Benign Neural Sheath Tumours of Major Nerves: Characteristics in119 Surgical Cases

Peripheral benign nerve sheath tumours are infrequent tumours and affect major nerve trunks. Some authors have indicated a high and prohibitive incidence of neurological injury in resection of these lesions. The authors describe their findings in a retrospective study comprising 119 patients with spontaneous benign nerve sheath tumours of the peripheral nervous system. Seventy-three patients had a schwannoma, 41 had neurofibroma and 5 had plexiform neurofibroma; 25 of the 119 patients suffered from neurofibromatosis. All schwannomas were excised completely and the outcome of patients was 41.0% improved, 6.8% worsened, 52.0% unchanged. Twenty-eight neurofibromas were excised completely and 13 subtotally; the outcome for patients was 19.5% improved, 19.5% worsened and 61% unchanged. All plexiform neurofibromas were removed subtotally and the outcome for patients was 20% improved and 80% unchanged. The best surgical results at average follow-up of 6 years were observed in the patients with schwannoma, the worst in those with plexiform neurofibroma. Our results demonstrated that it is often possible to remove schwannomas as well as neurofibromas with an acceptable risk of injury to the nerve

Origin of the v. portae and variability of its tributaries in laboratory animals. V. The golden (Syrian) hamster (Mesocricetus auratus).

The authors studied the origin and variability of the v. portae in 30 adult golden hamsters (Mesocricetus auratus) of both sexes after injecting blue-dyed latex into their portal bed. In 16 cases (53.3%) the v. portae was formed from three tributaries and in 11 cases (36.7%) from four. The v. mesenterica cranialis was the only constant tributary, the v. lienalis was a tributary in 28 cases (93.3%) and the other most frequent tributaries were the v. gastroduodenalis and the v. pancreaticoduodenalis cranialis. In one case there was an anastomosis between the v. portae and the v. cava caudalis. In 25 cases (83.3%) the v. gastrica sinistra joined the v. lienalis, in four (13.3%) it was an independent tributary of the v. portae and in one case (3.3%) it was duplicated. A v. cardiaca was found in 25 cases (83.3%), when it was most frequently a tributary of the v. gastroepiploica sinistra and v. gastrica sinistra. In one case only it was an independent tributary of the v. portae. A v. pylorica was observed in 29 cases (96.7%), usually (in 17 cases--56.7%) as a tributary of the v. gastroepiploica dextra; in three cases it was an independent tributary of the v. portae (10.0%). A v. pancreaticoduodenalis cranialis was formed in 28 cases (93.3%). In 12 cases (40.0%), together with the v. gastroepiploica dextra, it was a tributary of the v. gastroduodenalis and in eight cases (26.7%) it was an independent tributary of the v. portae. In two cases (6.7%) the two vv. pancreaticoduodenales united to form v. pancreaticoduodenalis communis. In three cases (10.0%) this vein was duplicated and in one case it was triplicated. A v. gastroepiploica dextra was found in 26 cases (86.7%) and a v. gastroepiploica sinistra in 22 (73.3%). Both veins occurred simultaneously in 19 cases (63.3%). In no case, however, was there a continuous venous arc along the curvatura major ventriculi. A v. lienalis was present in 28 cases (93.3%). It was absent in two cases (6.7%), in which it was replaced by inter-organ anastomoses with the stomach and pancreas. In 19 cases (63.3%), the v. gastroepiploica sinistra and v. gastrica sinistra were both its main tributaries and in five cases (16.7%) its main tributary was the v. gastrica sinistra. In one case the v. lienalis was duplicated. Inter-organ anastomoses were formed in all 30 cases (100%). They occurred between the spleen and the stomach in 27 cases (90%) and between the spleen and the pancreas in 28 cases (93.3%).(ABSTRACT TRUNCATED AT 400 WORDS

Variability of the v. cava caudalis and its tributaries in some laboratory animals. I. The guinea pig (Cavia aperea f. porcellus).

