Pseudomyxoma peritonei: treatment with intraperitoneal 5-fluorouracil.

Four patients with pseudomyxoma peritonei associated with mucinous tumors of the ovary were treated with cytoreductive surgery followed by intraperitoneal (IP) 5-fluorouracil (5-FU). CA-125 was elevated in three, and ca cinoembryonic antigen (CEA) in one patient; both fell to within normal levels following treatment. Two patients underwent reassessment laparotomy and one a reassessment laparoscopy with no evidence of disease following chemotherapy. The fourth patient refused surgical reassessment but remains clinically free of disease. Intraperitoneal 5-FU appears to be effective in pseudomyxoma peritonei. Précis: Four patients with pseudomyxoma peritonei associated with ovarian tumors were successfully treated with surgery and intraperitoneal 5-FU.

Papillary peritoneal carcinomatosis after prophylactic oophorectomy.

Prophylactic oophorectomy has been recommended in patients with a strongly positive family history for ovarian carcinoma. A patient with a strongly positive family history underwent a prophylactic oophorectomy and, 5 years later, developed a primary peritoneal papillary serous adenocarcinoma. A prophylactic oophorectomy does not afford complete protection in some patients with familial ovarian cancer syndrome. Any tissue derived from the coelomic epithelium may potentially undergo multifocal malignant transformation.

Echinomycin (NSC 526417) in recurrent and metastatic nonsquamous cell carcinoma of the cervix. A phase II trial of the Gynecologic Oncology Group.

Eighteen evaluable patients with recurrent or metastatic nonsquamous carcinoma of the uterine cervix were treated with 1,500 micrograms/m2 of echinomycin every 4 weeks. Seven patients had received prior chemotherapy. There was one complete response (5.6%), 95% confidence interval for response of 0-27%. The major toxicity was nausea and vomiting, which was moderate to severe in eight patients. Myelosuppression was minimal. Echinomycin in this dose and schedule displays minimal activity in patients with advanced nonsquamous carcinoma of the cervix.

Transitional cell carcinoma of the renal pelvis with ovarian metastasis.

This article describes the first reported case of a primary transitional cell carcinoma of the renal pelvis metastatic to the ovary. The clinical presentation in our patient was similar to that of a primary ovarian carcinoma. The differential diagnosis of a primary or metastatic transitional cell carcinoma in the ovary is important and has therapeutic as well as prognostic implications.

Methotrexate in advanced endometrial carcinoma. A phase II trial of the Gynecologic Oncology Group.

Thirty-three patients with advanced or metastatic endometrial carcinoma were entered in a Phase II trial utilizing methotrexate, 40 mg/m2 intravenously on a weekly basis. Almost all patients had prior total abdominal hysterectomy and almost two-thirds prior pelvic irradiation. No patient had prior chemotherapy. There was one complete and one partial response, for a complete and partial response rate of 6% (95% confidence intervals for a response of 1.7 to 19.6%). Toxicity was mild, with major adverse effects being nausea and vomiting and myelosuppression. One death may have been drug related. Methotrexate displays minimal clinical activity in patients with advanced or recurrent endometrial carcinoma who have received no prior chemotherapy.

Tumor implantation after diagnostic laparoscopic biopsy of serous ovarian tumors of low malignant potential.

Two cases of tumor implants occurring in the abdominal trocar sites after diagnostic laparoscopic biopsies of ovarian papillary serous tumors of low malignant potential are presented. To the authors' knowledge, there have been no previous reports to describe tumor implants in the abdominal trocar sites after diagnostic laparoscopic biopsies of ovarian tumors of low malignant potential.

Malignant melanoma presenting as a unilateral ovarian neoplasm.

A 45-year-old female with a unilateral ovarian melanoma without residual ovarian teratoma or clinical evidence of primary lesion is described. The clinical and pathological differential diagnosis is discussed.