For patients with localized SS, histologic grade but not SYT-SSX fusion type is a strong predictor of survival.

The aberrant nonspherical portion of the femoral head in young patients with an impingement conflict consists of hyaline cartilage which shows clear degenerative signs similar to the findings in osteoarthritic cartilage. The tissue alterations are distinctly different when compared with a control group, which substantiates an impingement conflict as an early mechanism for degeneration at the hip joint periphery.

Background-Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. Aims-To determine the significance of histological findings of patients with malignant polyps. Methods-Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67 months). Results-Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16 (42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. Conclusion-As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems suYcient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk. (Gut 1998;43:669-674)

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BACKGROUND The low incidence and histologic heterogeneity of primary parotid carcinomas makes it difficult to evaluate the value of preoperative fine‐needle aspiration cytology (FNAC) and intraoperative frozen section (FS) analysis. In the current study, the authors reviewed a single institution's experience regarding the preoperative and intraoperative diagnostic value of FNAC and FS in primary salivary gland carcinomas. METHODS Between January 1990 and December 2002, 108 primary parotid carcinomas were resected at the Department of Otorhinolaryngology, Head and Neck Surgery at the University of Berne, Inselspital (Berne, Switzerland). Included in the study were a total of 101 carcinomas with preoperative FNAC results in 88 tumors and/or intraoperative FS results in 45 tumors. In a retrospective study, the results of FNAC and FS were analyzed and compared with the corresponding histopathologic diagnoses. RESULTS The cytologic findings were true‐positive for malignancy in 63 tumors (72%), false‐negative in 22 tumors (25%), and nondiagnostic in 3 tumors (3%). The tumor grading was correct in 29 of 63 tumors (46%), and the exact tumor typing was correct in 27 of 63 (43%) true‐positive tumors. The FS findings were true‐positive for malignancy in 43 of 45 tumors (96%), the tumor grading was correct in 35 of 45 tumors (78%), and the tumor typing was correct in 32 of 45 tumors (71%). Overall, at the time of surgery, of the 101 parotid carcinomas, the tumor was known to be malignant in 83 tumors (82%), and the correct grade and the exact tumor type were known in 55 tumors (54%) and 48 tumors (48%), respectively. CONCLUSIONS FNAC recognized malignancy in 72% of tumors, but it could not be relied upon to provide an accurate tumor grading or typing. Therefore, FNAC alone is not prone to determine the surgical management of primary parotid carcinomas. The current analysis showed the statistically significant superiority of FS compared with FNAC regarding the diagnosis of malignancy, tumor grading, and tumor typing in primary parotid carcinomas. Cancer 2004. © 2004 American Cancer Society.

CXPAs are difficult to identify preoperatively. FNAC has a low accuracy and sensitivity. CXPAs versus PAs are significantly more frequently localized in the deep lobe and are significantly greater in size.

The diagnosis of malignancy was known preoperatively in 59 (71%) cases, the exact histologic tumor type in 36 (43%) and the grade in 37 (44%) of 83 cases. Occult metastases were detected in 8 (20%) of 41 cNO patients, in 5 cases associated with a high-grade and in 3 cases with a low-grade carcinoma. Recurrence of disease developed in 5 (12%) patients in the elective neck dissection group and in 11 (26%) patients in the observation group. All of the 7 neck recurrences occurred in the observation group. The 5-year actuarial and disease-free survival rate was 80% and 86% for patients with elective neck dissection and 83% and 69% for patients without neck dissection. Conclusion and significance A routine elective neck dissection is suggested in all patients with primary carcinoma of the parotid gland. The efficacy of elective neck dissection, nevertheless, has never been evaluated prospectively.

MAT represent an important source of arterial thrombembolism. A diagnostic workup of the aorta, preferably by means of CT or MRI, should be performed in all patients in whom other sources of embolization have been ruled out. The ideal therapeutic approach to these patients still awaits prospective evaluation. However, based on our experience, MAT can be successfully treated with a definitive surgical procedure in selected patients, with low mortality and morbidity.