Raymond E. Anderson

A familial instance of appendiceal carcinoid

Abstract A relatively rare case of carcinoid of the appendix in a fifteen year old girl is reported. The fact that the father of this child also had an appendiceal carcinoid establishes the second instance of a familial relationship in this disease reported in the literature.

Tumors of the testicle in childhood

T UMORS of the testicIe which occur during infancy and chiIdhood constitute an intenseIy interesting group of neopIasms. The trigermina1 potentia1 of the testicuIar ceIIs provides the basis for an intriguing array of growth patterns, each with a somewhat different architectural structure and each inherently capabIe of invasion and maIignancy. NeedIess to say, such unpredictabIe characteristics emphasize the importance of earIy recognition and immediate therapy but the extreme infrequency with which tumors of the testes occur in chiIdren does not permit any great individual experience in their diagnosis and management. Kretschmer [IO], for example, refers to a survey of the Iiterature between 1803 and 1944 by Matassarin, who couId find onIy 131 testicular tumors occurring in children under the age of fifteen during that period of time. A more recent report by DoyIe [6] states that onIy twenty-five proved cases of embryonal carcinoma in children were found in the entire Iiterature for a thirty-year period prior to 1g55. The Canadian Tumor Registry has tabuIated seven cases of adenocarcinoma of the testes in infants [12], and Rusche [20] compiIed the records of tweIve tumors, both benign and maIignant, from hospita1 admissions covering a twenty-five-year period. MeIicow [r4], Boehme, BagIey and Pumphrey [3], Magner and Bryant [I I], MeItzer and BIoom [15] and others [2,5,22-253 have aIso contributed case reports. IncIuding the analysis of those patients as far back as 1803, however, it is unIikeIy that the tota number of pubIished reports of testicular neopIasms of infancy and chiIdhood exceeds 160 cases. The rarity of these tumors therefore warrants a continuation of the recording of observations and data reIative to them. This thought has prompted us to discuss two cases of childhood testicuIar tumors which we have recently treated. One of these represents a maIignant growth and the other a microscopicaIIy benign type of neopIasm.

The posterior triangular space: Troublemaker of the anus

Abstract The posterior triangular space of the anus is an important anatomical landmark in the anal canal. This potential compartment lies between the subcutaneous and deep components of the external anal sphincter and within the V-shaped convergence of the posterior fibers of the superficial portion of that muscle. The central boundary of the compartment is made up of the fibers of the internal anal sphincter. Infection gains entrance to the space by means of bacterial growth in the anal crypts, passage along the anal ducts and finally invasion of the anal glands with perforation into the adjacent potential space. Localization in the posterior space is the initial phase of the development of fistula-in-ano, anal fissure, pectenosis and cellulitis. Early diagnosis is important and immediate and adequate surgical drainage with posterior sphincterotomy is essential in order to prevent the development of these undesirable sequelae.