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Vascular tumors of the breast are rare, and reports in the literature suggest that most are malignant. The present study is concerned with a benign vascular tumor of the breast, a lesion generally known as perilobular hemangioma. This microscopic lesion consists of a meshwork of thin-walled, dilated vascular channels that may be situated within a breast lobule or in the extralobular mammary stroma. Hemangiomas of this type were found in seven or 1.2% or 555 mastectomies performed in 1974 in female patients who had mammary carcinoma. There was no association with a specific type of mammary carcinoma. Similar hemangiomas were observed as often in a series of breast biopsies performed for benign conditions. None of the angiomas showed any significant atypia or anaplasia.

All consecutive patients with advanced gastric carcinoma who came to the Oncology Dept. of the "L. Pierantoni Hospital" in Forlì, between June 1, 1980 and August 30, 1983, were treated with 5-fluorouracil, adriamycin and mitomycin C (FAM). None of the patients had previously received chemotherapy. The dominant location of metastasis was the liver in 21 pts (48.8%), the abdomen in 15 pts (34.8%) and distant organs in 7 pts (16.2%). The schedule of FAM regimen used was: 5 Fluorouracil, 600 mg/m2, days 1, 8, 29, 36; Mitomycin C 10, mg/m2, day 1; Adriamycin, 30 mg/m2, days 1, 29. Complete remission (CR) was reached in 2 pts (4.6%) with a median length of response (m.l.r.) of 55 weeks (range 20-90), partial remission (PR) in 9 pts (20.9%) with a m.l.r. of 15.1 weeks (2.2-60), no change (N.C.) in 19 pts (44%) with a m.l.r. of 10 weeks (2.2-54) and progression (P) in 13 pts (30.2%). Median survival of patients in CR + PR considered together was 48 weeks (12 months), for the NC pts 20 weeks (5 months) and for those in P 14.1 weeks (3.5 months). The authors reached the conclusion that gastric carcinoma may be treated with FAM both for palliation and to improve survival even if in a small number of patients.

Inflammatory breast carcinoma is a dramatic tumour with a five-year survival rate of almost 3%. Various therapeutic approaches have been made for this neoplasia: surgery, radiotherapy and chemotherapy, alone or in combination. The best results were obtained with the use of a multidisciplinary approach. The authors developed a treatment in which chemotherapy and radiotherapy, together with surgery, are used. After three cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) the patients with partial remission, no change or disease progression were changed to adriamycin + vincristine plus radiotherapy. Surgery was performed on patients with complete remission or partial remission after chemo-radiotherapy. After surgery, maintenance chemotherapy was used with the more active drugs. The actuarial survival rate at 5 years was 30.65% and median survival 34 months.

Cardiac amyliodosis is frequently associated with major electrocardiographic conduction disturbances; but that these disturbances are due to infiltrative destruction of the conduction system by amyloid is unclear. We studied the conduction systems in 23 autopsy patients with cardiac amyloidosis (group 1) (mild in seven, moderate in five and severe in 11), 21 (91 per cent) of whom had had abnormalities of conduction or rhythm during life. For comparison, we examined the conduction system in 23 control subjects matched in age and heart weight (group 2). Of the 23 patients in group 1, only three had extensive amyloidosis of the conduction system; in all three, electrocardiograms showed first degree atrioventricular block and left anterior hemiblock. A more common morphologic abnormality of the conduction system was severe sinoatrial node fibrosis present in seven (30 per cent) patients, and idiopathic atrophy and fibrosis of the bundle branches present in six (26 per cent) patients. None of the patients in group 2 had severe sinoatrial node fibrosis, but two (9 per cent) had idiopathic atrophy and fibrosis of the left bundle branch. Marked fibrosis of the sinus node was more frequent in patients with severe or moderate amyloid, but fibrosis of the bundle branch did not appear to be related to the amount of amyloid elsewhere in the heart. Varying degrees of atrioventricular and bundle branch block were also present in six patients with no morphologic abnormalities of the conduction system. Thus, conduction and rhythm disturbances are frequent in cardiac amyloidosis, but direct amyloid infiltration of the specialized conduction tissue of the heart does not account for the majority of these disturbances. Whether the increased incidence of fibrosis of the conduction system in group 1 compared to that in group 2 relates to the infiltrative myocardiopathy is uncertain.