A 2‐month‐old female baby was noticed to have liver tumor. A hemangioma of the right lobe was suspected from the findings by celiac angiography. Histologic findings of the surgically resected material revealed choriocarcinoma of the liver. At autopsy, multiple metastatic nodules were found in the lungs, but remnant liver, ovaries, uterus, mediastinum, and sacrococcygeal region were free of tumor. The ovary had several thecalutein cysts, and the endometrium of the uterus showed pseudodecidual change of the stroma. The mother died two months later. Although histologic materials were not available, the clinical findings including a high value of serum HCG seemed to show that she had been affected by choriocarcinoma. The most probable origin of the choriocarcinoma in the infant from the mother is discussed.

A live varicella vaccine was given to children with acute leukemia or other malignancies with minimal clinical reactions.1 In that study, anticancer medication was suspended beginning one week before vaccination and was not resumed until one week after vaccination. In the present study, we attempted to vaccinate such children without suspension of anticancer medication. SUBJECTS AND METHODS Fifteen children with acute leukemia, 12 children with malignant solid tumors (4 neuroblastoma, 4 retinoblastoma, 2 Wilms tumor, 2 teratocarcinoma), and 1 child with lymphosarcoma received a live varicella vaccine1 (500 plaque forming unit/dose) without suspension of anticancer medication. All of these children had been in remission.

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A five-year-old boy with hepatoblastoma, who showed a severe hypoglycemia as an initial symptom, was studied. After resection of tumors, hypoglycemia disappeared and did not recur despite recurrence of tumor. A high concentration of insulin-like activity (ILA) was found in preoperative serum and in the tumor extract. Hypoglycemia in this patient seemed to depend mainly on ILA and in part on liver enzyme activities related to carbohydrate metabolism.

Three children with advanced neuroblastoma developed pleural effusion in the course of their disease. This unusual complication was successfully treated with intrapleural administration of a nonspecific "immunostimulatory" agent; cell wall skeleton of Nocardia rubra (N-cws). The side effects of this procedure were mild and well tolerated even in infants in spite of their terminal stage. Intrapleural therapy in this study seemed to be useful for the treatment of pediatric malignant pleurisy.