Yale Rosen

Fibromatosis of the breast

A case of fibromatosis of the breast occurring in a 37‐year‐old woman is described. Only 15 cases of this type have been previously reported. In 5 of these cases there was also involvement of the underlying pectoral muscles, raising the possibility that some of these may have been of pectoral musculoaponeurotic origin. Two of the previously reported cases occurred in patients with Gardners syndrome and 1 in a patient with “familial muticentric fibromatosis.” It is anticipated that fibromatosis of the breast will behave in a similar fashion to fibromatosis occurring in other sites; i.e., as a local aggressive lesion which exhibits a high incidence of local recurrence following incomplete excision.

Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens

Intraoperative pathologic examination with frozen section (FS) was performed on 504 specimens of thyroid tissue obtained from 457 patients over a period of 9 years. After examination of permanent sections (PS) a malignant neoplasm was diagnosed in 57 specimens (11.3%); 50 (87%) of these were primary thyroid carcinoma, four (8%) metastatic carcinoma, and three (5%) malignant lymphoma. The FS diagnosis was “benign” in 448 (88.9%), “malignant” in (30) 5.9%, and “deferred” in 26 (5.2%). The sensitivity of FS diagnosis of malignancy was 53% and the specificity and positive predictive value 100%. The negative predictive value was 97.8% and overall accuracy 97.9%. The PS disclosed a malignant neoplasm in 62% of specimens in which FS diagnosis was “deferred.” Sixty‐eight percent of papillary carcinomas, 87% of undifferentiated carcinomas, and a single case of medullary carcinoma were diagnosed with FS examination. A FS diagnosis of malignancy was not made in any of the ten specimens containing follicular carcinoma; in all ten the neoplasms were well‐differentiated and eight were encapsulated and minimally invasive. The inability to diagnose follicular carcinoma intraoperatively with FS is the most significant factor accounting for the relatively low sensitivity of FS diagnosis of malignant thyroid neoplasms.

Eccrine sweat gland tumor of clear cell origin involving the eyelids

A 47‐year‐old patient with an unusual tumor involving the right upper and lower eyelids has been followed for almost 6 years. The tumor has remained localized to the eyelids and has recurred locally following attempts at complete or partial excision. The morphological features of the tumor as seen by ordinary light microscopic methods were puzzling, and resulted in a variety of pathologic diagnoses. Light microscopic examination of plastic‐embedded semithin sections, and electron microscopic examination indicate that this is a hitherto undescribed eccrine sweat gland tumor of clear cell origin. Its infiltrative growth pattern and tendency to local recurrence suggests that it may be a low‐grade malignant neoplasm.

Small cell epidermoid carcinoma of the esophagus. An oat‐cell‐like carcinoma

A case of small cell anaplastic epidermoid carcinoma of the esophagus is reported. The morphology of this rare esophageal neoplasm simulates that of oat cell carcinoma. Four similar cases have been previously reported. The finding of epidermoid differentiation in two of these tumors, including the present one, raises considerable doubt that any are truly oat cell carcinomas of the esophagus. Although it is theoretically possible that an oat cell carcinoma may arise in the esophagus, there is as yet no conclusive evidence for the existence of such an entity.

Metal chelates of dl-penicillamine

Abstract Other investigators have reported that the administration of penicillamine (β,β-dimethylcysteine) to patients with Wilsons disease results in a marked urinary excretion of Cu. Also, the toxic effects of Hg and Pb are reduced by treatments with penicillamine. These observations suggest that penicillamine has an exceptional ability to bind with metals. Hence, in the present investigation, the formation constants of penicillamine chelates were determined by the potentiometric titration method of Bjerrum. Affinity of bivalent metals for penicillamine results in the following decreasing order: Hg > Ni > Cu > Zn > Cd > Pb. The over-all formation constants (log K 1 K 2 ) for the 2:1 chelates for Hg, Ni, and Cu are 23.5, 22.3, and 21.7, respectively, placing penicillamine among the most potent chelating agents for the heavier metals. The structure of the chelates was deduced as a combination of the metal between the NH 2 and SH groups as is the case with cysteine.

Leiomyoblastoma of the stomach. Report of 9 cases.

Gastric leiomyoblastoma is a rare intramural tumor which originates in the smooth muscle. Nine cases were studied with respect to their clinical, radiological, and pathological features. Six distinct radiological patterns may be seen, of which 5 are represented in this series. Most such lesions occur in the gastric antrum. Leiomyoblastomas are generally benign and do not recur following removal.

Intraoral papillary squamous cell tumor of the soft palate with features of sialadenoma papilliferum‐? malignant sialadenoma papilliferum

An unusual, recurring, squamous papillary tumor involving and possibly arising from minor salivary gland excretory ducts in the palate is presented. Similarity to sialadenoma papilliferum and upper respiratory tract papillomatosis is noted. A paraglandular cystic mass with some resemblance to the palatal lesion, and a solitary lymph node with papillary squamous epithelial deposits was found in a radical neck dissection. We suggest that the lymph node lesion represents a metastasis which may have arisen from the palatal lesion, and therefore propose the concept of a possible malignant analogue of sialadenoma papilliferum. Cancer 42:1859–1869, 1978.

Metastatic malignancy in the submandibular gland.

Metastatic disease in the major salivary glands has been observed and reported in the literature. Often the site of origin of the primary tumor is the skin or mucosal lining of the head and neck structures, and the primary tumors most commonly are melanomas or squamous-cell carcinomas. The most frequently involved salivary gland is the parotid. The submandibular and sublingual glands are rarely involved by mestastatic disease. Secondary lesions arising from distant primary tumors may occasionally involve the parotid gland, but they are extremely rare in the other major salivary glands. The second reported case of metastatic carcinoma in the submandibular gland is presented here. Our case and the previously reported case are similar in that both primary tumors originated in the breast. The clinical and morphologic features are reviewed.

Intraoral submucosal pseudosarcomatous fibromatosis.

Abstract Presented is a case of intraoral pseudosarcomatous fibromatosis. The clinical, gross, and microscopic aspects are illustrated, and comparison is made to previously documented lesions in the oral cavity. Histologic evaluation of fibroproliferative lesions and their subsequent behavior and possible etiology are discussed.

Calcifying epithelial odontogenic tumor. A histologic, histochemical, fluorescent, and ultrastructural study.

A previously unreported calcifying epithelial odontogenic tumor (CEOT; Pindborg tumor) occurring in a Negro patient is presented. Only 12 per cent of these neoplasms have been found in nonwhite patients. Ultrastructural and histochemical studies indicated that the amorphous, acellular, eosinophilic substance present within the tumor was not amyloid. The presence of only sparse calcifications is an unusual histologic variant. No relationship between neoplasm and reduced enamel epithelium could be demonstrated.