Rapid growth of human cancer cells in a mouse model with fibrin clot subrenal capsule assay.

Rapid in vivo growth of cultured human cancer or leukemia cells was achieved by implantation into the subrenal capsule of mice. A solid structure, necessary for accurate implantation and measurement of tumor growth in this model, was provided by stepwise addition of fibrinogen and thrombin to the tumor cells, leading to rapid enzymatic formation of a solid tumor-fibrin matrix. Human leukemia and epithelial cancers increased in volume between 6- and 40-fold when measured 6-10 days after implantation into normal or immunosuppressed mice. Immunosuppression of host CD-1 mice was achieved by cyclosporine given daily after tumor implantation, cyclophosphamide given preimplantation combined with cyclosporine, or whole-body irradiation given preimplantation. Confirming the validity of tumor measurements, tumor histology in the immunosuppressed mice revealed cell proliferation, invasion, and neovascularization. Similarly, no artifactual measurement of tumor growth was observed by nonviable cancer cells, implanted after in vitro exposure to a known cytotoxic concentration of thiotepa. This model provides an economical, short-term technique for the in vivo study of human tumor growth, for the evaluation of new cancer therapies, and for in vitro - in vivo drug activity correlations in specific types of human cancer or leukemia cell lines.

Malignant mixed mesodermal tumors of the ovary.

OBJECTIVE: To review the experience at Women & Infants Hospital and Hartford Hospital of patients with malignant mixed mesodermal tumors of the ovary, and to review the pertinent literature. METHODS: Fourteen cases of malignant mixed mesodermal tumors of the ovary at the two hospitals over a 5-year period were identified through their tumor registries. Demographic data, pathology, treatment, and survival rates were reviewed. RESULTS: The median survival of the patients in our series was 7 months, with 64% dead of disease in 1 year. A review of the pertinent literature indicated median survivals of 6-12 months, with more than 70% of the patients dead of disease at 1 year, despite treatment. CONCLUSION: Further investigation is needed to determine the proper management for malignant mixed mesodermal tumors of the ovary. Meanwhile, current treatment strategies should recognize the present therapeutic limitations, so as not to diminish any further the quality of life for women with this malignancy.

Serous carcinoma of the peritoneum after oophorectomy.

BACKGROUND: Prophylactic oophorectomy in premenopausal women has been recommended to prevent ovarian cancer. However, serous carcinoma of the peritoneum, which is indistinguishable from ovarian carcinoma, can occur after oophorectomy. CASES: Two cases are reported of serous carcinoma of the peritoneum after oophorectomy. Presentation, management, and outcome are similar to those for ovarian carcinoma. CONCLUSION: More data are needed to quantify the risk of carcinoma after oophorectomy. Such knowledge may change the risk-benefit calculations of recommending prophylactic oophorectomy to premenopausal women at a certain age, and must be discussed with the patient who is considering prophylactic oophorectomy with or without other planned surgery.

Absence of estrogen and progesterone receptors in glassy cell carcinoma of the cervix.

OBJECTIVE: To evaluate the estrogen and progesterone receptor status of glassy cell carcinoma of the cervix to assess the possible implications of hormone replacement therapy in these patients. METHODS: The estrogen and progesterone receptor status of 13 glassy cell carcinomas was evaluated by immunohistochemistry using commercial monoclonal antibodies and a streptavidin-biotin detection system. RESULTS: No immunohistochemically detectable estrogen or progesterone receptor protein was present in tumor cells, although both receptors were identified in the adjacent normal cervical tissue. CONCLUSION: The absence of estrogen and progesterone receptors in glassy cell carcinoma suggests that this tumor would not be hormonally responsive and that these patients can be safely treated with hormone replacement therapy. Further studies are indicated to confirm this observation.

Caelyx/Doxil for the treatment of metastatic ovarian and breast cancer.

Caelyx/Doxil is a novel pegylated liposomal formulation of the first-generation anthracycline, doxorubicin. The pharmacokinetics of this polyethylene-glycol-coated liposome are characterized by a reduced volume of distribution, a long intravascular circulating half-life and slow plasma clearance compared with free doxorubicin. This, coupled with a small vesicular size, uniquely promotes the localization of Caelyx/Doxil at tumor sites and explains its altered toxicity profile. The FDA and EMEA have approved its use for the treatment of AIDS-related Kaposi's sarcoma and, more recently, for recurrent epithelial ovarian cancer (EOC). Numerous investigations have focused on its use in the treatment of metastatic breast cancer, as well as recurrent squamous cell cervical carcinoma, soft tissue sarcoma, squamous head and neck cancers, prostate cancers and malignant gliomas. Ongoing clinical studies of combination regimens incorporating Caelyx/Doxil will further clarify its role in the treatment of advanced solid tumors.

Ovarian cancer.

Ovarian cancer is the leading cause of death in women with pelvic malignancies. Because of the multiple histologic types of malignancy that can arise within the ovary, accurate diagnosis and staging is critical for optimal patient care. The current standard of proper surgical management followed by combination chemotherapy is outlined. In addition, risk factors, screening, prognostic factors, and the approach to the relapsed patient is discussed.

Synchronous endometrioid tumors of the ovary and endometrium. A clinicopathologic study of 22 cases.

