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Background: Colorectal cancer is one of the most common malignancies in the Western World and in Israel. Most patients with colon cancer are older than 50 years of age. There is no consensus in the literature regarding the behavior of this disease in young patients., Aim: The aim of the present study is to compare clinical and ic pathological features of colon cancer between young and sold patients., Methods: All clinical and pathological characteristics of 200 patients with colon cancer treated at our center during the period 2001-2006 were retrospectively reviewed., Results: Twenty five patients (12.5%) were <50 years age (young patients) at diagnosis (mean age 41 years) and 175 were >50 years (mean age 68 years). Males were 56% of the young group and 60.1% of the old one. Arab patients were 52% of the young group, although their total number was 35 of the 200 patients. No significant difference was found in the stage of tumor at diagnosis between the two groups. Histopathological grade 3 tumors were found in 33.3% of young versus 7.7% in old patients. Surgery and chemotherapy were performed in 96% and 88% versus 95.4% and 69.7% in the two groups respectively. In a median follow-up period of 96 months, 35% of young patients died of their disease compared to 33.1% of the old patients., Conclusions: Other than histological grade, no difference was found in colon cancer features and survival of young compared to old patients. Further studies with higher numbers of patients are suggested to clarify our findings.

During the period 1991 till 1999, ten patients with primary stromal tumors of the gastrointestinal tract (stomach, duodenum, jejunum, ileum and rectum) were treated. Nine patients underwent radical resection and one patient had non-complete resection of the tumor. The median age of the group was 63 years for 7 male and 3 female patients. The median follow-up period was 58 months. The tumor size was 4.5-17 cm. (median 10 cm.) The median survival was 43 months. Five patients remained alive without the disease (median survival 87 months). One patient died with no evidence of the disease after 12 months. One patient remains alive with liver metastases for 13 months and 4 patients died of metastatic disease (median survival 10 months). Features associated with decreased survival included tumor size > 5-8 cm., mitotic counts > 5 mitotic figures per 50 high-power microscopic fields and high cellularity.

The effectiveness of sequential chemo-radiotherapy in preserving the larynx in advanced laryngeal carcinoma was assessed. 4 unselected patients (19 men and 2 women, mean age 60 years) with advanced squamous cell carcinoma of the larynx (T3-4/N0-3) received induction chemotherapy consisting of 2-3 cycles of cisplatin (100 mg/m2) and 5-fluorouracil (1000 mg/m2/day) as a continuous infusion on days 1-5, followed by definitive radiotherapy: 50 Gy to the whole neck, 70 Gy to the larynx and clinically involved nodes, using a combination of 6 MV photons and 9-12 MeV electrons. 19 of the 21 patients responded to combined therapy but there was no response to induction therapy in 2 (10%) and 2 did not complete therapy due to severe toxicity. At a mean follow-up of 40 months, 7 had undergone total laryngectomy (33%), for an overall 5-year laryngeal preservation rate of 66%. Reasons for total laryngectomy in 2 patients were no response, and in 5 tumor recurrence. Mean survival was 39 months (range 11-46 months); at last follow-up, 17 of 21 were alive and disease-free, 11 of whom had a functional larynx (65% of survivors). 2 had died due to disease progression and due to a cardiovascular event. Sequential chemo-radiation allows laryngeal preservation in about 2/3 of surviving patients without compromising survival.

Secondary malignancy is a well-recognized complication of radiation therapy. The risk of postirradiation sarcoma in long-term follow-up is 0.03-0.8%. We report a case of radiation-induced perisacral angiosarcoma 6 years after pelvic irradiation for sigmoid cancer in a 77-year-old man. The tumor was diagnosed postmortem and was locally advanced and metastatic. He died 6 months after onset of symptoms. This case demonstrates the importance of long-term follow-up in those given radiotherapy.

Prognostic factors and survival rate of 53 Arabs with differentiated carcinoma of the thyroid treated here were reviewed. Papillary carcinoma was diagnosed in 35 (66%) and follicular carcinoma in 18 (34%): the female/male ratio was 2.3/1 and the median age 32. Age, gender, tumor size, histology and tumor stage were important prognostic factors. The 20-year actuarial survival rate of the entire group was 96%. The probable reason for the high survival rate was the low median age.

Primary malignant melanoma of the rectum is a very aggressive tumor with a 5-year survival rate of 6%. Most reports include cases of both anal and of rectal melanoma together. We report 2 women with primary melanoma of the rectum, aged 67 and 72 years, who underwent abdominoperineal resection and survived 5 and 7 months respectively.

The ultrastructural effects of gentamicin on the stria vascularis of the inner ear of guinea pigs were studied by transmission electron microscopy. In a single specimen of an isolated, inner ear we found an unexpected variation in the structure of the stria vascularis in a normal, pigmented, guinea pig not treated with ototoxic drugs. There were prominent, wide protrusions from the apical surfaces of marginal cells into the endolymphatic space. This finding has not been previously reported and was seen in only 1 of 7 animals studied. It may be considered a normal structural variation, and is not pathological change in the stria vascularis due to ototoxic drugs.

2 cases of infants who refused to nurse from a breast with a cancerous tumor are reported. The first 6 cases of this nature were described 28 years ago. Though this sign could lead to earlier detection of breast cancer in lactating women, it has not been accepted as such by the medical profession. Had the milk-rejection sign been recognized in our cases, breast cancer could have been diagnosed months earlier. We suggest that lactating women should be asked about the nursing habits of their babies and if there is milk-rejection, the breasts should be examined with special care.

500 surviving Arab cancer patients in follow-up were interviewed with regard to other cases of cancer in their families. Among 73 who had breast cancer, in 15 (20.3%) there was another case of breast cancer among first-degree relatives. The incidence of both primary and familial breast cancer was higher among Christian than among Moslem women. We conclude that Arab women with breast cancer in their families are at high risk for developing breast cancer themselves.