Lymph node size in uterine cancer: A revisit.

To study whether lymph node size is a good predictor of lymph node metastasis in uterine cancer, we reviewed the pathologic sections of pelvic and para-aortic lymph node removed from uterine cancer patients who underwent surgical staging in our institution from January 1994 to December 2004. The long axis of each individual node was measured. Out of 4280 total nodes obtained (178 cases), 86 nodes (28 cases) were positive for metastatic cancer (2.0% of total nodes or 15.7% of cases). Among the positive nodes, 11 nodes (12.8%) had nodal long axis <5 mm, 34 nodes (39.5%) had long axis of 5-9 mm, and 32 (37.2%) and 9 nodes (10.5%) had long axes of 10-19 mm and >20 mm, respectively. More than half (52.3%) of these positive nodal long axes were less than 10 mm. At lymph node size of 10 mm that was the common point of reference for pathologic enlargement, the sensitivity, specificity, negative and positive predictive value of lymph node to predict metastatic cancer were 47.7%, 76.7%, 98.6%, and 4.0%, respectively. From these findings, we tended to conclude that lymph node size is not a good predictor of lymph node metastasis in uterine cancer.

Squamous cell carcinoma arising from dermoid cyst: Case reports and review of literature.

Malignant transformation of a dermoid cyst is rare, with squamous cell carcinoma (SCC) being the most common type. During a 10-year period in our institution, we encountered only four cases of SCC out of 425 cases of dermoid cyst, an incidence of 0.94%. Two were of old age, in menopausal status (63 and 74 y), while the other two were in their early forties. Three cases presented with pelvic masses while the other one had nonspecific wasting symptoms and later diarrhea. Three were in early stage and have survived to date without evidence of disease at 8, 12, and 116 months after diagnosis. The other case, in stage III, had suboptimal surgery and responded partially to chemotherapy, subsequently progressed after cessation of the drug, and finally died within a year after diagnosis.

The incidence of K-ras codon 12 mutations in cholangiocarcinoma detected by polymerase chain reaction technique.

In the study, to analyse a K-ras oncogene mutated at codon 12 in 24 patients with cholangiocarcinomas, four (16.67%) of them contained this point mutation. One of 4 was peripheral and the others were hilar tumors. There was no significant relationship between mutation and clinical features in terms of age, sex, endemic area, tumor location, tumor grading and pathological features. In our study, the incidence of K-ras codon 12 mutation in Thai patients with cholangiocarcinoma was lower than that found in British and Japanese patients. The discrepancy of incidence and type of the mutations, in different races and environment probably indicates that there is/are different etiologic mechanism(s) in the pathogenesis of cholangiocarcinoma.

Spontaneous exit of a gnathostome through a surgical wound.

A case of subcutaneous gnathostomiasis in which subsequently a gnathostome larva crept out through a surgical wound in a 22-year-old Thai male is described. This case disclosed that although a worm may creep out of the body through certain natural passages as well as the skin, spontaneous exit via a surgical wound is a possibility. Based on the morphology and number of the head-bulb hooklets and cuticular spines by light and electron microscopy and gnathostome was confirmed as a third stage larva of gnathos toma spinigerum.