Soft tissue sarcomas: a ten-year analysis

Malignant soft tissue tumours are uncommon and the diagnosis is often difficult to make. This study of fifty-nine cases represents a pathological perspective of our experience with these tumors over a 10-year period. Malignant fibrous histiocytoma was the most frequent diagnosis made (36 percent) and the Majority of these occurred in the lower limbs. In 11 (19 percent) cases, the sarcomas could not be further classified along histogenetic lines. We consider some of the reasons for this and discuss these findings in the light of an increasing trend towards the use of smaller samples for diagnosis. (AU)

Primary tumors of the small intestine in Jamaica

A review of 60 patients with primary small bowel tumors seen at the University Hospital, Jamaica, during the 15 year period 1971-1985, revealed that adenocarcinoma was the commonest tumour (27 percent), followed by smooth muscle tumour (23 percent), and carcinoids (11 percent). There were 32 malignant and 28 benign tumours. The mean age at presentation was 56 years, with a range of 4 to 85 years. The most common clinical presentation was intestinal obstruction, followed by pain, weight loss, abdominal mass and intussusception. In the majority of patients the diagnosis was not made preoperatively, and 80 percent with adenocarcinoma had lymph node metastases. Increased awareness of the diagnosis in symptomatic patients may result in improved survival. (AU)

Uterine sarcoma in Jamaican women

A review of 55 cases of uterine sarcoma recorded in the Jamaican Cancer Registry for the period 1958-1973 showed an annual incidence of 0.45 cases per 100,000 population, representing a 2.9 percent tumour incidence among all female genital cancers. Clinicopathological studies of 34 cases revealed that these tumours in the Negro population showed little difference from reports elsewhere in their epidemiological, clinical, pathological and prognostic aspects. The only difference was in cases of leiomyosarcoma in the young premenopausal women with rapidly growing uterine masses together with a high mitotic count, who had a poorer prognosis compared with older patients with this tumour. Surgical treatment of patients with leiomyosarcoma was hysterectomy and bilateral salpingo-oophorectomy, while mesenchymal sarcomas were treated with extended hysterectomy. Both groups of patients had postoperative radiotherapy. The 5-year survival was 30 percent in the former and 10 percent in the latter group. Postoperative radiotherapy in both groups failed to improve this poor prognosis but adjunctive immunotherapy may have a role in future treatment schedules (AU)

Endometrial stromal sarcoma of the broad ligament arising in an area of endometriosis in a paramesonephric cyst: case report

A 63-year-old Jamaican negress had an endometrial stromal sarcoma arising in a paramesonephric cyst of the broad ligament. Morphological evidence is presented to show that the tumor arose from an area of endometriosis within the cyst wall. Subsequent metastases responded for a few months to cyclophosphamide therapy and the patient died 14 months after the onset of symptoms. (Au)

Uterine leiomyoma: incidence of degenerative change and a correlation of associated symptoms

A clinical and pathologic study of 298 patients with uterine leiomyomas revealed no significant relationship between the presenting symptoms and degenerative changes in the tumors. Some form of degeneration was demonstrated in 65 percent of specimens. Hyaline degeneration occurred most frequently, accounting for 63 percent of all types of degeneration. Sarcomatous change occurred in two tumors, giving a corrected incidence of 0.37 percent.(AU)

Malignant mesenchymal tumours of the corpus uteri

Fourteen cases of malignant mesenchymal tumours of the uterine bidy, observed over a 13 year period (1953-1966), have been reviewed. There were 9 examples of leiomyosarcoma, 1 endometrial stromal sarcoma and 4 malignant mixed mesodermal tumours. These tumours are uncommon in that they accounted for only 3 percent of uterine malignancies, and 0.6 percent of all female cancers in Jamaica. Seven of the 9 cases of leiomyosarcoma arose in previously benign fibroids, making the incidence of malignant transformation in benign fibroids 0.42 percent. Mixed mesodermal tumours constituted 0.72 percent of all uterine malignancies and 8 percent of the corporeal cancers. The prognosis was uniformly poor (AU)

Radiological observation on an alveolar soft-part sarcoma complicated by trauma and myositis ossificans

The alveolar soft-part sarcoma is a rare tumour that has recently been identified. It resembles chemodectomas and arises from primitive nerve cells. It differs from chemodectomas in its location and in its more malignant behaviour. The tumour was highly vascular and similar in appearance to chemodectomas. The author's patient complained of symptoms after an injury that was complicated by the development of myositis ossificans. The possible relationship between trauma and the development of the tumour is discussed. (AU)