Occult breast cancer presenting with axillary metastasis.

The literature of occult breast cancer is reviewed and the management of our 43 patients is discussed. In 20 patients mastectomy and axillary block dissection, in nine upper-outer quadrant resection of the breast with axillary block dissection, and in two axillary biopsy were carried out. The primary tumour was found only in 11 patients during the first operation, either by macroscopic or microscopic examination. In 12 patients the primary breast tumour became detectable only later. Out of the 20 mastectomy specimens two primary tumours could not be identified even with the most thorough examination. In four patients of the breast conservation group the primary tumour remained occult until recently, and in the axillary block dissection group (12 patients) the site of the primary cancer could be identified only in two patients. The difficulties of the diagnosis and the dilemmas of the surgical indications and treatment are dealt with.

Comparative evaluation of manual and instrumental rectum resections.

The authors compared the perioperative results of 125 + 125 Dixon operations performed at two time intervals (1956-1979 and 1985-1990), the postoperative recurrences and the survival data. It is established that, from the anastomosis point of view, the instrumental resections--beside their rapidity and favourable sterility--are safer interventions associated with less complications. With respect to local recurrences the two methods do not differ significantly. A further advantage of the double stapling is that a larger number of patients can undergo a sphincter-saving resection, and a lower lying anastomosis can be performed than with hand-sewn sutures.

Surgery of primary retroperitoneal tumours.

Upon detecting 112 retroperitoneal space-reducing processes the authors operated on 62 adults with primary retroperitoneal tumours (12 benign and 50 malignant). The diagnostics and complex therapy of these tumours are dealt with. It is established that although the CR, MRI and USG have resulted in a considerable development, the therapeutic results are still not much better. In the surgical management of benign lesions total tumour extirpation is recommended even with extensive multivisceral resections. For tumours of low grade malignancy the authors have the same standpoint. In case of PRTs of high grade malignancy--and a considerable number of patients belongs to this group--the ultraradical interventions are not associated with promising results and therefore are not recommended by the authors. In the complex management of primary retroperitoneal tumours the achievements of radio- and chemotherapy are nowadays rather only promising, rather than notable.

[Occult breast cancer causing axillary metastasis]. / Hónalji nyirokcsomó áttétet adó okkult emlörák.

Authors review 43 cases of occult breast cancer selected from 6396 patients operated on for breast cancer in the National Institute of Oncology, Budapest over a 20-year period (1972-1991). In 20 patients mastectomy and axillary block dissection, in 9 upper-outer quadrant resection of the breast with axillary block dissection, in 12 only axillary block dissection, and in 2 axillary biopsy were carried out. The primary tumor was localized only in 11 patients during the first operation either by macroscopic or by microscopic examination. In 12 patients' breast the primary tumor became detectable only later. Out of the 20 mastectomy specimens, 2 primary tumors could not be identified even with the most thoroughful examination. Out of the breast conservation group in 4 patients, the primary tumor remained occult until recently, and in the axillary block dissection group (12 patients) the site of the primary cancer could be identified only in 2 patients. The authors deal with diagnostic difficulties and the dilemmas of the surgical indications and treatment.

[Diagnosis and therapy of retroperitoneal tumors]. / A retroperitonealis daganatok diagnosztikája és therapiája.

Upon detecting 112 retroperitoneal space reducing processes the authors operated on 62 adults with primary retroperitoneal tumours. Of them there were 12 benign and 50 malignant tumours. The diagnostics and complex therapy of these tumours are dealt with. It is established that although the CR, MR, and USG have resulted in a considerable development the therapeutic results are still not far better. In the surgical management of benign lesions total tumour exstirpation is recommended even with extensive multivisceral resections. For tumours of low grade malignancy the authors have the same standpoint. In case of retroperitoneal tumours of high grade malignancy--and a considerable number of patients belongs to this group--the ultraradical interventions are not associated with promising results therefore they are not recommended by the authors. In the complex management of primary retroperitoneal tumours the achievements of radio- and chemotherapy are nowadays rather only promising than notable.

[Carcinoid tumor of the breast]. / Az emlö carcinoid daganata.

Two cases of carcinoid breast tumour are presented by the authors. Discussing the diagnostic and therapeutic possibilities, it is emphasized that this type of tumour represent a bad prognosis, in spite of the relative benign behaviour of the carcinoid tumour of other organs. In case of carcinoid tumour of the breast, radical operation and careful follow-up is recommended.

[Tuberculosis of the female breast]. / Die Tuberkulose der weiblichen Brustdrüse.

The authors briefly summarize the most important characteristics of the female breast tuberculosis. They base their data on 7 histologically verified cases as well as on 2 other cases which, in view of the course of disease, were suspected to be breast tuberculosis. The various courses of disease as well as the difficulties in its differential diagnostic are described.

Correlation between the results of carcinoembryonal antigen (CEA) test and the clinical stage of colorectal carcinoma.

Correlation between results of CEA test and clinical stage of colorectal carcinoma is described. No correlation was found between the different stages and the actual CEA titre. Normalization of an increased preoperative serum CEA level indicated, however, nearly always the radical character of the intervention. Critically high (above 30 ng/per ml) CEA value observed in Dukes' stages C and D can be considered bad prognostic signs. Patients like these died within one year. Results of CEA tests are also useful complementary data contributing to the diagnosis of recurrence or distant metastases.

Branchiogenic carcinoma (malignant branchioma).

The authors describe the characteristics of branchiogenic carcinoma as that of a pathological entity on the occasion of reporting four cases. The clinical course of the disease and the cytological and histological features are discussed on the basis of our observations and literature data. The authors stress the importance of careful and repeated clinical examinations, which exclude the possibility of a primary tumor of other localization, in establishing the diagnosis of branchiogenic carcinoma.

Indication and clinical evaluation of radical and semiradical neck dissection on the basis of 271 operations.

Between the period of 1956 and 1973, 271 radical and semiradical neck dissections were performed. The 'en bloc' method was used in 75 patients with cancer of the larynx and in 47 thyroid cancer patients. Analysis of the patient material revealed the operative mortality of 1.5%. 5-year survival was observed in 34.8% of the patients. The incidence of local recurrence amounted to 21%.

[Operability and prognosis of rectosigmoid cancer]. / Angaben zur Operabilität und Prognose der rektosigmoidalen Krebse.

The data of 571 rectosigmoidal cancer patients treated between 1959 and 1972 analysed to establish the factors hindering operability. The most important factor was a belated diagnosis. Suggestions are made for early diagnosis to improve the rate of early operations and thereby the prognosis.