Feline mammary carcinoma is highly malignant and generally associated with a poor prognosis, although studies suggest the range of survival times in affected cats is broad. Histologic grading of these tumors is achieved using the Elston and Ellis system, originally developed for human breast cancer. In cats, however, classification using this method has variable prognostic value. Therefore, objectives of this study were (1) to evaluate the Elston and Ellis grading system for feline mammary carcinoma in a predominantly spayed population and (2) to determine whether modification of this system or development of a novel system improved the prognostic value of histologic grading. Survey data and histologic features for 108 carcinomas from 97 cats were analyzed with respect to overall survival. Elston and Ellis grading failed to correlate significantly with overall survival. Using multivariable analysis, lymphovascular invasion, nuclear form, and mitotic count each demonstrated independent prognostic significance (P ¼ .008, <.001, and .004, respectively). Modifications of the Elston and Ellis system and a novel grading system were proposed based on these results; all showed significant correlation with overall survival (P < .001). Median survival times were 27, 29, or 31 months for grade I; 14, 12, or 14 months for grade II; and 13, 5, or 8 months for grade III carcinomas using the mitotic-modified Elston and Ellis, the revised Elston and Ellis, or the novel grading system, respectively. Based on this retrospective study, adoption of the species-specific systems as proposed here may improve the prognostic value of histologic grading for feline mammary carcinoma.

Context.—Second-year medical students are introduced to many new terms and concepts in a short time frame in the hematology system and the neoplasia section of the undergraduate pathology course. It is a challenge to provide adequate practice and necessary repetition to reinforce key concepts. Objective.—To determine student perceptions of the usefulness of crosswords as a quick and effective way to reinforce essential concepts and vocabulary. Design.—Crosswords with ensured content validity built on a free Internet resource were completed by the students in collaborative and cooperative groups of 6 to 7 with a reward for the first group to successfully complete the puzzle. Student perceptions of the value of crosswords for their learning were examined in 2003 (39 students) with a survey of yes or no responses and in 2004 (41 students) with a survey using questions with a 5-point Likert scale. Results.—Many students (37 of 39 in 2003 and 24 of 41 in 2004) indicated that crosswords were useful and contributed to their learning. Specifically, crosswords were found to be useful for identifying key concepts and vocabulary and for their collaborative and competitive aspects. Written and informal comments indicated student enthusiasm for and a desire to participate in more of these exercises. Students have transferred this review strategy to other classes and the peer teachers have expressed an interest in it as an adjunct teaching tool. Conclusions.—The judicious use of crosswords was useful for near transfer content and provided an opportunity to discuss and recall essential concepts, think critically, and collaborate in small groups.

Background: Despite extensive research data indicating that cooperative learning promotes higher achievement, the creation of positive relationships, and greater psychological health for students at all levels in their education, cooperative learning as a teaching strategy is still underutilized in undergraduate medical education.

Four patients with haemangioendothelioma of the spine which was treated surgically are presented. Two were male and two female, mean age 30 years (range 5-60). All tumours were sited in the thoracic spine between T5 and T10; three were primary and one metastatic from a hepatic haemangioendothelioma. Each patient had a significant neurological deficit at presentation; three were paraplegic. A diagnosis of vertebral neoplastic disease was suggested on plain radiographs, and in three cases this was supported by computed tomography or magnetic resonance imaging. Two patients underwent anterior decompression and posterior instrumented stabilisation, one anterior decompression alone and one posterior decompression followed by tumour vessel embolisation and then anterior decompression. Intra-operative blood loss was a significant feature despite the use of hypotensive anaesthetic techniques and local haemostatic agents. Three of the tumours were tested for Factor VIII (a tumour for vascular tumours), and all proved positive. In these, sufficient histological material was available to grade the tumours according to the classification of Campanacci et al. [1]. All were grade II. Three patients recovered completely from paraglegia; one had residual mild spasticity which required the use of a walking aid. The mean improvement in Frankel grade was 2.5 (range 1-4). In two the tumour recurred outside the spine within 18 months; one had subsequently died. The presentation, investigation and results of surgery for haemangioendothelioma of the spine are presented. Particular attention is drawn to the neurological status at presentation, the effect of pre-operative tumour embolisation and the dramatic recovery that can be achieved in these patients following surgery.