Endometrial carcinoma of prostate.

Endometrial carcinoma of the prostate is a unique lesion which contrasts markedly to the more ubiquitous prostatic acinar carcinoma with regard to morphology, clinical manifestations, localization stage at diagnosis, and possibly prognosis. Although endometrial carcinoma of the prostate may occur more commonly than previously recognized, wider recognition and study are essential for further delineation of this lesion. Finally, the inherent limits of endoscopic or of enucleative surgery and the propensity of endometrial carcinoma to present at a low stage suggest in appropriately selected cases that radical prostatectomy or possible external radiotherapy may offer the best opportunity for cure.

Surgical treatment of non-seminomatous germinal testes tumors.

Surgical management of germinal testis tumors other than seminoma is presented. Phase I consists of removal of the primary tumor; phase II, the surgical removal of retroperitoneal metastatic disease, and phase III, surgical management of chest metastasis. Seventy-two patients were explored with the intent of performing a simultaneous bilateral retroperitoneal lymphadenectomy. Each had a radical orchiectomy prior to exploration. Seven patients were found unresectable because of extensive disease above the renal pedicle and lymphadenectomy was not performed. The remaining 65 were found resectable and a transabdominal bilateral retroperitoneal lymphadenectomy was done. Of this number, 20, or 30%, had metastatic nodes. No other treatment was used. All had a 3-year follow-up and 53 were followed for 5 years or more. The 3-year survivals for stage I is 93%, and for stage II, 75%. Survivals of 5 or more years in stage I are 86% and in stage II, 70%. Thus, this experience with pathologic stage II cases clearly demonstrates the capability of surgery as a primary treatment to control 70% of patients with retroperitoneal lymph node metastases. This surgical technique is therfore recommended as primary therapy in stage I and II non-seminomatous geminal testis tumors.

The value of erythropoietin assay in the follow-up of Wilms' tumor patients.

Ectopic tumor associated erythropoietin release was measured preoperatively and postoperatively in 36 Wilms' tumor patients followed for an average of three years. Erythropoietin assay results in plasma and urine were related independently to tumor stage as well as to the general clinical judgment following appropriate and exhaustive tests as to whether the disease was active or inactive at the time of the assay. Consistent erythropoietin plasma elevations were correlated with the presence of active disease in all stages of Wilms' tumor. Less consistent elevations were noted in urine specimens concomitantly obtained and assayed. This hormonal assay continues to be of consistent and long-term benefit in predicting or correlating disease recurrence or persistence in Wilms' tumor.

Ectopic production of erythropoietin in Wilms tumor patients in relation to clinical stage and disease activity.

Measurement of erythropoietin levels was achieved in urine, plasma and tumor extract specimens in 27 Wilms tumor patients. Good correlation of the stage of the disease, the clinical judgment of inactive or responding tumor foci and erythropoietin levels was noted. Erythropoietin levels are believed to reflect ectopic hormone production by the primary or secondary tumor. Since the erythropoietin hormone assayed in these and other Wilms tumor patients was not associated with polycythemia, it is believed that Wilms tumor-associated erythropoietin differs in some manner from the hormone produced normally in man and possible in other states associated with secondary polycythemia. Etythropoietin assay with further purification and technical development can be of additional widespread assistance in the clinical classification and subsequent management of the tumor state. Our study confirms this biological potential.