Age estimation and validation for South Pacific albacore Thunnus alalunga.

Validated estimates of age are presented for albacore Thunnus alalunga, sampled from a large part of the south-western Pacific Ocean, based on counts of annual opaque growth zones from transverse sections of otoliths. Counts of daily increments were used to estimate the location of the first opaque growth zone, which was completed before the first assumed birthday. The periodicity of opaque zones was estimated by marginal increment analysis and an oxytetracycline mark-recapture experiment. Both validation methods indicated that opaque zones formed over the austral summer and were completed by autumn to winter (April to August). The direct comparison of age estimates obtained from otoliths and dorsal-fin spines of the same fish indicated bias, which was assumed to be due to poor increment clarity and resorption of early growth zones in spines, resulting in imprecise age estimates. As such, age estimates from otoliths are considered to be more accurate than those from spines for T. alalunga. This is consistent with results for a growing number of tropical and temperate tuna Thunnini species. It is recommend that validated counts of annual growth zones from sectioned otoliths is used as the preferred method for estimating age-based parameters for assessment and management advice for these important stocks.

Chest wall tumors: experience with 58 patients.

A total series of 58 patients with chest wall neoplasms were compiled. There were 13 benign neoplasms and 45 malignant neoplasms. There were 28 total primary chest wall neoplasms, 15 (53.3%) of which were malignant. Of the primary chest wall neoplasms, chondrosarcoma was the most prevalent (5) followed by fibrosarcoma (3) and plasmacytoma (3). Because of the high incidence of malignancy found in this study, all chest wall tumors should be regarded as malignant until proven otherwise. Because of this, wide excisional biopsy with tumor-free margins should be carried out for all chest wall neoplasms to ensure the best survivability.

Adenocarcinoma of unknown primary site presenting as an isolated retroperitoneal mass and Trousseau's syndrome.

BACKGROUND: There are few reported cases of adenocarcinoma of unknown primary site (ACUPS) presenting with Trousseau's syndrome, and no cases presenting as an isolated retroperitoneal pelvic mass. CASE: This is a case of a 36-year-old woman who presented with an isolated "pelvic" mass and Trousseau's syndrome. The patient underwent abdominal hysterectomy and bilateral salpingo oophorectomy with resection of the retroperitoneal lymph nodes. Surgical findings included normal-appearing uterus, fallopian tubes, and ovaries, with bilaterally enlarged pelvic lymph nodes. Pathology was positive for adenocarcinoma only in the pelvic lymph nodes. Uterine, ovarian, and fallopian tube final pathologies were negative for malignancy. Postoperative metastatic survey was negative, and the patient was diagnosed with ACUPS. The patient received adjuvant chemotherapy consisting of etoposide, carboplatin, and taxol. The patient died 18 months after diagnosis. CONCLUSION: This case reminds us that ACUPS can present as Trousseau's syndrome and rarely as an isolated retroperitoneal pelvic mass.

Cervical carcinosarcoma occurring after subtotal hysterectomy, a case report.

Subtotal hysterectomy has been advocated in recent years as an alternative to total abdominal hysterectomy. In leaving behind the uterine cervix, this remnant can be at risk for dysplastic and neoplastic changes. The development of cancer of the cervix after subtotal hysterectomy is considered low and is usually of an epithelial origin. Carcinosarcomas of the uterine corpus are infrequent aggressive tumors with a very poor prognosis. This malignancy of the cervix has been rarely reported. We present a case of cervical carcinosarcoma occurring in the remaining lower uterine segment and cervix following subtotal hysterectomy for pelvic pain.

Late presentation of an alpha-fetoprotein secreting isolated large upper abdominal retroperitoneal Sertoli-Leydig cell tumor recurrence.

The following case reports the surgical and adjuvant treatment of a solitary upper abdominal retroperitoneal recurrence of a poorly differentiated Sertoli-Leydig cell tumor (SLCT) which presented 4 years after the original diagnosis. The patient was treated with en bloc resection of the mass, which included her left kidney, adrenal gland, and distal pancreas. She received four courses of adjuvant chemotherapy and remains without evidence of malignancy. Both the primary and recurrent tumor secreted alpha-fetoprotein allowing serologic follow-up. The utility of serum alpha-fetoprotein in disease response to treatment and for surveillance of recurrence is also shown.

Recurrent squamous cell carcinoma of the Bartholin's duct treated with en bloc resection.

Bartholin's gland carcinomas are a rare entity. A case of a recurrent Bartholin's gland carcinoma is described. These neoplasms have a myriad of treatment options for primary therapy but there is a paucity of information regarding treatment for a lethal recurrence. The patient's primary therapy consisted of an initial wide local excision followed by radiation therapy with chemosensitization. She was disease-free for 2 years before her recurrence. A novel treatment approach incorporating a mulitdisciplinary en bloc radical surgery is described. The patient is alive and well without evidence of disease at 22 months.

Ureteral carcinoma presenting as a complex pelvic mass in a post menopausal patient.

This is a report of a low-grade ureteral carcinoma presenting as a pelvic mass in a postmenopausal woman with a prolonged history of lower back pain. A right complex adnexal mass and right hydroureter and hydronephrosis in an atrophic nonfunctioning right kidney was found during evaluation for the back pain. Operative evaluation revealed a normal uterus and ovaries; however, a 2 x 3-cm mass in the right ureter was found at the level of the uterine arteries. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and right nephroureterectomy were performed with pathology returning grade I papillary transitional cell carcinoma of the ureter.

Collision of uterine rhabdoid tumor and endometrioid adenocarcinoma: a case report and review of the literature.

