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This article discusses four wide-ranging books that illustrate several facets of the history of surgery in the twentieth century, notably the shift of the centre of academic surgery from the German- to the English-speaking world, changes in the training of surgeons, advances in technique, and the opening of new fields.

Mucinous tubular and spindle cell carcinoma (MTSCC) is an uncommon, newly recognized tumor that in its classic histological form shows tightly packed, elongated tubules with transition into spindle cell areas and pale mucinous stroma. The current data suggest that the great majority of MTSCCs have a favorable prognosis; however, the follow-up data are limited and the full biologic potential of this tumor remains to be established. There are a few examples of MTSCCs metastatic to lymph nodes and rare cases with sarcomatoid differentiation associated with distant metastases. We report on a case of MTSCC of kidney with concurrent nodal and liver metastases. The metastatic nodules were well circumscribed and showed morphological and immunophenotypic features similar to those of the primary tumor. Extensive sampling revealed no evidence of sarcomatoid morphology. To our knowledge, this is the first case of MTSCC without sarcomatoid differentiation showing parenchymal metastasis.

MAY I first express a deep sense of honor for having been selected as the 75th Shattuck Lecturer? To be associated, however illogically, with the great men who have in past years been the lecturers...

Of the many functioning islet-cell tumors of the pancreas that have been reported, approximately 10% have metastasized to lymph nodes, liver, or elsewhere. In some of these cases the metastases have produced insulin, 1-3 whereas in others the metastatic processes apparently have been inert. 4 In most instances death has occurred within a short time after the diagnosis of frank islet-cell carcinoma was made. In at least two instances the patient survived for a considerable time. Holman's 5 patient lived 16 years from the onset of symptoms, and Brunschwig's 6 patient lived 47 months after an operation which revealed a pancreatic tumor and metastasis to the liver. Our report concerns a man with proved islet-cell carcinoma of the pancreas with metastasis to the liver and peritoneum who has had symptoms suggestive of hypoglycemia for approximately 25 years, and from whom an islet-cell tumor was first removed 15 years ago. Metastasis