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A histologically confirmed malignant, primary bone tumour in the pelvis, presumably an osteosarcoma, underwent spontaneous regression. The large tumour was inoperable and gave rise to severe pain as well as difficulty in walking. After 2 years of progression, with increasing desition improved spontaneously, and at present the patient is alive, almost symptom-free, after 6 years follow-up.

A national Danish series of 68 breast sarcomas from 66 women and one man (age 17-86 years) was investigated. Tumour sections from 22 stromal sarcomas (SS), 24 phyllodes tumors of malignant type (MCSP), seven phyllodes tumors of borderline type (BLCSP), four malignant fibrous histocytomas (MFH), eight liposarcomas, two angiosarcomas and one leiomyosarcoma were reviewed retrospectively, and all patients were traced with a minimum follow-up of 15 years. Tumor contours appeared to be the best prognostic factor in predicting the risk of metastatic spread. Stromal overgrowth of MCSP was considered less utilizable due to difficulties in distinguishing between MCSP with marked stromal overgrowth and SS, which we consider as a variety of MCSP and which only showed slightly increased death rates compared to MCSP (45% versus 38%). Both angiosarcomas and the leiomyosarcoma proved lethal, and the other sarcoma subtypes had a death frequency of about 50%, with the exception of BLCSP, neither of which proved lethal. All patients, who died from metastases, were dead within 5 years irrespective of treatment. No positive lymph nodes were identified at the time of primary treatment, supporting the findings of previous investigators. We therefore advocate simple mastectomy or local excision with a wide margin as sufficient treatment of breast sarcomas. The indications for adjuvant therapy is as yet unclarified.

Histological and immunohistochemical features of 87 patients with conventionally diagnosed Ewing's sarcoma were studied retrospectively on routinely processed material and evaluated with regard to prognostic significance. 74% were convincingly positive when stained for vimentin, 13% were doubtful, and 13% were negative. A varying degree of positivity for neuron-specific enolase (NSE) was found in 15%; these cases all co-expressed vimentin. A single tumour contained scattered cytokeratin-positive cells. Positivity for the leukocyte common antigen (LCA) could be demonstrated in three cases; these were excluded from the statistical analysis of prognostic factors. Growth pattern, soft tissue invasion, monomorphic or dimorphic cell population, and PAS-, NSE- or vimentin-positivity did not influence survival significantly. However, prognosis was increasingly poor with increasing degree of necrosis: median survival was 28 months for grade I necrosis (less than 10%), 16 months for grade II (10-50%), and 11 months for grade III (greater than 50%), p less than 0.0005. A mitosis count of less than 1 per high-powerfield (HPF) was correlated to a median survival of 26 months, greater than or equal to 1 per HPF to 12 months, p less than 0.05. The findings indicate some degree of heterogeneity in Ewing's sarcoma which may be related to primitive peripheral neuroectodermal tumours (PNETs), or be a true blastoma. In future trials, diagnostic criteria (including immunohistochemistry) should be clearly defined and materials should be large enough to allow for stratification according to prognostic factors.

Mucoepidermoid tumors of salivary glands are relative rare and it has often been difficult to correlate the pathologic features and clinical aspects. The literature recommends long term follow-up studies. The object of the present study was therefore to follow this recommendation. The clinico-pathological features of 39 mucoepidermoid tumors are presented. The material was retrieved from the files of the pathological institute, Rigshospitalet, Copenhagen, during the period 1941-75. All patients, 24 males, 15 females, were followed for a minimum of 5 years. The lesions were classified into low grade (13 cases), intermediate grade (14 cases) and high grade (12 cases). The corresponding 5, 10 and 15 years cumulative survival rates were 92%, 92%, 92% for low grade, 47.4%, 47.4%, 35.5% for intermediate grade and 0%, 0%, 0% for high grade tumors. Thus we found a close correlation between pathology and clinical course. Furthermore, a 5 year observation period appeared an acceptable approach, because 17 of the 18 patients who succumbed of the disease, did so within 4 years following surgery. We consider all grades of mucoepidermoid tumors to be potential malignant. In our study one patient with a low grade tumor died of the disease.

Ten patients with giant cell tumours of the bone were treated by radiation therapy. Indications were non-radical primary surgery in 8 cases and recurring lesions in 2. Tumour doses ranged from 23 to 75 Gy delivered with supervoltage equipment in 8 cases. There were 3 recurrences after radiation therapy, all occurring in patients with tumor doses less than 39 Gy; 2 of these had received orthovoltage therapy and 2 died later from lung metastases. Modern supervoltage irradiation is probably as effective as surgery which is nevertheless recommended in operable cases.

A survey of the oral mucosa in 661 of the people living in various geographical locations of the Gizan region has been carried out. Mucosal lesions compatible with 'oral leukoplakia' have been found to affect approximately 68% of the users of the native snuff known as 'Shammah'. The lesions were almost always at the site where 'Shammah' was habitually held. Histological examination of biopsy specimens obtained from 29 different individuals revealed squamous cell carcinoma in 7 cases and carcinoma in situ in 2 cases, whereas the remaining specimens showed ortho- and para-hyperkeratosis, some of which also had premalignant changes. The results of this study point to a possible causal relationship between the use of 'Shammah' and the development of oral premalignant and malignant lesions among snuff-dippers in the Gizan region.

A material of 87 consecutive patients with Ewing's sarcoma referred for treatment in the period 1962-1983 was retrospectively analysed. Thirteen patients had metastases at the time of diagnosis. Of the remainder, 71 received radiation therapy and 32 adjuvant chemotherapy. Survival rate was not influenced by age, sex or treatment delay. Metastatic disease predictably shortened survival (median 6 months vs. 23 months for localized disease). Tumour site did not significantly influence survival rate, although pelvic localization was associated with a slightly shorter median survival. Both pain and objective impairment of movement at presentation correlated to a poorer prognosis, possibly because of larger tumours or soft tissue extension. Adjuvant chemotherapy prolonged recurrence-free survival from a median of 6 months to 16 months, but survival was not improved significantly. Local failure occurred in about 40 per cent, regardless of radiation dose and tumour site. At the time of evaluation, 13 patients (15%) were alive with no evidence of disease and a median follow-up time of 68 months (range 16-196). So far, 2 patients have developed secondary malignancies in irradiated areas (one malignant fibrous histiocytoma and one osteogenic sarcoma).