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In the present retrospective study, 79 percent of the patients were men with a median age of 65.5 years. Of 91 patients, 84 were surgically explored. Excision of the tumor was carried out in 57 patients (63 percent) and was curative in 28 cases and palliative in 29 cases. Curative resection included proximal gastrectomy in 5 patients and total gastrectomy in 23 patients, which was extended to the spleen and distal pancreas in 18 patients. Lymph node metastases were found in 67 percent of the patients treated by resection. According to the TNM classification, 18 percent of the patients undergoing resection had stage I tumor, 28 percent had stage II tumor, 40 percent had stage III tumor, and 14 percent had stage IV tumor. The postoperative mortality rate was 16 percent for the entire series, 21 percent for patients undergoing palliative resection, and only 4 percent for patients undergoing curative resection. Three patients had an obvious anastomotic leak, one of whom died. Median survival time was 5 months for patients who had exploration only, 6 months for patients who had palliative resection, and 36 months for patients who had potentially curative resection. The 5 year actuarial survival rate was 20 percent for patients having resection and 40 percent for patients having curative resection. Survival was closely related to tumor stage. These results indicate that total gastrectomy with complete abdominal lymph node dissection can give comparatively good long-term results when performed for cure. Nevertheless, only one of three patients in this series could have a potentially curative resection. The only way to increase the curative resection rate and to improve survival is to detect the cancer at an early stage.

The authors describe a case of sacrococcygeal chordoma which was detected in a 49-year old male subject in the course of a clinical examination. Bone X-rays and CT-scans confirmed the diagnosis of sacral tumor, and radical excision was performed via combined abdominal and sacral approach. The chief characteristics of these rare tumors are further discussed, with particular focus on the therapeutical problems arising in relation with the fact that surgical removal, alone, can prevent tumor recurrences.

The authors report a case of "spontaneous" rupture of the liver in a woman of 35 years of age. This occurred immediately after post-partum eclampsia. It was not possible to obtain complete haemostasis using absorbable haemostatic compresses along the convexity of the liver. Complete cessation of bleeding only occurred after the operation when posterior pituitary abstracts had been transfused. The patient died 53 days after the initial procedure from a high gastro-intestinal haemorrhage. A study of the literature shows that this rare condition is most probably a complication of toxaemia of pregnancy but the physio-pathology of these liver lesions is ill-understood. The clinical picture is in two phases--the first corresponds to the formation of a sub-capsular haematoma and the second to the intra-peritoneal rupture of this haematoma. The prognosis for this condition is poor, the maternal mortality ranging from 56%-75%. The prognosis is linked to the speed with which the diagnosis is made and surgical intervention is carried out. This should be done before the capsule of the liver ruptures. Haemostasis is nearly always best obtained by using haemostatic compression with packs but haemostasis is not always adequate, particularly if there are several lesions in both lobes of the liver. This case history shows that using posterior pituitary abstracts in transfusion can be helpful.

Anterior sacral meningocele is a rare affection (150 cases published) that is frequently misdiagnosed with resulting inappropriate, always dangerous treatment. Diagnosis should however be simple to establish on the finding of a fluid hypogastric mass attached to the sacrum with associated radiologic anomalies of the sacrum. Two cases are reviewed and diagnostic and surgical therapy features discussed.

A homogeneous series of 88 patients with a history of surgery for Basedow's disease was studied retrospectively to evaluate long term recurrences. A total of 88 cases were reviewed after a follow up of a median of 50 months (range 1 to 13 years), and hormone assays were carried out in 74 cases. Surgical complications were minor: no mortality, no definitive hypoparathyroidism, 45% unilateral recurrent nerve palsies and 14.3% definitive hypothyroidism occurring during the first year. Fifteen patients had one or several recurrences of hyperthyroidism. The actuarial recurrence rate at 5 years was 17%, the risk increasing progressively up to the sixth year. The type of operation was the only predictive factor of recurrence surveillance of these patients should be prolonged and involve regular hormone assays, since 6 of the 15 recurrences were poorly symptomatic.

Graves' disease was diagnosed in a 35-year old woman with a history of myxoedema in childhood. Clinical data, ultrasonography and radioisotope scanning showed that the disease had developed in an ectopic subhyoid thyroid gland. Although numerous thyroid diseases associated with an ectopic thyroid have been described, Graves' disease does not seem to be frequent since only one case has been published so far.

Examples of mucinous tumors from retroperitoneum (2) and pancreas (1) were studied. These tumors share many morphological similarities with ovarian mucinous tumour and adenoma malignum of uterine cervix. They have a similar spectrum of endocrine cells; serotonin, somatostatin, gastrin and pancreatic polypeptide cells were characterized. In nonproliferative areas was found a well-differentiated mucinous columnar epithelium with scarce endocrine cell. In more proliferative areas were found either a mucinous columnar lining with infolds and secondary glands or a less well-differentiated intestinal-type epithelium with papillary formations; both linings were well supplied in endocrine cells.

This report is a retrospective analysis of the results of surgical treatment in 234 consecutive cases of adenocarcinoma of the colon; 56.4 p. 100 of patients were male with a mean age of 66. Sixty per cent of the carcinoma were situated in the sigmoid. Carcinoma was complicated in 26.1 p. 100 of cases. The tumor was confined to the bowel wall in 14.3 p. 100 of cases (stage A), involved the serosa in 36.3 p. 100 of cases (stage B), lymph nodes in 25.5 p. 100 of cases (stage C), and distal organs in 23.8 p. 100 of cases (stage D). Global operative mortality was 10 p. 100. Obvious anastomotic leakages occurred in two patients with one death. The overall five year survival rate was 35 p. 100. The stage-by-stage 5-year survival rates depended mainly on the differentiation and on the extension of the tumor: 59.2 p. 100 in patients with stage A lesions, 54.8 p. 100 in those with stage B lesions, 30.2 p. 100 in those with stage C lesions, 3.9 p. 100 in those with stage D lesions. On the other hand, survival was not significantly related to the duration of symptoms. This suggests that early diagnosis of symptomatic disease does not guarantee a better prognosis. This can only be achieved by prevention of the disease.