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A man aged 42, with increasing clinical signs of feminization over a 2-yr period and a testicular tumor, was studied. An interstitial cell tumor of the testicle was removed. Urinary steroid excretion and plasma androgen concentrations during both the control and postoperative periods were not indicative of the source of the causative agent. The tumor was homogenized and incubated with pregnenolone-7α-H3 with the isolation products including 19-hydroxyandrostenedione and minor quantities of 2 phenolic compounds, estrone and 16-ketoestrone. A definite answer to the source of estrogens could not be demonstrated via the urinary estrogen excretion or tumor biosynthesis. Possible explanations for the clinical findings, laboratory results and incubation data are discussed.

Nephrogenic adenoma is a rare, benign lesion of the urothelium that generally occurs after open surgery or other bladder trauma. We present 2 recently treated patients with nephrogenic adenomas, both of whom had been treated previously with transurethral resection and intravesical thiotepa for histologically proved transitional cell carcinoma of the bladder. The occurrence of nephrogenic adenoma after transurethral resection alone is extremely rare and suggests a possible adjuvant role of the intravesical thiotepa. With the increasing use of such local chemotherapeutic agents, the incidence of nephrogenic adenoma in such patients may be increasing.

• A 9-month-old female with opsoclonus and ataxia was examined. Computerized axial tomography (CT) of her abdomen identified a retroperitoneal mass of neural crest origin that was not recognized by more conventional roentgenographic methods. The syndrome of cerebellar ataxia, myoclonus, and opsoclonus, and its relationship to neural crest tumors is reviewed along with the usefulness of abdominal CT. (Am J Dis Child134:1057-1059, 1980)

Fourteen of 27 patients with advanced squamous cell carcinomas of the head and neck had objective responses to single, intravenous doses of methotrexate sodium, 20 to 50 mg given every 4 to 7 days. The median duration of response was 92 days. Four patients had complete remissions. Four patients did not have toxic reactions. Signs of toxicity in oral mucous membranes occurred in 12 of 14 responders and in 8 of 13 nonresponders. Moderate hematologic changes occurred in four responders and in one nonresponder. Severe hematologic signs of toxicity developed in one responder and in five nonresponders. One nonresponder died of drug toxicity. This regimen of methotrexate administration appears to be a practical and moderately effective treatment for the management of patients with advanced squamous cell carcinoma of the head and neck.