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Carcinoma of the gallbladder is a rare malignancy, with an incidence rate in the United States of 2.2 to 4.4 per 100,000 persons. Its clinical presentation is nonspecific, and the majority of patients have advanced disease at

Although generally benign tumors, meningiomas can cause serious neurological injury and, at times, vexatious management difficulties. Currently, the accepted management of these tumors is attempted total surgical excision when technically possible and associated with an acceptable risk. However, even with innovations in instrumentation and refinements in surgical technique, the goal of total resection may not be achievable. For these patients, and for those with recurrent tumors, options for treatment include reoperation, radiation therapy, and chemotherapy. Recent developments in surgical technique and instrumentation, radiosurgery, and brachytherapy have increased the treatment options, while clinical trials with tamoxifen and mifepristone (RU486) are adding information on the effectiveness of these drugs as chemotherapeutic agents. While the search continues for a uniformly successful management plan, physicians must be aware of the available options and try to help the patient decide which treatment is appropriate, based on current medical knowledge. [ONCOLOGY 9(1):83-100]

Primary CNS lymphoma is rising in incidence in both the AIDS and non-AIDS populations. It is a non-Hodgkin's lymphoma that usually presents as a brain tumor, but the leptomeninges, eyes, and spinal cord also are

Dr. DeAngelis has written a succinct and accurate assessment of management of primary central nervous system lymphoma. Non-AIDS-related primary central nervous system lymphoma is a rare, highly malignant primary brain tumor. However, its incidence is increasing, as are AIDS-related tumors of this type. Patients with primary central nervous system lymphoma usually have widespread infiltration throughout the brain, rendering aggressive resection of no benefit. There is a significant incidence of leptomeningeal and ocular involvement (the latter a "sanctuary site," thus posing a particular therapeutic dilemma).

Drs. Abi-Rached and Neugut have presented a comprehensive review of the natural history and epidemiologic characteristics of patients who develop carcinoma of the gallbladder. They correctly point out that this tumor is a rare neoplasm, with the annual incidence in the United States being quite low; the number of patients dying from gallbladder cancer in 1978 was estimated to be 2,469, representing only .3% to 1.0% of total cancer deaths in the United States [1]. Since incidence rates vary significantly by geographical area, the risk factors associated with this tumor are of interest. For example, in Chile, cancer of the gallbladder and bile ducts accounts for 5.25% of cancer deaths [2]. Among Jews in Israel, the incidence appears to be higher in patients of European birth compared with those born in Asia [3]. Incidence also appears to be higher in Native Americans and Mexican-Americans born in the United States than in other population groups in the United States [4]. For instance, gallbladder cancer is the most common gastrointestinal malignancy among Southwestern Native Americans [5].

DENVER, Colo--Although oncologists have long been concerned about cachexia and other nutritional problems in cancer patients, nutritional oncology, which includes nutritional assessment and intervention for cancer patients, is just beginning to emerge as a recognized medical discipline and as an important adjunct to standard cancer therapy.

WASHINGTON--John Durant, MD, has been named to the newly created position of executive vice president of the American Society of Clinical Oncology (ASCO). Formerly president of ASCO and a member of its board of directors, Dr. Durant will become the society's leading spokesman and advocate in Washington on April 1. He is currently vice president for health affairs and director of the medical school at the University of Alabama at Birmingham.

Neuroendocrine differentiation has been foundin 50% to 100% of prostate neoplasms of all stages. Furthermore,10% of prostatic tumors are extensively or fully differentiated.Thus, neuroendocrine-specific

PARIS-Physicians need to make a more concerted effort to consider quality of life issues when devising a management strategy for patients with HIV-infection, an infectious diseases specialist said at a conference on cancer, AIDS, and quality of life, sponsored by UNESCO.