OBJECTIVE: To analyze a group of 22 patients with synchronous endometrioid tumors of the ovary and endometrium. STUDY DESIGN: A retrospective chart review was undertaken and information collected on patient age, parity, tumor grade and stage, presence of coexisting endometriosis and survival. Flow cytometry was determined from archival samples of the endometrial and ovarian tumors. RESULTS: The mean age at diagnosis was 52.8 years (range 36-71); mean parity was 1.05. With regard to the endometrial component, 68.2% were grade 1, 63.6% were stage I and, by flow cytometry, 62.5% were aneuploid. With regard to the ovarian lesions, 68.2% were grade 1, 68.2% were stage I, and 71.4% were aneuploid by flow cytometry. Twelve (54.5%) of 22 patients had pathologic evidence of coexisting endometriosis. Overall, three-year survival was 75%. All 11 patients with stage I disease at both sites were alive, without disease, at a mean follow-up of 34.9 months. CONCLUSION: Patients with synchronous endometrioid tumors of the endometrium and ovary are generally younger than reported for either endometrial adenocarcinomas or ovarian epithelial adenocarcinomas. They tend to be low grade and early stage and are frequently associated with endometriosis. Our data suggest that the survival of patients with synchronous primaries correlates with the stage of the individual tumors and that a second, synchronous primary does not adversely affect prognosis.

The use of minoxidil to attempt to prevent alopecia during chemotherapy for gynecologic malignancies.

Minoxidil 2% topical solution applied twice a day is known to induce hair growth and prevent hair loss in normal male pattern baldness. Based on this potential, this pilot study tested the effect of Minoxidil on hair loss during chemotherapy for gynecologic cancers. Ten women about to start alopecia-inducing chemotherapy protocols were entered into this non-randomized prospective trial. By study design, each patient served as her own control, as only a portion of the scalp was treated with Minoxidil. Four of the ten patients were unevaluable for failing to comply with the twice-a-day Minoxidil application schedule. Of the six evaluable patients, five experienced complete or severe symmetrically diffuse hair loss, all of which occurred within four weeks of initiating chemotherapy. One patient had no hair loss in either the treatment or control area. Application of the topical Minoxidil in all ten patients had no untoward side effects, skin changes or hypotension. Thus, in this pilot study, 2% Minoxidil was non-toxic but showed no benefit in the prevention of chemotherapy-induced alopecia.

[Endomyocardial biopsy in children and adolescents]. / Biopsja endomiokardialna u dzieci i mlodziezy.

24 endomyocardial biopsies were performed in children aged 4-18 (x = 12.9) without any complications. The endomyocardial biopsy was performed in 12 patients with the heart failure of unknown origin (6 - restrictive heart disease, 4 - dilated cardiomyopathy with arrhythmias, 2-post-inflammatory dilated cardiomyopathy), in 5 patients with a clinical diagnosis of myocarditis, in 1 with the hypertrophic cardiomyopathy, in 2 cases of the dilated cardiomyopathy without heart failure and in 1 girl with the recurrent exudative pericarditis. Active myocarditis with fibrosis was stated in 2 cases of a restrictive heart disease, mild inflammatory state in 2 patients with a clinical diagnosis of the myocarditis and in 3 others with the dilated cardiomyopathy. All of 7 patients with the myocarditis underwent the immunosuppressive therapy. In the patient with endomyocardial fibrosis the result of left ventricular biopsy corresponded with angiocardiographic diagnosis. Non-specific changes in biopsies were stated in 2 children with the restrictive cardiomyopathy and in 5 with the dilated cardiomyopathy. Bioptic, morphologic lesions in patients with the dilated cardiomyopathy did not correlate with hemodynamic parameters of contractility. Biopsies were normal in 6 subjects. Endomyocardial biopsy influenced on making a decision of the therapy in 9 of 21 patients (42.8%). Diagnosis was verified in 7 patients (38.3%) basing on endomyocardial biopsy. In 18 of 24 subjects (75%) endomyocardial biopsy contributed to the interpretation of the disease pathology.

[Late results of immunosuppressive therapy in patients with heart failure and biopsy proven myocarditis]. / Odlegle wyniki leczenia immunosupresyjnego u chorych z niewydolnoscia serca i bioptycznie rozpoznanym zapaleniem miesnia sercowego.

Late results of 6-month immunosuppressive therapy (prednisone from 1.5 mg/kg b.w. and azathioprine 2 mg/kg b.w.) simultaneously performed with a conventional treatment were analyzed in 20 patients with heart failure of unknown origin and bioptic diagnosed myocarditis. Average patients' age was 33.8 +/- 10.7 years, mean disease duration--7.8 month, mean left ventricular ejection fraction--25.9 +/- 8.9%. Follow up period was at least 24 months in all patients. 1 patient died before the end of therapy. After 6-month immunosuppressive therapy improvement was stated in 10 patients (50%)--group A, stable disease course in 3 (15%)--group B and deterioration in remaining 6 (30%)--group C. After the next 18 month conventional therapy as many as in 8 of 10 group A patients deterioration was observed, further improvement (EF increase from 17% to 43%) in 1 female patient and a stable disease course in the another female. Of 3 group B patients in 1 further improvement was observed and a stable course in 2 remaining. Of 6 group C patients 4 died, 1 underwent cardiac transplantation, 1 female patient is still alive, but does not put herself to control examinations. Early improvement after 6-month immunosuppressive treatment does not prejudge the later prognosis.

[A case of eosinophilic leukemia]. / Przypadek bialaczki kwasochlonnej.

The clinical course and diagnostic difficulties in a case of eosinophilic leukaemia are described. For a long time period the case showed clinical manifestations of a hypereosinophilia syndrome. Shortly before death clinical signs of leukaemia developed, and the diagnosis was confirmed on autopsy.