Weldon K. Bullock

Yolk sac tumors of the testis

The discovery of 2 yolk sac carcinomas of the mouse has established a basis in comparative pathology for the occurrence of this type of tumor in other species with yolk sacs. Grafts and tissue cultures of extra‐embryonic yolk sac of the mouse have developed a clear understanding of the types of tissues one might expect in yolk sac carcinomas. The morphological appearance, age of incidence, and natural history of yolk sac carcinomas of the testis of boys have been compared to those of embryonal carcinomas. The prognosis for boys under 2 years of age with this tumor is astonishingly favorable, but that for boys over 2 years of age is desperately bad. An elderly man with the disease developed metastases soon after treatment. It is clear that yolk sac carcinoma is an entity deserving incorporation in the classification of testicular tumors as suggested by Teilum.

Yolk sac tumors of extragonadal origin

Five instances of tumors arising in extragonadal sites which we believe are properly classified as yolk sac tumors are presented. One of these tumors constituted the malignant component of a mediastinal teratoma; one represented the development of malignancy in a sacrococcygeal cyst; a third started in the broad ligament; and two others have to be classified simply as pelvic extragonadal. All five patients died of their tumors. The histogenesis of these tumors is discussed and compared with that of testicular and ovarian yolk sac tumors.

Yolk sac tumors of the ovary

Eighteen instances of ovarian tumor with microscopic pattern similar to that of the testicular tumors which we termed yolk sac or vitelline are presented. In the ovary, though not in the testis, this pattern has often been called “Schiller mesonephroma.” Reasons are given for our preference for the term yolk sac tumor to that of mesonephroma for these neoplasms. The ovarian tumors, though occurring in young individuals, unlike the testicular tumors are not concentrated in early infancy. Moreover, the ovarian tumors do not exhibit the striking age‐prognosis relationship which characterized the testicular tumors. Two of the 18 subjects with ovarian tumors appear to have survived their neoplasms; one of these was 7 and the other 15 at the time of surgery. The remaining 16 subjects have died of their neoplasms.

Giant cell adenocarcinoma of the lung.

The 63 giant cell adenocarcinomas of the lung which were found among 592 primary lung carcinomas in 25,785 necropsies during the period from 1945 through 1957 at the Los Angeles County Hospital were studied in detail by histochemical methods. These tumors constitute 10.3% of the primary pulmonary lung carcinomas in this group. Giant cell adenocarcinomas can be separated from the other types of lung carcinomas only by their characteristic morphology and by the demonstration of intracytoplasmic mucin. Their most striking clinical feature was the short survival time which paralleled that of small cell carcinoma of the lung.

Metastatic uterine leiomyomata. A case report

Pulmonary metastases from uterine leiomyomata are extremely rare and unpredictable, despite the high frequency of uterine leiomyoma. Review of the literature reveals seven previous examples of pulmonary metastasis from uterine leiomyomata; other cases may exist, but they were not considered because there was little evidence to distinguish them from leiomyosarcoma. The case we report is unusual in: 1) its prolonged course of 21 years, 2) its lack of pulmonary symptoms, despite extensive multiple nodules; and 3) the cystic change of the multiple lesions, which mimicked cystic lung disease.

Cancer detection during pregnancy: A progress report

Abstract The results of 5 years of cytodetection of cancer of the cervix during pregnancy in the Prenatal Clinics of the city and county of Los Angeles are presented. Abnormal cytology rates or each month of pregnancy and post partum are compared. Rates for different racial groups are shown. The accuracy of fluorescent staining is compared to the Papanicolaou staining method. The percentage of false negatives by the cervical scrape method is discussed. The tissue diagnoses and treatment of 988 patients are reported. The report includes prevalence rates for dysplasia and in situ carcinoma, the fate of 475 patients with dysplasia, and the treatment of 274 patients with in situ carcinoma, 14 patients with microinvasive carcinoma, and 18 patients with invasive disease.

THE MOUTHWASH TECHNIC. A METHOD OF SCREENING FOR INTRA-ORAL CARCINOMA.

Abstract The method presented is suggested as a valuable screening test in intra-oral carcinoma, and we believe it is simple, reproducible, accurate, and results in a cell population representative of the entire oral cavity.

CARCINOMA OF THE CERVIX UTERI DURING PREGNANCY. A STUDY OF THE COMBINED EFFECT OF A TRICHOMONACIDE, A BROAD-SPECTRUM ANTIBIOTIC, AND A LONG-ACTING PROGESTIN ON DYSPLASIA AND IN SITU CARCINOMA OF THE CERVIX.

Abstract 1. 1. An in vivo study has been started of patients with in situ carcinoma and dysplasia found during pregnancy to discern whether these lesions can be reversed by chemical substances. 2. 2. The first clinical trial with a trichomonacide given orally, a broad-spectrum antibiotic used vaginally, and a long-acting progesterone given intermuscularly (in sequential order) failed to produce regression in 50 per cent of cases within the time limit described. There was a suggestive change in some of the dysplasias. 3. 3. This group of cases demonstrates that the lesions found during pregnancy are similar to those found at other times and the majority persist if not treated or removed.