominance amongst girls was mainly due to the more frequent involvement of ovaries as compared to the testes. Twenty nine of the children were in the first year of life. The factors probably responsible for the higher incidence of malignancy, the differences in anatomic location, and the sex distribution in comparison to other reports have been examined and discussed.

Adenocysitc carcinoma of the uterine cervix: a clinicopathologic study.

Eight cases of adenocystic carcinoma of the uterine cervix, a rare histologic variant, are presented, with a brief review of 41 cases previously reported in the literature. They represent only 0.27% of 3254 cervical carcinomas that we encountered between 1962 and 1977. In all eight cases, there was early parametrial involvement, and the majority behaved aggressively. All eight patients were multiparas, and six of them were postmenopausal. Interestingly, including this series, 15 of 49 reported cases of this entity have been from India.

In-situ carcinoma of the uterine cervix showing superficial endometrial spread.

Superficial spread of invasive carcinoma cervix over the endometrial surface is extremely rare and may follow radiation therapy (3, 5). Ferenczy et al. (1) have reported an instance of carcinoma in situ of ecto cervix spreading on the endometrial surface via the endo-cervical canal. This paper reports another in situ lesion of the cervix showing superficial endometrial spread.

Host response and tumour biological behaviour in the two histological types of gastric carcinoma.

It appears that there is validity in categorizing gastric carcinoma into two histologic types, intestinal and diffuse. The local host tissue response in 92.5% of cases of the intestinal type of gastric carcinoma was of an exudative nature. Diffuse gastric carcinoma in 70% of cases incited a dense productive fibrosis. Pools of mucin and large number of 'signet-ring' cells were mostly encountered in the intestinal type of carcinoma. Applying Dukes' parameters the tumour was found to be more than three times more invasive in cases of diffuse carcinoma. The prognostic bearing of the two histologic types, different host tissue response, behaviour of the tumour in terms of mucous production and local extension are discussed and it is suggested that diffuse gastric carcinoma carries a worse prognosis than the intestinal type. Study of a larger series of cases and longer follow-up with controlled treatment is essential to confirm this assessment.

Malignant melanoma in Nigeria-pathological studies.

Pathological features of twenty-one cases of malignant melanoma studied in the University of Nigeria Teaching Hospital, Enugu during the period January, 1974 to December, 1975 are presented. Malignant melanoma accounted for 2.4% of all tumours and 4.5% of all malignant tumours, greatest age incidence being in the fifth to seventh decades. The male to female sex ratio was 2:1. 73.2% of cases were of the nodular variety. 81% melanomas occurred on the sole of feet validating the hypothesis that the pigmented skin in Africans is resistant to malignant melanoma. Melanoma in Nigerians would appear essentially to be arising from epidermal melanocytes and not from preexisting naevus cells. Hence we do not feel prophylactic removal of plantar moles as suggested by Onuigbo (1975) is desirable. Histologically, there was no clear association between the cell types and the kind of melanoma or invasion of the tumour. The difference in behaviour and natural history of malignant melanoma would appear to have a bearing on the local tissue and also general immune mechanisms of the host.

Oesophageal carcinoma in India. Some epidemiologic and morphologic considerations.

Oesophageal carcinoma constituted 2.39% of all malignancies, and 17.11% of gastrointestinal tract malignancies, over a period of 12 years, in Sir Sunder Lal Hospital population in Varanasi. The highest frequency occurred in the sixth decade. The male:female ratio was 2.2:1, this ratio tended to diminish with age. Out of 202 cases the middle third of the oesophagus was involved in 104, the lower third in 72 and the upper third in 26 cases. Although squamous cell carcinoma was by far the most frequent histologic type (193 cases), genuine primary oesophageal adenocarcinoma did occur in 3, and the tumour was completely anaplastic in the remaining 6 cases. The prognostic bearing of certain morphologic features has been discussed. Oesophageal carcinoma is one of the most frequent malignancies of the gastrointestinal tract and a common tumour in elderly Indian men and women.

Teratoma of the thyroid gland.

A case of teratoma of the thyroid gland in a 3-month-old child is reported. Present since birth, it presented as an acute respiratory emergency. This was relieved by surgical removal. The tumor showed normal thyroid tissue flanking the mass and at surgery was seen to derive its blood supply from the main thyroid vessels.