Michael Nielsen

Radium Treatment of Cancer of the Cervix During Pregnancy

Professor Pouey of Montevideo reports the case of a multipart aged 34) who when three and a half months pregnant noticed some red discharge after coitus. Three months later the discharge was more abundant, often contained clots and occurred spontaneously without any obvious cause. On examination a hemorrhagic warty growth was found invading the cervical canal from the posterior lip. It did not apparently involve the vagina and histological examination showed it to be a flat-cell epithelioma with a sparse connective tissue stroma. I he application of radium was proceeded with at once and a month later the tumour had disappeared. At term after a normal labour ^

Periurethral tumor involving the vagina: clinical and sonographic findings.

Dear Sir, To our knowledge a case of a vaginal tumor encircling the urethra confirmed by endosonographic quided biopsy has never been described and we wish to call attention to its features. The case was a 52-year-old woman presenting with complaints of vaginal discharge and pruritus over some months. A gynecological examination revealed a vaginal polyp with a diameter of about I cm in the anterior vaginal wall. The polyp was avulsed and the histopathological examination showed adenocarcinoma, probably of mesonephrogen (Wolffian) origin. Dilatation and curettage were performed and histopathological examination excluded malignancy. Cystoscopy showed a normal bladder and urethra, but vaginal examination revealed a tumor with a diameter of about 3 cm close to the urethra. Endosonography was performed using a Bruel & Kjzr (Gentofte, Denmark) Type 3535 sonographic scanner with a 7-MHz multiplanar endoprobe Type 855 1. This showed a well-defined 3 X 3 cm mass of mixed echogenicity encircling the urethra (Fig. 1). Transvaginal core-needle biopsies were obtained under sonographic guidance with an Autovac (Angiomed, Karlsruhe, Germany) device with a 0.95 mm needle. The histopathological examination showed adenocarcinoma of the same type as the vaginal polyp. Ultrasound and CT of the abdomen, intravenous urography, chest X-ray, rectoscopy and a barium enema examination showed no sign of malignancy. Primary carcinoma of the vagina is rare and represents only 1-2% of all genital malignancies, and

Vaginalplastik ad modum Kirschner‐Wagner

Durch die I(IRSCHNER-WAGNERSChe Operation wird im Gegensatz zu den friiher angewendeten Methoden gefahrlos und durch einen relativ kleinen Eingriff eine plat tenepithelbekleidete Vagina geschaffen. Die Methode wurde das erste Ma1 von KIRSCHNER urid WAGNER im Jahre 1930 mitgeteilt, es war jedoch schon vor 30 Jahren FORGUE gelungen, durch ahnliche Plastik eine funktionstaugliche Vagina zu bilden. An der St. Lukas-Stiftung haben wir in den letzen 2 Jahren 2 Falle von kongenitalem Vaginaldefekt mit jedenfalls vorlaufig befriedigendem Resultat a. m. KIRSCHNERWAGNER behandelt. Die Krankengeschichten lauten folgendermasseii:

A Case of Isolated Tuberculous Infection in a Multilocular Ovarian Cyst

Tuberculous infection of the ovary is usually considered a very rare disease, even though i t looks from recent reports as if it occurs somewhat more frequently than assumed before. Tuberculosis of the ovary is always a secondary process; a t any rate the existence of a primary tuberculosis of the ovary has never been proved. Isolated tuberculosis of the ovary i. e. , without coinciding tubercu. losis of the tube or the pelvic peritoneum is a very rare affection; in the great majority of cases the ovarian tuberculosis is a part of a more general genital tuberculosis or of peritoneal tuberculosis. Statements as to the frequency of ovarian tuberculosis differ a good deal. Some authors have found involvement of the ovary in 30-50 % of all cases of genital tuberculosis (CUMMINS, GREEN-

Tumors of the appendix

As a rule, the tumors of the appendix are small, and often they are accidental findings in operations or on autopsy. Large tumors are rare except for the retention cysts, which may be rather large. Of true tumors there are benign ones (fibroma, polyp, angioma, neuroma) as well as malignant, and also carcinoids. As to the frequency of appendix tumors, statements have been rather divergent. In several fairly large works on the pathology of the appendix there is no mention whatever of appendix tumors; but this needs not mean that tumors have not occurred in the materials. Most authors give the frequency of appendix tumors as 1-15 Oleo. Still, BREITSCHYER found the frequency to be4 Oleo, and STAEMMLER found 3.4 O i o 0 . The frequency is strikingly greater among women, because a greater majority of the appendix tumors are carcinoids, which are found mostly in younger women. Therefore, and perhaps also hecause the appendix often is removed in gynecological operations, tumors of the appendix are seen relatively more often in the gynecological departments than in the surgical. In the St. Lucas Hospital no less than 5 cases of appendix tumor were encountered in a period of about 4 years. In four of these cases the tumor was a carcinoid, in one i t was a lymphosarcoma. The case histories were briefly as follows:

Two cases of endometriosis externa extraperitonealis

By ))endometriosis>) is meant more or less well-defined structures of tissue resembling uterine mucosa which may occur elsewhere in the female genitals outside the endometrium and also outside the genitals, that is, in places where endometrium is not present normally, and these structures respond to ovarian hormones in the same manner as does the normal endometrium. These endometrial heterotopies have been described also under the terms: adenofibrosis, adenomyosis, adenosis and endometrioma. According to their localization they are classified as follows: