Tsuneo Imai

Primary hemangiopericytoma of the breast is a rare disease, especially the malignant one is. <BR>Preoperative examinations of a 48-year-old woman had indicated an advanced breast cancer. According to the General Rule for Clinical and Pathological Record of Mammary Cancer, it was diagnosed as T4bN1bMO Stage IIIb. Radical mastectomy was carried out. The resected specimen revealed that yellowish and grayish white tumor was arising in the mammary gland, accompanied by hemorrhagic necrosis, and had not invaded the greater pectoral muscle. Histologically, it was poor in connective fibers; the tumor cells seemed to fill up between numerous vessels;and mitosis was frequently found. From these findings, she was diagnosed to have a malignant hemangiopericytoma which was keratin-negative and epitherial membrane antigen-negative. Furthermore, the diagnosis was immunologically confirmed, because factor 8 was not stained with the tumor cells but did with some area of the vascular endotherium. Electron microscopy also showed the characteristic features. <BR>In Japan, only few cases of primary hemangiopericytoma of the breast have been reported, particularly fewer cases of malignant hemangiopericytoma having been found.

A case of follicular carcinoma of the thyroid and Hashimoto's thyroiditis occurring in association with sarcoidosis is reported. Association of chronic thyroiditis with sarcoidosis has previously been documented and the coexistence of chronic thyroiditis and thyroid cancer have occasionaly been noted. However, it is rare for thyroid cancer to be associated with sarcoidosis. A review of the literature found no report of follicular carcinoma of the thyroid.

The serum TPA (tissue polypeptide antigen) concentration was measured to determine whether TPA is usable for differential diagnosis in various surgical endocrine diseases. As for malignant diseases, breast cancer and malignant thyroid diseases were studied as well as benign thyroid diseases and benign adrenal diseases. In some cases, measurement of CEA (cartioembryonic antigen) was also performed for the purpose of comparison.<br> Breast cancer showed a high TPA value and positive ratio of 65% against a positive ratio of 23% by CEA. TPA and CEA values were normal in both malignant and benign thyroid diseases and the positive ratio for each was 0%. In three adrenal diseases, namely pheochromocytoma, Cushing's syndrome and primary aldosteronism, three was a significantly high TPA positive ratio of 97%. All three adrenal diseases simultaneously showed hypertension, renal dysfunction and a diabetes mellitus condition, one of which was presumably cause of the high TPA values. CEA displayed a slightly higher value in pheochromocytoma and a normal value in the other two adrenal diseases. No clear correlation with TPA was observed.