Fritz Lin

Two entities in angiolipoma. A study of 459 cases of lipoma with review of literature on infiltrating angiolipoma.

A study of lipomas collected over the past 20 years in a university hospital indicated that there are two types of angiolipoma, namely noninfiltrating and infiltrating. Noninfiltrating angiolipoma is seen in young individuals and presents as painful, soft, cutaneous nodules. Occasional compression of nerve fibers that accompany the vascular channels could be demonstrated. Treatment is merely enucleation. Infiltrating angiolipoma is rather rare. Only 23 cases have been reported in the English literature. Though histologically benign, the tumor can infiltrate bony, muscular, neural, and fibrocollagenous tissues to cause unusual symptoms and signs and can clinically simulate malignant neoplasms. Wide excision to include the normal tissue surrounding the tumor is mandatory. Radiotherapy should be rendered to cases with recurrence.

Treatment of cervical intraepithelial neoplasia with the carbon dioxide laser beam

Forty-five patients with histologically proved cervical dysplasia or carcinoma in situ were treated by the carbon dioxide-laser method. The carbon dioxide laser induces cell vaporization by causing intracellular steam combustion stimulated by the emission of a mixture of carbon dioxide, nitrogen, and helium. This method of treatment is easily performed in the outpatient clinic without anesthesia, is inexpensive, and is effective in the treatment of cervical intraepithelial neoplasia. The treatment allows preservation of the transformation zone, thus permitting future colposcopic visualization.

Computed tomography in detection and diagnosis of breast cancer

From October 1, 1976 through July 31, 1979, at the University of Kansas Medical Center, CT/M examinations were performed on 1625 patients. Seventy‐eight cancers were histologically diagnosed.

Prevalence of aneuploidy, overexpressed ER, and overexpressed EGFR in random breast aspirates of women at high and low risk for breast cancer

SummaryBreast tissue biomarkers which accurately predict breast cancer development within a 10 year period in high risk women are needed but currently not available.We initiated this study to determine 1) the prevalence of one or more breast tissue abnormalities in a group of women at high risk for breast cancer, and 2) if the prevalence of biomarker abnormalities is greater in high risk than in low risk women. Eligible high risk women were those with a first degree relative with breast cancer, prior breast cancer, or precancerous mastopathy. Low risk women were those without these or other major identifiable risk factors. Ductal cells were obtained via random fine needle aspirations and cytologically classified. Biomarkers included DNA ploidy, estrogen receptor (ER), and epidermal growth factor receptor (EGFR).The prevalence of DNA aneuploidy was 30%, overexpression of ER 10%, and overexpression of EGFR 35%, in the 206 high risk women whose median 10 year Gail risk (projected probability) of developing breast cancer was 4.5%. The prevalence of aneuploidy and overexpressed EGFR was significantly higher in the high risk women than in the 25 low risk controls (p < 0.002), whose median 10 year Gail risk was 0.7%. The difference in the prevalence of ER overexpression between high and low risk groups was not statistically significant (p = 0.095). This may be due to the low prevalence of overexpressed ER and the small number of controls. A significant difference was noted in the prevalence of one or more abnormal biomarkers between the high risk and low risk women (p < 0.001).A large prospective trial is needed to determine if one or more of these biomarkers, is predictive of breast cancer development.

Local recurrence of soft tissue sarcoma following brachytherapy

Twenty-five patients with soft tissue sarcomas were treated with Ir192 implants following wide local excision at our institution between 1982 and 1987. External beam radiotherapy was given in addition to the implant in a majority of patients. The median follow-up in these 25 patients is 36 months (12 to 75 months). Twenty patients have had no evidence of local recurrence following their primary treatment (FFR = 80%). A multivariate analysis using stepwise logistic regression was used to predict failure in 3 years or less. Potential predictors examined included age, sex, tumor location, primary versus recurrent disease, grade, histology, surgical margins, implant only versus implant plus external beam, and a ratio of the volume of tissue which received 65 Gy (TV65) to the tumor volume (TV), that is (TV65/TV). The single variable which was significantly associated with local failure by 3 years was a TV65/TV of less than one. Once this variable was entered into the analysis, no other factor proved statistically significant. Our data suggest that when attempting local control of soft tissue sarcomas with brachytherapy, the volume of tissue receiving 65 Gy (TV65) from both implant and external beam must exceed the volume of the excised lesion (TV). Since the volume of a tumor can be readily determined prior to surgical excision either by CT or MRI scanning, pre-planning of the implant volume could potentially reduce the rate of local failure.

