No abstract

Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder, characterized by the occurrence of multiple leiomyomas scattered throughout the peritoneal cavity. Until this report DPL had been observed only in women and there is only one previous case with malignant change. A case of DPL in a male, complicated by sarcomatous transformation is reported. DPL has a definite malignant potential; patients with the disease should be followed closely for signs of progression.

Partial cystectomy was performed for urothelium-derived bladder carcinoma in 55 patients in the period 1958-78. Ureteral re-implantation was done in 14 cases. The operative mortality was 7.3%. The five-year and ten-year survival rates were, respectively, 47.1 and 35.4%. The series was subdivided according to grade and T-stage of the tumours. The patients with a grade I or II tumour had significantly better survival rates than those with a grade III or IV tumour. T1 tumours had a more favourable outcome than T2 or T3 tumours, though the difference was not statistically significant. The ten-year prognosis was best when the tumour measured less than 1 cm, but tumour size did not otherwise influence the result. The tumour recurred in 32 (58%) of the patients, in 25 of them within 2 years of operation. The attractions of partial cystectomy include avoidance of urinary diversion and possibility of later, more radical surgery. Prophylactic antibiotic treatment is recommended in order to reduce the operative mortality and morbidity.

The material presented dates from a nationwide Cancer Registry, and covers all cases of papillary thyroid carcinoma (T.C.) diagnosed in Denmark from 1943 to 1968, including those based on postmortem examinations. Direct comparison with clinical data from hospitals elsewhere will therefore tend to show less favorable results. In general, Danish cases show a higher average age than those from American hospitals. For the younger age groups this may to some extent be explained by the fact that therapeutic x-irradiation of the thymus during childhood has never been practiced in Denmark. However, the later occurrence in life of Danish cases and the less favorable prognosis might suggest a failure to realize the malignant character of the lesion in the earlier part of its course, and a variable experience on the part of the surgeons and the variety of institutions from which the material was collected. The age-adjusted incidence rate, the mortality, and complications are discussed. It is concluded that the prognosis may be improved considerably by more extensive operations on the thyroid gland, avoiding complications such as paralysis of the recurrent laryngeal nerve and tetany. The surgical efforts should be supplemented with suppression of the TSH production. In the present retrospective study it was not possible to report 20- and 30-year survival rates. This is a task for the future, as is the planning of prospective studies which, in the case of a disease as rare as papillary T.C., should be established on an international basis.