Carcinoma of the tongue in young persons is uncommon. A search of records of the Memorial Hospital revealed six such cases, and 13 others were encountered in the literature. The preponderance of females in this small series is not significant. The high survival rate (50%) is directly attributed to the infrequency of cervical metastasis and the favorable location (anterior two-thirds) of the primary lesion.

We report the case of a white male who underwent a classic hemipelvectomy due to a femur fibrosarcoma with inguinal metastases, which 33 years later, developed into a posthemipelvectomy hernia in the amputation stump that impaired the use of his Canadian prosthesis. The hernia was repaired with a polypropylene mesh in a subaponeurotic position. A seroma was drained in the postoperative and it was only 2 months after the operation that he could use his prosthesis with any difficulty. A year after the operation, the hernia had not recurred. Only seven similar cases have been published, and there are only four cases with details of their correction, two with a mesh as was our case, and the rest with a primary suture of the aponeurotic borders. A brief review of the bibliography is given on this subject.

Case reportsterile. The ureteral catheter was removed by cystoscopy 30 days after A 49-year-old, white woman. who complained of umbilical pain, hac. had a laparotomy at another hospital; a retroperitoneal turnour was found and the biopsy showed the turnour to be a .well-diKerentiated leiomyosarcoma .to the left of the umbilicus, An intravenous pyelogram showed that the left ureter was displaced towards the midline with no evidence of obstruction and there was a calcified stone in the left kidney (Fig. I).At operation on 20 December 1978, the retroperitoneal tumour was the inferior mesenteric vessels and cm of the left ureter which was appendix. which was transected at its base and the tip discarded. The lumen of the appendix was washed with saline solution. The appendix with the appendicular artery was transposed towards the left and an isoperistaltic end-to-end anastomosis was performed to the transected ureter, with 5-0 silk, not including the mucosal layer. A ureteral catheter was placed through the transplanted appendix and its lower tip left loose in the bladder. A Penrose drain was placed near the anastomosis. An intravenous pyelogram performed 15 days after the operation showed a small leak in the superior anastomosis which closed spontaneously (Fig. 2). Urinary cultures repeated after the operation were Operation.The Pathological report revealed. 'tWnoUr of 14 X 10 X 8 cm to which a segment of X cm of ureter was attached'. Microscopic diagnosis was 'leiomyosarcoma which did not invade the ureter'.The subsequent intravenous p y e h r a m s showed a perfect ureteral transit without fistula. We were, however, unable to visualize the lumen of the transplanted appendix but, since no ureteral dilation was seen above the anastomosis, we confirmed that the function of the appendiceal graft was good.two nodular metastases in the right lung and several in both lobes of the resectable liver metastases in both lobes. However, at this time, the function of the left ureter is perfect (Fig. 3).Examination was normal apart from a 10cm removed with the aponeurosis ofthe psoas muscle to which it was fixed, adherent to the tumOUr, The defect was reconstructed using the At present, 40 months after the Operation, the patient has developed laparotomy showed nonliver, demonstrated by CT scan. ~i~~~~~iThe substitution of the ureter by the vermiform appendix has been considered a simple and 'elegant' solution (1). The technique has been described by Melinkoff (21, Kuss (31, Soloviov (4) and Couvelaire (5. 6). The appendix is not always available since appendectomies are frequent but, when present, eter from renal pelvis to hludder. Leak of the superior ureterouppendireal anastotnosis.Postoperative introvenous pyelograpliy with a ureteral cath-

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