Before and after androgen replacement therapy prostatic and seminovesicular volume was estimated by means of transrectal ultrasonography in 13 hypogonadal men. Volume of the prostate (p less than 0.001) and seminal vesicles (p less than 0.01) significantly increased after treatment with testosterone enanthate. However, the plasma level of testosterone remained abnormally low. These results indicate that volume determination of the prostate and seminal vesicles by means of transrectal ultrasonography is suitable for evaluating the adequacy of androgen replacement therapy in male hypogonadism.
We report a case of primary osteosarcoma of the breast, which is a rare histological type of all breast tumors. A 58-year-old woman had noticed a right breast mass long before presenting to our hospital because it had gradually increased in size. The mass was bony-hard, 90 x 70 mm in size, and was located mainly in the upper outer quadrant of the left breast. Mammography demonstrated a round radiopaque mass with a shaggy outline. There were small bone metastases to the pelvis and scapula on bone radionuclide scan, but no other metastasis was observed with subsequent investigations. Modified radical mastectomy including axillary lymph node dissection was performed. Histologically, the excised tumor was consistent with extraskeletal osteosarcoma of the breast accompanied by lymph node metastses. In spite of adjuvant chemotherapy, the patient suffered a local recurrence four months later and died of aggressive multiple metastases 7 months after surgery.
Malignant fibrous histiocytoma (MFH) in the stomach is very rare, and only four cases have been reported. As a result, there is still little understanding of its clinical and pathological features. We recently experienced two cases of gastric MFH. The first case was a 78-year-old man with epigastralgia and a loss of body weight. Endoscopy revealed an ulcerated submucosal tumor. A gastrectomy was performed and the diagnosis of MFH was made histopathologically. The second case was a 77-year-old man with pulmonary symptoms. An image diagnosis indicated a strong suspicion of lung cancer, and a right middle and lower lobectomy was thus performed. One month after the operation, a bleeding gastric tumor was found and therefore a gastrectomy was performed. Both tumors were diagnosed as MFH. From the analysis of six reported cases including ours, a preoperative correct diagnosis is found to be difficult although the lesion has grown to a considerable size at the time of operation. Since a metastatic lung lesion was first detected in two out of six cases, it is thus recommended that the stomach should be examined when lung MFH is found. Considering the high mortality and the short survival in the six cases, the prognosis for gastric MFH seems to be poorer than that in the extremities. However, lymph node metastasis is uncommon, and a curative resection is possible in some cases such as in our second case.
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