OfT malignant melanomas in childhood21 8% 4% 61 and contradictory statements in the literature regarding their occurrence,l7. 84metastasis, and mortality ratelo.3% 38 originally stimulated our interest in this group of childhood lesions.The presentation of histological descriptions by Spitz and her attempt to differentiate childhood juvenile melanomas with a benign course from adult malignant melanomas prompted us to investigate our experience with patients in this age group.The purpose of this article is to present our findings in a study of benign and malignant pigmented tumors surgically removed from children at the Mayo Clinic. MATERIALS AND METHODSIn order to collect as complete a series of pigmented tumors as possible, a review was made of the records of all children 12 years of age or younger seen at the Mayo Clinic from 1907 to 1949 inclusive in whom diagnoses of benign and malignant tumors were made.From this group were selected all cases in which tissue representing surgically removed pigmented nevi and malignant melanomas of the skin was available for study.Lesions of the eyes and mucous membranes were excluded.A total of 172 pigmented lesions (moles and melanomas) was collected in this fashion.Routine histological sections stained with hematoxylin and eosin were used throughout.Multiple sections were made and, when necessary, serial block sections of an entire lesion were studied.Silver nitrate and iron stains were found useful for identification of melanin.
Mesothelioma, even of the pleura alone, is a ubiquitous pathological designation. The diffuse variety is associated with an ominous prognosis. The localized mesothelioma generally has been assumed to be benign. A review of tumors from 60 patients with localized pleural mesothelioma seems to justify separation into benign (52 patients) and malignant (eight patients) variants. Histologic criteria are used primarily to make this division. No single clinical feature allowed preoperative predictability concerning benignity or malignancy, although extrathoracic osteoarthropathy was seen only with benign lesions (20 percent), usually those greater than 7 cm. Follow-up periods of as long as 24 years revealed recurrent tumor in only two of the 58 patients with benign lesions and revealed a survival curve identical to that of the general population. All of the patients with the malignant variety had recurrence or metastasis, and all but one were dead within 2 years of the initial operation. One patient died of tumor complications after 9 years. More aggressive local resection is indicated for the malignant variant.
Four women and 1 man receiving protracted treatment with iodides for asthma or bronchitis and exhibiting diffuse thyroidal enlargement were studied. Needle biopsy of the thyroid gland revealed parenchymatous hypertrophy in all. The goiter and myxedema receded on discontinuance of the use of iodides or on administration of thyroid. One patient, followed for more than two years, demonstrated rapid uptake of radioactive iodine over the thyroid gland when the scrum iodide127 reached levels of 12.4 micrograms per 100 ml.; organic binding of iodine did not occur at that time, as documented by the lack of proteinbound radioiodine (PBI131) in the serum (conversion ratio), the rapid decay of radioactivity from the thyroid gland at rates parallel with the decay from the thigh, and the appearance of radioactivity in the urine. Lack of organic binding also was demonstrated by historadiologic technics. When concentrations of iodide127 had reached 0.56 microgram per 100 ml. of serum, the uptake of I131 over the thyroid gland was avid and protracted; at that time, PBI131 appeared in the serum at a rate that was faster than normal. Studies with potassium iodide showed pronounced sensitivity of the thyroid in these patients to the inhibiting effects of iodides on the organic binding of iodine, quite comparable in nature to the findings in Graves′ disease. The similarities between the clinical picture of iodide goiter and that of Hashimoto's thyroiditis are stressed.
Abstract A series of twenty-nine cases is presented in which thirty parotidectomies were performed for recurrent chronic sialadenitis. The results during the follow-up period have been excellent, except in one case in which subtotal parotidectomy had been performed and a recurrence developed five months later. Based on the experience in this series it is recommended that when symptoms of chronic or recurrent parotitis are of sufficient severity and duration and do not respond to conservative measures, subtotal or total conservative parotidectomy should be performed. With proper technic these procedures can be performed without danger of injury to the facial nerve and with complete relief of symptoms.
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