A case of an infiltrative adenocarcinoma developing in a villous adenoma in a reduplication of the cecum is presented. Review of the causes of reduplication of the colon as well as the presence of villous adenomas of the right colon are discussed by the authors. The clinical difficulty of the recognition of this entity is emphasized. The authors believe this to be the only case ever reported.

A case of malignant interstitial cell tumor of the testis in man and a review of the literature is presented. This is a rare steroid‐producing tumor; a careful search revealed only 9 published cases. The inadequacy of radiotherapy in management of the disease is dramatically demonstrated. (Periaortic nodes containing metastatic cancer were identified in retroperitoneal areas previously exposed to intensive cobalt therapy.) This lack of radiosensitivity leads to a plea for the use of a radical surgical attack as initial therapy. Illustrations of the comfortable and extensive exposure for a retroperitoneal node dissection using the Nagamatsu approach and technique are presented. Particular interest is aroused by this tumor because its endocrine activity so closely resembles that of cancer of the adrenal cortex. The hormonal disturbances such as gynecomastia and elevated testosterone levels are discussed, as well as the use of OP1‐DDD as a chemotherapeutic agent.

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Amputation of a limb has been the treatment of choice for osteogenic sarcoma of bone for the past 50 years with little change in the 5%‐10% 5‐year survival rate. Preoperative radiation therapy and amputation between tourniquets has not altered the survival rates in our area. In the State of Connecticut, 75% of the cases have died of pulmonary metastases within one year. This suggests that bloodstream metastases are extremely important. We have been doing preliminary laparotomies prior to amputation in bone sarcoma to determine evidence of intra‐abdominal spread to the liver or periaortic nodes. Common iliac vessels and femoral vessels are tied off to prevent dissemination of the cancer prior to manipulation for ampuatation of the extremity.

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