Extrarenal malignant rhabdoid tumors have been reported in a variety of anatomic sites but infrequently in the female genital tract. In the uterus, they have been described as a pure tumor, in association with endometrial stromal sarcomas, and as a component of a malignant mullerian mixed tumor. This study reports an unusual uterine neoplasm in a 49-year-old woman, in which a malignant rhabdoid tumor occurred as a collision tumor with a well-differentiated endometrioid adenocarcinoma. The tumor was a 14-cm polypoid mass that filled the endometrial cavity. The two neoplastic components were distinct on microscopic and immunohistochemical examination. Ultrastructural examination confirmed the rhabdoid phenotype of the sarcomatous component. The patient died of disease 4 months after diagnosis with progression of the malignant rhabdoid tumor. The highly aggressive behavior of the rhabdoid (i.e., nonepithelial) component in this collision tumor lends support for a distinction of this neoplasm from a malignant mullerian mixed tumor, with which it may be confused.

Age-specific survival of women with endometrioid adenocarcinoma of the uterus.

OBJECTIVE: The purpose of this paper was to evaluate the age-specific survival for women diagnosed with endometrioid adenocarcinoma of the uterus. METHODS: A retrospective analysis was conducted of 328 patients diagnosed with endometrioid adenocarcinoma of the uterus between January 1990 and December 1997. Patients were followed for 3 to 96 months with a mean of 43 months. The impact of age on survival was assessed using Cox proportional hazard regression and multivariate analysis for age, stage, and grade. Stage and grade were analyzed using log-rank tests, and survival curves were generated by the Kaplan-Meier method. RESULTS: A total of 328 patients were evaluated. Multivariate analysis revealed age, stage, and grade were all significant independent predictors of survival (P < 0.0001). Age-specific survival varied from a high of 90% at age 40 to a low of 55% at age 80. Interval age-specific survival decreased below 86% at age 50. Subset analysis of patients younger than 50 compared with older patients revealed no difference in surgical stage or grade of tumors among these patients. Patients older than 50, however, were 41% more likely to receive adjuvant radiation therapy. CONCLUSION: Age is a specific, significant predictor of outcome in endometrioid adenocarcinoma of the uterus. Survival decreases significantly in patients older than 50. This decreased survival associated with age is unrelated to surgical stage or grade of adenocarcinoma. Decreased survival could involve molecular differences in the developing endometrial cancer or an increased risk of death from other non-cancer-related factors.

The role of p27 in endometrial carcinoma.

OBJECTIVE: The cyclin-dependent kinase inhibitor p27 has been shown to mediate cell growth arrest in response to various environmental stimuli. p27 protein levels have shown prognostic value in several different types of cancer. We examined the prognostic value of p27 protein expression in endometrial cancer, the most common gynecologic malignancy. METHODS: A total of 95 paraffin-embedded tumor blocks were obtained and stained via immunohistochemical techniques with a monoclonal antibody against p27. Ten high-power fields were evaluated per slide with at least 1000 cells per slide and two slides per specimen evaluated by two reviewers for nuclear and cytoplasmic staining. The specimens were evaluated for associations with age, stage, grade, and histology. Statistical analysis was performed using the Student t test, chi(2) Kaplan-Meier, and likelihood ratios to assess the data and to generate P values. RESULTS: A total of 91 patients met inclusion criteria for statistical analysis. Fifty-three patients were stage I, 13 stage II, 14 stage III and 11 stage IV with a positive stain (>50% of cells) for p27 obtained in 32.1, 23.1, 35.7, and 36.4%, respectively (Student t test P = 0.77). Survival data were available on 24 advanced stage patients. p27 protein immunostaining showed no association with patient survival. We also found no association of p27 staining with age or histology. Notably, we found a trend in increasing staining with increase in grade, particularly with stage I patients. Also, there was an association of the nuclear and cytoplasmic staining and stage (P = 0.05), but it had no correlation with patient survival. CONCLUSION: Our study showed decreased p27 protein staining in endometrial cancers compared to normal endometrial cells. We found that p27 protein staining shows no association with stage, age, or histology and is not prognostic for survival in advanced endometrial cancers. However, there may be a trend associated with increased p27 protein staining with advanced grades of tumors.

Equal care ensures equal survival for African-American women with cervical carcinoma.

BACKGROUND: [corrected] It was the purpose of this study to investigate whether race is an independent prognostic factor in the survival of patients with cervical carcinoma in a health care system with minimal racial bias, and few barriers to access to care. METHODS: Records for patients with a diagnosis of invasive cervical carcinoma from 1988 to 1999 were obtained from the Automated Central Tumor Registry for the United States Military Health Care System. Clinical data including race, age at diagnosis, histology, grade, stage, socioeconomic status, treatment modality, and survival also were obtained. Survival analysis was performed with Kaplan-Meier survival curves. RESULTS: One thousand five hundred fifty-three patients were obtained for review. Sixty-five percent of patients were Caucasian, and 35% were minorities. Of the minorities, 29% were African Americans (AAs). Mean age of diagnosis was similar among AAs and Caucasians, 44 and 42 years, respectively. There was no statistically significant difference between the distribution of age, stage, grade, or histology between Caucasians and AAs. Forty-six percent of patients were treated with surgery and 56% with radiation therapy, with no difference in type of treatment between the Caucasian and AA groups. Five- and 10-year survival rates for Caucasians and AAs were 75%, and 76%, and 64% 65% (P = 0.59), respectively. CONCLUSIONS: In an equal access, unbiased, nonracial environment, race is not an independent predictor of survival for patients with cervical carcinoma. This study has shown, for the first time to the authors' knowledge, that when they receive equal treatment for cervical carcinoma, AA women's survival can approach that of their nonminority counterparts (75% at 10 years).