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Orville T. Bailey and Franc D. Ingraham

of the descriptions and the changes in conception of the nature of dural tumors since the publications were written. It seemed advisable, therefore, to discuss these tumors in relation to the grouping of tumors arising in the dural connective tissue now in use at this clinic rather than to attempt a discussion and review of all recorded examples. Among the tumors of the meninges, a sharp distinction should be drawn between the sarcomas of the leptomeninges and the sarcomas of the dura. The sarcomas of the leptomeninges spread freely in the subarachnoid space and

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Harry S. N. Greene and Hildegarde Arnold

glioblastomas to survive and to grow in animals of alien species is a property held in common with the malignant tumors of other organs and tissues and, from the standpoint of autonomy, identifies these growths with the ordinary sarcomas and carcinomas. The failure of glioblastomas to metastasize, therefore, cannot be related to an absence of the biological attribute of autonomy but, on the other hand, would appear to be associated with some peculiarity in brain structure or chemistry. The ability to transfer the growths to other sites in foreign hosts brings the problem into

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Herbert Olivecrona

meningiomas of the falx, this means that the suspicion of a meningioma is confirmed by the röntgen films in a little more than a third of the remaining group of parasagittal meningiomas. Sometimes atypical bony changes are encountered which may lead to diagnostic difficulties. Occasionally the destruction of bone may be so extensive that a malignant tumor, either an osteogenetic sarcoma or a metastatic tumor, is suspected. In arteriovenous aneurysm vascular changes of the skull may be present that closely resemble those seen in meningiomas. Arteriovenous aneurysms with

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B. K. Bagchi and R. C. Bassett

satisfactory for definite localizing purposes ( Fig. 6 ). Fig. 6. Case 2. Ventriculogram of poor diagnostic value due to inadequate amount of gas filling the system. Vestibule of left ventricle is displaced anteriorly. At operation a left occipital pole endothelial sarcoma was removed. Explanation of Fig. 5 The electroencephalogram shows the presence of 1.5 to 2 per sec. delta waves in reverse phase in the left occipital area (first 2 strips) but not in the same area on the right side (the last 2 strips). Only routine leads were placed on the

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Franc D. Ingraham and Cully A. Cobb Jr.

is followed by scarring, and sarcogenesis. 23 Both of these reactions were first observed in watch workers who painted luminous dials. Careful studies of these patients were made by Martland 16 and the insidious nature of the thorium poisoning was brought to light. In experimental animals thorotrast injected intravenously is deposited in the liver, spleen, bone marrow and lymph nodes, and the changes of irradiation damage develop slowly over a period of several years. 3, 19, 25 Sarcoma of the peritoneum was produced in rats by Roussy, Oberling and Guérin 24

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Paul C. Bucy and Hardin Ritchey

the spinous processes were removed the remaining sheet of bone was opened with a perforator and burr and then removed with a rongeur. Beneath the laminae was a friable vascular tumor which compressed the dura mater and the spinal cord. All of this tumor lying posterior to the dura mater was removed but that portion lying lateral and any which might have been lying anterior to the dura mater was not disturbed. Bleeding was profuse but was controlled with the electro-surgical unit and fibrin foam. The tumor was regarded as an extradural sarcoma. Pathology

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Eldridge Campbell and Robert D. Whitfield

tumor, resection was abandoned as soon as normal pulsations of the brain appeared. The patient was transfused with 1000 cc. of citrated blood. The wound was closed in layers with interrupted silk without drainage and she was returned to her room in good condition. Pathologic Diagnosis (Dr. A. W. Wright and Dr. Abner Wolf of N.Y.). Meningo-sarcoma ( Figs. 9 and 10 ). Fig. 9. Case 5. Low power microphotograph showing increased cellularity of tumor. (Hematoxylin and eosin, × 180) Fig. 10. Case 5. Higher power view of tumor shown in Fig. 9

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The Torkildsen Procedure

A Report of 19 Cases

Edgar F. Fincher, Gordon J. Strewler and Homer S. Swanson

. 11. S.R. 6 months Headaches, choked disks Ataxia, nystagmus Disorientation Ventriculogram Cerebellar craniotomy Metastatic sarcoma—neurogenic Primary—Intestinal Autopsy Died 24 hours after operation. Considered primary cerebellar lesion, failure to release hydrocephalus initiated the catheter release. 12. R.Mc 2 weeks Vomiting Drowsiness Papillitis Ventriculogram Cerebellar craniotomy Later—occipital craniotomy Papilloma choroid plexus Chemotherapy Radiation Autopsy Lived 12 weeks after tube operation, 10 days after occipital craniotomy

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Meningeal Meningiomatosis

Report of Case

Alfred Uihlein, Edward M. Gates and Robert G. Fisher

sections that the entire arachnoid had, in various and multiple locations, undergone malignant changes, giving rise to many primary malignant tumors which were highly invasive. The term “sarcoma of the meninges” was avoided for it was felt that insufficient evidence exists to justify classification of the meningiomas as of mesodermal origin. Thus until such time as it could be shown that the meninges arise from mesoderm, it was felt better to adhere to a different term for these arachnoid tumors; accordingly, in this case the term “malignant meningeal meningiomatosis

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Ernest Sachs Jr. and Gilbert Horrax

Der. T7-S — 17 cm. in length 17. * Melnikoff-Raswednenkoff 1926 F 26 Epi. T5-6 — Intramed. 18. * Salotti 1927 M 31 Der. T12 Died Septicemia from decubitus ulcers 19. Shallow 1928 M 30 Der. L? Improved 20. Sharpe & Sharpe 1928 M 3 Der. T11 Improved Communicating infected sinus 21. Critchley & Ferguson 1928 M 15 Epi. T7-8 Improved 22. * Delrez 1929 F 5 Der. L3-S Improved Also sarcoma kidney 23. Fraser 1930 F 22 Epi. T11