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A 61-year-old man was admitted to our hospital in December 1994 for a suspected retroperitoneal tumor. Systemic imaging investigations demonstrated retroperitoneal solid tumor, which was diagnosed as malignant fibrous histiocytoma (MFH) by immunohistochemistry for alpha 1-antitrypsin. In March 1995, he was treated with 3 courses of systemic chemotherapy with cisplatin, ifosfamide and doxorubicin followed by the same therapy in March 1996, without serious side effects. MFH is known to be resistant to ordinary chemotherapy. However, the CT showed a marked decrease in the size of the tumor, and the tumor disappeared within 2 months after the first treatment. The patient also recovered rapidly from abdominal pain, for which complete remission has been achieved for more than 5 years. The present chemotherapy may be an effective treatment for retroperitoneal MFH.

A 62-year-old man was given a diagnosis of Waldenström macroglobulinemia (WM) in January 1995. He was treated with melphalan and corticosteroid until January 1996, when he experienced high fever and weight loss. The patient visited a nearby hospital, received a diagnosis of liver abscess, and was referred to our hospital on February 23, 1996. Computed axial tomographic scans demonstrated multiple isodensity masses in the liver, left adrenal region, and right kidney hilum. Needle biopsy specimens of a liver mass revealed infiltration of diffuse large B-cell lymphoma (REAL classification), suggesting that non-Hodgkin's lymphoma supervened WM. Despite multiple cycles of chemotherapy, the lymphoma responded poorly. The patient died of pneumonia and sepsis on May 10, 1996 and an autopsy disclosed broad involvement of liver and spleen with lymphoma. Southern blot analysis of DNA samples obtained from the patient's bone marrow at the time of the initial diagnosis of WM, and later from the needle biopsy specimen of liver mass, displayed different patterns of immunoglobulin heavy chain gene rearrangement. We therefore concluded that in this patient the lymphoma was not a progression of WM, but rather, an independent B-cell malignancy.

Clinical and pathological studies were performed on 51 cases with endometrial cancer. The results are as follows: The average age was 58.9 years and the range 41 to 80 years. Forty-one (80.4%) patients were postmenopausal and the average menopausal age was 49.1 years. All cases were symptomatic and in 35 (76.5%) cases the postmenopausal bleeding was noted as a chief complaint. The chief complications were obesity (37.5%), hypertension (25.0%), infertility (13.7%) and diabetes mellitus (9.4%). Of 51 cases, 36(70.6%) were in Stage I, 7(13.7%) in Stage II, 6(11.8%) in Stage III and 2(3.9%) in Stage IV. When the depth of the invasion was classified into 3 grades, less than 1/3 of the muscular layer, between 1/3 and 2/3, and over 2/3 in 48 cases examined, they were observed in 20(41.7%), 10(20.8%) and 18 cases (37.5%) respectively. There were 6 cases (15%) with lymph node involvement in 40 cases examined. Those in which the depth of invasion was over 2/3, had a significantly higher incidence of lymph node involvement. The five year cumulative survival rate was 66.7%(14/21) for all cases. The clinical stage and age of the patients had a significant correlation with the prognosis of endometrial cancer, but the histological grades, the depth of invasion, and lymph node involvement did not demonstrate the a significant correlation in prognosis in this study. The five year survival rate for the group treated by modified pan-hysterectomy with pelvic lymphadenectomy was 92.3% which was significantly higher than the 25% of the group treated by simple hysterectomy or than the 0% of non-surgical group.(ABSTRACT TRUNCATED AT 250 WORDS)