Cervical adenocarcinoma in women with nasopharyngeal carcinoma (NPC).

Multiple primary cancers account for only 0.38% of all cases in the Singapore Cancer Registry. The close temporal association of nasopharyngeal carcinoma (NPC) in three Chinese women with uterine cervical adenocarcinoma was observed in our department within a 3-month period; one other case was extracted from the local literature. Although NPC is a common neoplasm in local Chinese women, uterine cervical adenocarcinomas comprise only 8% of cervical cancers locally. The close occurrence of these cancers does not seem to be related to the therapy used for cervical cancer and suggests that an association of the Epstein-Barr virus (EBV) with uterine cervical adenocarcinoma should be further investigated.

Vasoactive intestinal peptide secreting tumours in children: a case report with literature review.

A 3 year old Chinese girl with watery diarrhoea, abdominal distension and hypokalaemia due to a thoracic paraspinal vasoactive intestinal peptide (VIP) secreting ganglioneuroma is reported. The pre-operative serum VIP was 314 pmol/l (normal less than 30). Her diarrhoea stopped after the removal of the tumour. The VIP was 14 pmol/l 6 months post-operatively. Review of the 19 reported cases in children with documented elevated serum VIP showed that many of the cases presented with watery diarrhoea for prolonged duration before the diagnosis was made. Earliest age of onset was 2 weeks of age. The male to female ratio was 9:10. Ganglioneuroma and ganglioneuroblastoma were the commonest tumours. Pancreatic non-beta cell hyperplasia and neurofibroma were also reported. Location of the tumour was variable: neck, chest or abdomen. Increased urinary catecholamine excretion was reported in 50% of the cases. Abdominal distension, flushing, episodic hypertension and failure to thrive were the other associated features.

Immunohistochemical study of granular cell tumour.

Immunoperoxidase studies were performed on 8 granular cell tumours using various intermediate filament proteins, as well as lysozyme, S-100 protein, and lectins. All the lesions gave negative results to cytokeratin, vimentin, desmin, myoglobin, neurofilament protein, glial fibrillary acidic protein and lysozyme. One was positive for alpha-1-antitrypsin and alpha-1-antichymotrypsin. S-100 protein and lectins (Concanavalin ensiformis and Triticum vulgaris) were uniformly positive in all the lesions. S-100 protein positivity would indicate that granular cell tumours are of neural or neuroectodermal origin, although the cell type involved is not clear. There is no obvious explanation for the lectin-binding properties of granular tumour cells. It is hoped that further studies will evaluate the usefulness of lectin histochemistry in defining the nature of granular cell tumours.

In situ freezing of the pancreas and portal vein in the pig.

The pathophysiological results of a study of simultaneously freezing the pancreas and portal vein in the pig are presented. There was little reduction in portal venous flow despite the vein being frozen, and there were no cases of occlusion, rupture, or dilatation of the vein. Major histological changes in the vein wall were noted however. The frozen pancreatic tissue was completely destroyed and replaced by granulation tissue. The possible use of this form of therapy to treat pancreatic cancer is discussed.

Ulcerative vulvitis in Reiter's syndrome. A case report.

In a case of acute Reiter's syndrome with severe vulvitis the diagnosis was based on the presence of a vaginal discharge and dysuria, arthritis, conjunctivitis, buccal ulceration, keratodermia blenorrhagica, and HLA B27 tissue-typing antigen. The vulval lesions were similar in appearance to those of circinate vulvitis. The acute histological change were confined to shallow ulceration with an inflammatory infiltration of the subjacent dermis. Coincidential lichen sclerosus et atrophicus was present, which could have been masked by the acute lesions.