Topical 5-fluorouracil treatment of transformation zone intraepithelial neoplasia of cervix and vagina.

The authors present preliminary findings in 11 unselected patients with upper vaginal and/or cervical transformation zone intraepithelial neoplasia treated with a 5% topical 5-fluorouracil (5-FU) cream. Only 6 of 11 patients were found to be cured of disease when subsequently evaluated histologically by conization biopsy and/or hysterectomy. Although further clinical trials using differing concentrations and/or more prolonged exposure to the drug may be warranted, the authors cannot recommend topical 5-FU as a replacement for standard outpatient therapy for upper vaginal and/or cervical intraepithelial neoplasia.

Primary invasive squamous carcinoma of the vagina.

Forty-three cases of primary vaginal squamous cell cancer were treated at the University of Wisconsin Hospital between 1956 and 1971. These cases comprised 1.2% of patients admitted to the University Hospital with female genital tract cancer. Evidence is presented to support a modification of the currently accepted FIGO staging system for vaginal carcinoma (Stage II disease). Radiation therapy using both external beam and brachyradium equivalents or interstitial implantation of suitable isotopes was an effective method for the treatment of patients having early and locally advanced invasive vaginal cancer. The 5-year absolute survival rate for the entire series was 37.2%. Absolute survival rate by modified FIGO clinical staging was 66% for Stages I and IIA, 31% for Stage IIB, 25% for Stage III, and 0% for Stage IV.

Mechanisms of chromatid breakage in human lymphocyte cultures.

G2 banding of human peripheral blood cultures with actinomycin D and tetracycline produced chromatid breakage in lightly stained Giemsa bands, and the number of such breaks tended to increase with fixation time. Chromatid breakage due to 3H-thymidine incorporation into DNA was also localized in light bands, but the number of these breaks did not increase with fixation time. These findings suggest that modification of chromosomal protein as a result of exposure to AMD or other chemicals following DNA synthesis can result in fixative-dependent chromatid breakage of susceptible chromosomal regions, unlike breakage due to 3H-thymidine which primarily affects DNA and is not affected by fixation. Thus, chromatid breakage observed in short-term lymphocyte cultures is not necessarily evidence of mutagenicity involving DNA, but rather may be due to toxic effects on synthesis or attachment of chromosomal proteins.

Retroperitoneal seminoma.

A case of retroperitoneal seminoma is discussed, emphasizing the importance of diagnosing the primary lesion. Although the testes were normal to palpation and exploration a focus of seminoma was recognized in the left testicle. We prefer radical treatment of this potentially curable disease.