John McL. Morris

Adenocarcinoma of the endometrium

Abstract Analysis of 265 patients with adenocarcinoma of the endometrium treated at the Yale-New Haven Medical Center showed that older patients and those with an undifferentiated tumor had a less favorable prognosis. To permit comparison between the groups who received preoperative radiotherapy with one that received operation only, it was found necessary to adjust for differences in the incidences of the histologic grades among these two groups. This had a significant influence upon the interpretation of the survival rates in the patient with a histologically well-differentiated tumor. No relationship could be determined between survival and the size of the uterus in these patients nor between the radiation response (RR), sensitization response (SR), and the response of the tumor to radiotherapy. It is the feeling of the authors that histologic grade may prove the best subdivision for evaluation of results of tumor confined to the uterus.

Adenoid squamous cell carcinoma of the vulva

Fifty cases of histologically proven invasive squamous cell carcinoma of the vulva were reviewed. It was found that 2 of the patients had extensive areas of adenoid squamous cell carcinoma, and 15 had focal changes. The adenoid variety of squamous cell carcinoma consists of rounded spaces, lined by squamous cells primarily of one cell thickness, and conatining in the lumen single or grouped dyskeratotic acantholytic cells. The incidence of lichen sclerosus et atrophicus in the 50 patients with squamous carcinoma of the vulva was found to be 18%. There was no statistical significance in the observed difference in mortality between patients with adenoid squamous and the usual variety of squamous cell carcinoma. Adenoid squamous carcinoma, which is often attributed to solar damage, has previously been described only in sun‐exposed areas of the skin. Our report is the first describing this entity in the vulva.

The significance of pain in cervical cancer and its treatment by interstitial infiltration with colloidal radiogold

Abstract Two hundred and sixty-two patients with cervical cancer were reviewed with reference to symptoms of pain. The incidence of pain was found to be 59 per cent. 1. The 3 to 8 year “cure” rate was 37 per cent in patients with pain localized to the abdomen, pelvis, and back as compared to 88 per cent in patients without pain. 2. The 3 to 8 year “cure” rate in patients with pain in the lower extremities was 16 per cent. With the exclusion of those in whom the pain was probably due to conditions other than cervical carcinoma, the “corrected cure” was 6 per cent. 3. Varying degrees of leg edema were found in 42 per cent of patients with lower extremity pain. They all died of their disease. 4. Whereas the preliminary course of radiotherapy relieved 20 per cent of patients with pain, reirradiation gave only temporary relief. 5. Radical surgery was of no benefit in terms of cure in patients with lower extremity pain in whom a viable tumor was found on the pelvic wall. Of 22 patients so treated, all died of their disease. 6. A technique of direct infiltration of colloidal radiogold into residual tumor has been employed with some success. In 7 patients the relief obtained was marked, in 4 moderate, and in 3 only minimal. No improvement was noted in 3 patients.

Estrogen and progesterone receptors in vaginal and uterine adenocarcinomas following estrogen use

Abstract Estrogen and progesterone cytosol receptors in three clear cell adenocarcinomas following maternal DES administration during pregnancy were low. In contrast receptor levels were high in two endometrial adenocarcinomas in castrated women on long-term exogenous estrogens. These results suggest that estrogens may not stimulate growth of clear cell adenocarcinomas following maternal DES administration, while endometrial adenocarcinomas following prolonged estrogen treatment are likely to be hormone responsive.

Evaluation of Male Bufo Americanus and Rana Pipiens for Pregnancy Testing**Aided by grants from the National Institutes of Health. U. S. Public Health Service (C-2054). and the James Hudson Brown Memorial Fund of Yale University.

Summary 1. An accurate, rapid, simple, economical system of pregnancy testing employing the male toad Bufo americanus is described. 2. Of a total of 652 tests reported there were 391 patients subsequently shown to have normal pregnancies and 261 nonpregnant women. In these cases the toad testing system gave an accuracy of 100 per cent. If four patients are included whose specimens were collected before the tenth day following the missed period the accuracy is 99.8 per cent. 3. A very high degree of correlation was present between the toad testing system and the A-Z mouse and Friedman tests. 4. The male frog Rana pipiens proved considerably less accurate as a test animal for the diagnosis of pregnancy. 5. The male frog Rana pipiens and male toad Bufo americanus show considerable seasonal variation in sensitivity. 5. The male frog Rana pipiens and male toad Bufo americanus show considerable seasonal variation in sensitivity. We wish to thank Mr. James V. Massey, Jr., of the Fairfield Laboratories, Bridgeport, Connecticut, for his valuable assistance with the routine aspects of this study. Without the technical assistance of Patricia Bradt, Marion Brazel, Joan Crooker, Barbara DelGiorno, and Betty Weber this work would not have been possible.