Symmetrical multifocal liposarcoma.

Multiple liposarcomas are extremely rare. We report on a patient with liposarcoma of the right lower limb who had undergone surgery and radiotherapy 4 years previously for a liposarcoma in the left lower limb. An outline of the management is discussed and a short review of available literature is given.

Angiosarcomas--clinical profile, pathology and management.

Files of 8 patients with primary angiosarcomas treated in the Department of Radiation Oncology at the University of the Witwatersrand from 1982 to 1995 were identified. None of these patients had received prior radiotherapy or chemotherapy which would have predisposed them to the formation of an angiosarcoma. Slides of 6 patients were reviewed. Five of the 6 were confirmed as having angiosarcomas, while 1 patient was found to have a peripheral neuro-epithelial tumour. Four patients had angiosarcomas of the breast, while there was 1 patient each with angiosarcoma of the skin, intestine and brain. Complete excision was the primary modality of management whenever possible. Postoperative radiotherapy was given in cases of incomplete excision, patient refusal of radical surgery or gross tumour. Four patients died within 4 months of diagnosis. Three patients are alive (2 with no evidence of disease) 22-96 months after diagnosis. In 1 patient follow-up details were not available as he did not return for treatment. Angiosarcomas are aggressive malignant tumours arising from the endothelial cells. Complete surgical excision is the treatment of choice in the management of this aggressive disease, which has a poor prognosis.

Neuroblastoma in adults. A report of 3 cases.

Well documented as one of the more frequent tumours of childhood, neuroblastomas in adults are rare. Correct diagnosis, and distinction from other small-cell neoplasms, is thus often delayed. Three further cases are described in 2 women and 1 man between the ages of 26 years and 47 years. Metastatic disease existed at the time of initial presentation in 1 patient, while another had experienced multiple recurrences at the primary site before correct diagnosis. All, however, had a favourable response to chemotherapy, albeit in the short term. Primary diagnosis was made by fine-needle aspiration cytology, together with electron microscopic evaluation of aspirated cells in 1 case. The histological, cytological and electron microscopic characteristics of neuroblastomas are presented and illustrated, and their differentiation from other small cell tumours in adults discussed.

Von Recklinghausen's disease associated with a primary malignant schwannoma of the breast.

A case of a primary malignant schwannoma of the breast is reported. This case and the review of the literature illustrate the problems of diagnosing and treating this rare malignancy.

Toxicity in patients with testicular seminoma treated with radiotherapy. Different dose levels and treatment fields.

The aim of this study was to evaluate the acute and late effects of irradiation in 56 patients with stage I and II testicular seminomas. A retrospective study of patients' records was performed paying attention to the acute and late toxicity of radiation in relation to treatment fields and radiation doses. Treatment groups were compared using the chi squared-test. Mild to moderate nausea and/or vomiting was seen in 66% of patients and occurred equally independent of the treatment volume or radiation dose. Increased bowel frequency was seen in 59% and was more common when a larger treatment volume was used. Skin reactions increased with increase in treatment volume and dose (p = 0.046). Severe late complications were recorded in two patients (myocardial damage-1/4 at risk, duodenal ulcer-1/56 at risk). These could not be attributed solely to the irradiation as other contributing factors might play a role. Overall the data suggest that the risk of major posttreatment morbidity is minimal for patients with testicular seminoma treated with postoperative radiotherapy.