Clinical material and the results of treatment of 63 esophageal lye corrosion carcinoma patients are presented below. The mean age of patients at lye ingestion was 6.2 years; the mean latent time between lye corrosion and esophageal carcinoma was 41 years. The later the lye was ingested the earlier carcinoma of the esophagus appeared. Eighty-four percent of carcinomas(all of which were of histologically squamous cell type) were found to be in the bronchial bifurcation area of the esophagus. Sixty-eight percent of lye corrosion carcinoma patients had been treated with resection or radiotherapy (over 4000 rads). Every tenth patient of whole material had surveved for over seven years. Both surgery and radiotherapy as practiced in our clinics had better survival rates than for previous esophageal carcinoma series.

This report is an analysis of the medical records of 83 patients registered between 1960 and 1980 at Helsinki University Central Hospital as having malignant pleural mesothelioma. 65 of 83 patients had histologically confirmed malignant mesothelioma, and are the focus of this analysis. The remaining 18 (22%) patients were excluded because malignant mesothelioma was only confirmed cytologically, or because the primary tumor was not a mesothelioma. The ratio of men to women was 2:1.30 of 65 (46%) patients were not known or not likely to have been exposed to asbestos. The main symptoms at presentation were dyspnea, cough, chest pain, fatigue and weight loss. The median survival from diagnosis was 12 months, and from the onset of symptoms 18 months. Clinical stage and performance status were significant prognostic factors. Hematogenous metastases were present at autopsy in most cases. Disease and performance status therefore need to be well established and documented in clinical trials involving mesothelioma.

In a material consisting of approximately 6,000 injections of Adriamycin during a 2-year period, eleven moderate and five severe extravasation injuries have been observed. Even a small leakage of the drug may cause a permanent lesion. The most serious injuries were caused by large doses and on the dorsum of the hand. Plastic surgical operations were successfully performed in the severe cases. An active surgical intervention after primary neutralization of the extravasated Adriamycin is recommended.

Three cases are presented in which pericardial tamponade was the first indication of malignant disorder. The diagnosis and therapy of malignant cardiac tamponade was revealed by emergency pericardiotomy. In all cases the tumor was an adenomatous carcinoma and the site of primary tumor was unknown until death. The median survival time after onset of symptoms was 4 months. The primary site was the lungs in two and remained unknown autopsy in one case.

We review a series of 100 consecutive cases of malignancy treated for ascites with abdominal paracentesis. The results of treatment for ascites with intracavitary Thiotepa are reported for 23 patients. The temporary partial response rate was 8/23 (35%) patients. There were symptoms of intestinal obstruction in five patients (22%) treated with Thiotepa, and one of these patients died of intestinal obstruction. In 60% of autopsied patients there were abundant intestinal adhesions in the peritoneal cavity after Thiotepa. We concluded that Thiotepa is contraindicated for instillation into the peritoneal cavity. The median survival time for patients with carcinoma of the mammary gland was 47 days, carcinoma of the ovary 121 days, and carcinoma of the large intestine 54 days after the first abdominal paracentesis. We found that patients without clinical liver metastasis at the time of first abdominal paracentesis had almost three times longer median survival time than that of patients with metastatic liver. In four cases the immediate cause of death was a complication of an abdominal paracentesis.