Carcinoma of the oral cavity evaluated by specific red cell adherence test

Abstract The specific red cell adherence (SRCA) test which demonstrates in tissue the presence (positive) or absence (negative) of normal isoantigens A, B, and H was applied to sections from thirty-two cases of oral cavity carcinoma. The sources of these carcinomas included the tongue, floor of the mouth, gingiva, palate, alveolar ridge, lip, buccal mucosa, and maxillary ridge, and the microscopic types included carcinoma in situ, early invasive squamous carcinoma, and infiltrating squamous carcinoma of good, moderate, and poor differentiation. Complete or almost complete loss of isoantigens was demonstrated in invasive squamous carcinoma and partial loss of isoantigens in in situ cases, compared with forty-nine examples of normal oral mucosa, none of which showed loss of isoantigens. In well-differentiated squamous carcinoma the isoantigens were lost by the malignant cells but were often retained by the keratin. Built-in positive controls (normal squamous epithelium and blood vessel endothelium) often showed negative SRCA if the area had been previously irradiated.

Preoperative diagnosis of potentially precancerous breast lesions by computed tomography breast scanner: preliminary study.

Eighteen cases of severe atypical epithelial hyperplasia of the breast were detected preoperatively by computed tomography breast scanner (CT/M) with contrast enhancement. The CT number before enhancement ranged from -17 to +31 and increased to 26 to 42 after enhancement (5.2-8.4% increase in attentuation). These data suggest that CT/M can differentiate these potentially precancerous lesions from benign fibrocystic disease.

Muscular hamartoma of the breast

A rare case of muscular hamartoma of the breast was presented. An electron microscopic study confirmed that the proliferating spindle cells were of smooth muscle cell origin.

Radiobiological advantages of an immediate interstitial boost dose in conservative treatment of breast cancer

Minimum surgery with irradiation is emerging as one of the main modalities of therapy for operable early breast cancer. Between June 1982 and June 1986, 110 breasts with Tis, T1 to T3 lesions have been treated at our institution with lumpectomy and interstitial irradiation to the tumor bed with Iridium-192 perioperatively followed by external beam irradiation. There have been two local recurrences at or near the vicinity of the primary, at a median follow-up of 60 months. To analyze the parameters that might have contributed to the local control, we have examined the treatment volumes, prescribed dose to the tumor bed, dose at the core of the tumor bed, and dose to the surrounding normal tissue. Immediate interstitial implant has the radiobiological advantage of delivering continuous low dose irradiation, immediately upon removal of gross tumor to residual foci. Implantation of the afterloading catheters intraoperatively facilitates accurate dose delivery and avoidance of geographical misses. By precise treatment of any residual foci, immediately upon removal of the gross mass, perioperative interstitial irradiation improves local control and by facilitating less radical surgical excision, leads to better cosmetic results.

INFERIOR VENA CAVAL REPLACEMENT AFTER RESECTION OF LEFT RENAL TUMOR IN CANINE MODEL

An animal model simulating the necessity of replacing the inferior vena cava (IVC) with a prosthetic graft is described. Six dogs underwent replacement of the IVC with an expanded polytetrafluoroethylene (E-PTFE) graft using an interrupted-suture technique. Three dogs served as controls, undergoing resection and autograft of the native IVC. Distal side-to-side femoral arteriovenous fistulas were constructed in each case and allowed to remain for six weeks. Subcutaneous heparin and prophylactic antibiotics were administered in the early postoperative period. All grafts were patent at six months, indicating a potentially successful technique for reconstruction of the IVC involved in disease or trauma.