Search

Lymphovenous shunts have been detected in patients by lymphography with Ultrafluid Lipiodol. No shunts were found in patients with normal lymphatic systems. They were found in patients with lymphoedema, with lymph nodes involved by malignant disease, and in patients who had had surgical interruption of lymphatic pathways, either vessels or nodes. The total incidence of lymphovenous shunts in 700 lymphographic studies was 2·3%. The incidence in the various pathological groups was highest in those with obvious lymph node involvement. In certain situations, particularly primary lymphoedema, the role of a lymphovenous shunt appears favourable to prognosis. In other situations a deleterious effect may be produced.

In 1927 Wangensteen wrote, ‘No greater diversity of opinion probably exists concerning anything in medicine than the question of malignancy in the undescended testicle.’ Since this was written a great number of papers has been published on this subject, and now it is generally accepted that the maldescended testis is more liable to undergo malignant change than the normally descended organ. The main factors which swayed opinion to this view were Campbell's analytical papers of 1942 and 1959. His conclusions were that malignancy was eleven times more frequent in the inguinal testis and sixty times more frequent in the intra-abdominal testis. The maldescended testis is also known to be more liable to torsion and trauma than is the normal organ. The following case illustrates two of the dangers to which an intra-abdominal testis is exposed.

In the last 50 years, 15 malignant ovarian tumors have been encountered at the Hospital for Sick Children, Toronto. This paper will analyze and report this series.

In this paper, the relationships between the hormone levels in urine and plasma before semicastration, before radiotherapy, and after radiotherapy were studied in five patients with malignant teratoma of intermediate type B and three patients with malignant trophoblastic teratoma. Estrogen levels were significantly elevated preoperatively in all cases of malignant teratoma of intermediate type B, and one out of three cases of malignant trophoblastic teratoma. A follow-up study on one patient with malignant teratoma of intermediate type B and on two patients with malignant trophoblastic teratoma confirmed the diagnostic and prognostic importance of estrogen determinations in patients with testicular tumours. No clear-cut picture was obtained concerning testosterone excretion and blood testosterone levels. Whereas semicastration in some patients resulted in a fall of the plasma testosterone, other cases demonstrated significant elevated blood and urine testosterone levels. The possible influence of gonadotrophins – either produced by the tumour tissue or in increased amounts by the pituitary – on the steroid hormone content is discussed. Of practical importance is the finding that, even in malignant trophoblastic teratoma, the Pregnosticon test was not always sensitive enough to give a positive reaction. On the other hand, the quantitative HCG determination in blood and urine is of considerable importance for the differential diagnosis of the respective type of tumour.

Hypercalcemia is the most common para-endocrine disorder associated with ovarian neoplasms, 14 such cases having been reported in the world's literature including 3 serous cystadenocarcinomas, 2 mesonephromas, 1 dysgerminoma, 1 undifferentiated carcinoma, and 1 “hypernephroid carcinoma.” The present paper is a report of an additional case of mesonephroma associated with clinical and chemical evidence of hypercalcemia which remitted following surgical excision of the lesion. Mesonephromas of the ovary have a disproportionate high incidence of hypercalcemia in comparison with other ovarian neoplasms. The etiology of this association is obscure.

Summary This paper considers malignant testicular tumour formation in 76 phenotypic female patients possessing a Y chromosome. Forty-four patients were considered to belong to the syndrome of androgen insensitivity; 22 belonged to the syndrome of partial androgen insensitivity and 10 to the syndrome of testicular failure. No case of gonadal malignancy was found in the 44 patients with androgen insensitivity and one case of malignancy was found in the 22 with partial androgen insensitivity. Two cases of malignancy occurred in the ten patients with testicular failure. The relevance of these facts to the management of the problem of the female with a Y chromosome is discussed.

HERMAPHRODITISM in itself is a rare anomaly. The additional occurrence of bilateral gonadal neoplasms is exceedingly uncommon. The present paper reports the case of a "male" hermaphrodite with a pseudomucinous cystadenoma of the right ovary and a dysgerminoma (seminoma) of the opposite gonad. General Considerations Hermaphroditism is the term used to designate the congenital possession by one person of both male and female sex organs. Two forms exist, true hermaphroditism and pseudohermaphroditism. Diagnosis of the former requires the presence of both ovary and testis either as separate organs or combined to form unilateral or bilateral ovotestes. In pseudohermaphroditism, on the . . .

SUMMARY The present paper has presented a clinicopathologic survey of ten benign teratomas, eight malignant teratomas, one seminoma and five choriocarcinomas, all primary in the mediastinum. These tumors appear to represent a spectrum of morphologic patterns that may be seen in teratoid tumors. The frequency with which pure or combination patterns will be seen appears to be a function of the number of sections evaluated. Regardless of the type of therapy undertaken, the malignant teratomas, seminomas and choriocarcinomas were universally and rapidly fatal, with the choriocarcinoma having the shortest clinical course. All the patients with benign teratomas ran a good course after surgical removal of the neoplasm. In the case of the mediastinal seminomas and choriocarcinomas, primary origin in the mediastinum can only be validated by the complete absence of testicular pathology, since the former are morphologically identical with their counterparts in a gonadal location.