The authors studied variability of the v. caudalis and its tributaries in 30 guinea pigs (Cavia aperea f. porcellus--15 males and 15 females) after injecting the relevant venous system with blue-dyed latex. Since the largest lobe of the guinea pig's liver (the lobus sinister) is situated on the left, the right kidney lies further cranially than the left one. In males, as a rule, the right v. renalis opens into the v. cava caudalis further cranially than the left one. The number of vv. renales showed no sex-related differences, although in 17 regions (i.e. in 29%) there was more than one. The increase most often concerned the v. renalis dextra (the ratio in relation to the left vein was 15:2). The tributaries of the vv. renales are the v. spermatica or v. uterina cranialis a v. lumbalis and a v. or vv. suprarenales. There are usually two tributaries, (the commonest of which is the v. spermatica or v. uterina cranialis) on both the right and the left side, though somewhat more frequently on the left (23:19). Blood is drained from the surface or capsule of the kidney relatively often (in 75% of the cases) by the capsularis, which is the most frequent tributary of the v. spermatica or v. uterina cranialis of the corresponding side. Vv. suprarenales (1-4) are a constant finding on both sides. In males they open more often into the v. cava caudalis and in both sexes they also open into the v. renalis and v. lumbalis. The v. spermatica dextra opened into the v. renalis dextra in 10 cases and the v. spermatica sinistra into the v. renalis sinistra in 12 cases. The v. uterina cranialis dextra was a tributary of the v. renalis dextra in eight cases and the v. uterina cranialis sinistra joined the v. renalis sinistra in 13 cases. Drainage into the v. renalis can thus be regarded as the norm in both sexes and on both sides. The v. uterina caudalis leads from the corpus and cervix uteri and joins the v. uterina cranialis. It has a regular incidence and caudally it is most often a tributary of the v. iliaca communis. The v. ovarica is a constant tributary of the v. uterina cranialis; it is usually joined by several vv. lumbales or v. v. capsulares.(ABSTRACT TRUNCATED AT 400 WORDS

Variability of the v. cava caudalis and its tributaries in some laboratory animals. II. The laboratory rat (Rattus norvegicus v. alba).

Duplication of the v. renalis was found in 11 of the regions examined (18.3%), when it was more frequent on the right side. A v. capsularis was found in 35 regions (58.3%), usually as a single vein. There were 1-3 vv. suprarenales (but mostly two; on the right they usually joined the v. cava caudalis and on the left the v. renalis sinistra). A v. spermatica was present on the right side in every case, but on the left side in 11 cases only; in one case it was duplicated. In the rat, the v. spermatica was rather thin; if absent, it was replaced by the v. deferentialis. In nine cases (60.0%) the v. uterina cranialis dextra opened into the v. cava caudalis, while in 12 cases (80.0%) the left vein opened into the v. renalis sinistra. A v. uterina media, draining blood from the caudal third of the cornu uteri, was found in only five cases (16.7%). The v. uterina caudalis drained blood from the corpus and cervix uteri. The v. ovarica was a constant finding; it was mostly joined by the v. lumbalis--and on the left side by the v. phrenica sinistra. In males, the vv. lumbales occurred mostly as a pair of veins lying just below the vv. renales. In females, they were present on both sides. As a rule, the v. iliolumbalis occurred as a single vein on both sides. The v. cava caudalis originated at the level of the transition between the lumbar and the sacral spine, usually at the confluence of the two vv. iliacae communes, which in 14 cases (46.7%) were joined by the v. sacralis mediana. Duplication of the v. cava caudalis was found in only one case (a female). Comparison of the morphology of the v. cava caudalis and its tributaries in the rat and the guinea pig showed more slight differences between the two species

Severe thrombosis after chemotherapy for metastatic choriocarcinoma of the testis maintaining complete remission for a long period

We report the favourable outcome of a patient who suffered from severe arterial and venous thrombosis during chemotherapy for testicular pure choriocarcinoma. An increased paraneoplastic stimulus of HCG secondary to the marker surge phenomenon is suggested as responsible for transient hypercoagulability and subsequent thromboembolism