A patient with malignant carcinoid tumor of the ileum and a prior primary carcinoma of the cervix later developed primary adenocarcinoma of the ascending colon, an adenomatous duodenal polyp, and two gastric leiomyomas. The duodenal polyp contained neoplastic Paneth cells. The frequency of carcinoid tumors coupled with other primary malignancies (about one third), especially of the G.I. tract, may reflect ah enhanced susceptibility to cancer in carcinoid patients.
The rapidity and the magnitude of progress in molecular biology slipped by many of us practicing surgeons. Although articles about molecular medicine appear regularly in our surgical literature, for many of us, their content is rather mysterious. The articles often end with a glossary, because most readers do not understand the language. In November 1993, the entire issue of the Archives of Surgery was devoted to molecular medicine. In an editorial, Claude Organ, Jr, MD, a member of this association, encouraged the surgeon to "cohabit" with the molecular scientist. Many university departments of surgery have professors who are both surgeons and molecular biologists. Ed Passaro, MD, also a member of this association, observed in 1992 that most surgeons had overlooked this new field and needed to learn about it to play a role in applying it to clinical medicine. That means knowing what new tests and treatments are available and how to apply them. It means being able to counsel patients. Also, it is important for knowledgeable surgeons to serve on the regular hospital committees that will oversee these new tests and treatments, and to offer their unique judgment in assessing risk, reward, and ethical implications.
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