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Proximal-type epithelioid sarcoma (PES) of the vulva is an exceedingly rare soft tissue tumor with an unpredictable symptom pattern and frequent recurrences. Information on management is limited. This report describes a 51-year-old woman with proximal-type epithelioid sarcoma of the vulva which was resected surgically and reviewed the current medical literature regarding the diagnosis and management of this disease.

Objective: The incidence of early gastric cancer (EGC) is increasing gradually in countries such as Japan and Korea. Knowledge of EGC in other Asian countries, however, is limited. This study aims to describe the characteristics of this disease in Singapore. Method: A retrospective analysis of the operative results of a personal series of EGC was undertaken. The clinical and pathological characteristics were examined. Results: From 1979 to 1997, 226 patients with gastric cancer were operated on and 21 patients (9.3%) were diagnosed as having EGC by histological examination. All 21 patients received radical gastrectomy and lymphadenectomy. There were 12 males and 9 females with a median age of 59 years (range: 36–65). The presenting symptom was epigastric pain (15 patients), bleeding (two patients), weight loss (two patients), vomiting and incidental (one patient each). The majority of the tumours (76%) were located at the antrum and were intestinal type. Macroscopically, most of the tumours were either depressed (type IIc) or excavated (type III) type. Four cases were combined type. The lesion was limited to the mucosa in 10 cases. Only one patient had lymph node metastasis. There was no operative mortality and the morbidity rate was 14%. Nineteen patients had complete follow up for 3 months to 13 years. No patient developed tumour recurrence in the series. Conclusion: Early gastric cancer remains uncommon in Singapore. However, for these patients, radical gastrectomy yields excellent results with minimal morbidity.

Background. p53 mutations are known to occur frequently in human cancers, including gallbladder carcinoma. However, there has been no study of p53 expression in extrahepatic bile duct/ampullary carcinoma. Furthermore, gallbladder carcinoma is associated with cholelithiasis, whereas no such association is known for extrahepatic bile duct carcinoma, suggesting that they could arise from different pathogenetic mechanisms. Methods. Twenty-four gallbladder carcinomas and 35 extrahepatic bile duct/ampullary carcinomas were stained with an anti-human p53 protein monoclonal antibody by the streptavidin-biotin immunoperoxidase method. Both the extent and intensity of p53 protein staining were noted. Results. Ninety-two percent of the gallbladder carcinomas stained for p53 protein compared with only 66% of the extrahepatic bile duct/ampullary carcinomas. The statistical significance was maintained even when the comparison was restricted to strong p53 staining in moderately to poorly differentiated adenocarcinomas (P < 0.05). Of the gallbladder carcinomas, poorly differentiated adenocarcinomas stained more strongly than well to moderately differentiated adenocarcinomas; the converse was true for extrahepatic bile duct/ampullary adenocarcinomas. Conclusion. The majority of gallbladder and extrahepatic bile duct/ampullary carcinomas stain for p53 protein. The incidence and pattern of staining is different, however, and supports the contention that these could be different tumors with differing etiologies and pathogenetic mechanisms.

The binding of peroxidase-conjugated Dolichos biflorus (DBA), Triticum vulgaris (WGA), Canavalia ensiformis (Con A), Arachis hypogaea (PNA), Lotus tetragonolobus, and Bandeiraea simplicifolia I (BSAI) to gastrointestinal carcinoid tumours was studied. The results indicate that carcinoid tumour cells express certain carbohydrates similar to those present in the adjacent surface epithelium. The differences in the lectin-binding properties of carcinoid tumours of different sites of the gastrointestinal tract are closely related to the regional differences in the lectin binding of adjacent surface epithelium. These observations therefore form a useful basis for further studies in the application of lectin histochemistry to elucidate the histogenesis of carcinoid tumours.

Twenty-four male breast lesions including ten normal, ten gynaecomastia, and four infiltrating carcinomas were studied for the presence and distribution of lectin binding carbohydrates. For comparison, tissue sections of five normal female breast lesions, ten each of fibrocystic disease, fibroadenoma, and carcinoma, were also included in this study. Formalin-fixed, paraffin-embedded tissues were tested with Glycine maximus (SBA), Dolichos biflorus (DBA), Triticum vulgaris (WGA), Concanavalia ensiformis (Con A), Lotus tetragonolobus (LTA), Arachis hypogaea (PNA), and Bandeiraea simplicifolia (BSAI). The lectin-binding patterns were similar in normal, gynaecomastia, and carcinoma, and were not pathognomonic to any male breast lesion. These lectin reactive patterns in the male breast appear to be similar to those reported for the female breast lesions.