[Thermal ablation by radiofrequency of hepatic metastasis of colorectal cancer: short-term results]. / Termoablazione mediante radiofrequenza di metastasi epatiche da cancro colorettale: risultati a breve termine.

Radiofrequency (RF) was used to ablate 42 colorectal liver metastases in 20 patients (10 males and 10 females) in a four years period. Median age was 62.2 years, 36 lesions (75%) had 3 cm diameter or less. An open surgical approach was adopted in 13 patients, whereas a percutaneous one in 14. On 27 surgical sessions, RFA was used in 49 procedures for a total of 81 needle applications. Morbidity was 6.0% (3 cases), one patient died on third po day for myocardial infarction. No differences in terms of complete ablation rate was observed in the two approach's groups. Overall survival was 65% with a median follow-up of 18.5 months.

Radiofrequency thermal ablation (RFA) of liver tumors: open surgical or percutaneous approach?

RFA was used to ablate 81 liver lesions: 61 liver metastases and 20 hepatomas. An open surgical approach was adopted in 19 instances (27.5%), 12 of which were simultaneously treated for associated diseases, and percutaneous treatment was adopted in 50 instances (72.5%). The CT liver control at 6 months showed a complete necrosis in 50 lesions (66.3%). The advantages of the percutaneous approach include less invasiveness, reduced postoperative pain, shorter hospitalization, reduced costs and less discomfort in repeating the procedure. In conclusion, radiofrequency liver nodule ablation could be considered, today, as one of the promising and versatile techniques for loco-regional liver cancer control.

[Effect of preoperative biliary drainage on the immediate and long-term results after duodeno-cephalo-pancreatectomy for peri-ampullar neoplasia]. / Effetti del drenaggio biliare preoperatorio sui risultati immediati e a distanza dopo duodenocefalopancreasectomia per neoplasia periampollare.

Pancreaticoduodenectomy has a primary role in the treatment of patients with periampullary carcinoma. Several series have reported encouraging operative mortality and survival after resection. Controversies exist regarding the impact of preoperative biliary drainage on immediate and long-term results.

[Radiofrequency thermal ablation of hepatic nodules: selection criteria for percutaneous treatment]. / Termoablazione con radiofrequenza di noduli epatici: criteri di scelta del trattamento percutaneo.

Radiofrequency thermal ablation (RFA) of liver tumor is done by percutaneous, laparoscopic and open surgical approach. Selection criteria for percutaneous or open surgical ablation of 54 hepatic lesions are here evaluated in 30 consecutive patients. Open surgical approach was performed in 9 cases only, 5 of them due to concomitant treatment of associated diseases. Number and size of the lesions did not interfere with surgical approach. Postoperative CT control showed no differences in terms of complete ablation of the tumor in between the two groups of patients. Percutaneous approach of RFA is gone to be in the future the modality of choice in these patients.

Intracranial mass lesions: sequential thallium and gallium scintigraphy in patients with AIDS.

PURPOSE: To determine the efficacy of sequential thallium and gallium scintigraphy to differentiate intracranial neoplasms (lymphoma and glioma) from other nonmalignant intracranial mass lesions among patients with acquired immunodeficiency syndrome (AIDS). MATERIALS AND METHODS: The authors reviewed the cases of 40 patients with human immunodeficiency virus (HIV) who underwent thallium and gallium scanning to evaluate intracranial mass lesions from October 1991 through November 1997. There was a definitive final diagnosis of the nature of the mass lesions in 21 of these cases. In these 21 cases, the scintigraphic patterns were reviewed and were compared with the final diagnosis. RESULTS: On the basis of results at thallium and gallium scanning, the patients were divided into three groups. Group A included 13 patients (11 with brain tumors [lymphomas and gliomas] and two with progressive multifocal leukoencephalopathy [PML]) with thallium-positive, gallium-positive scans. Group B included five patients with intracranial infections (tuberculosis, Cryptococcus, bacteria) with thallium-negative, gallium-positive scans. Group C included three patients (one with PML and two with infarcts) with thallium-negative, gallium-negative scans. All patients with lymphomas were in group A. The sensitivity and specificity of the thallium-positive, gallium-positive pattern for intracranial malignancy were 100% and 80%, respectively. CONCLUSION: Sequential thallium and gallium scanning helped differentiate tumors from nonmalignant intracranial mass lesions and may help differentiate infections from PML or infarcts.

Polyarteritis nodosa presenting as temporal arteritis in a 9-year-old child.

A 9-year-old Haitian girl presented initially with monocular blindness and an isolated temporal arteritis, confirmed by angiographic studies and temporal artery biopsy findings. CT and MR studies of the intracranial circulation showed only an enlarged, dense superficial temporal artery. Systemic workup revealed a mildly elevated erythrocyte sedimentation rate, mild changes in white and red blood cells, and a remote history of sensorineural hearing loss. Pathologic examination of the biopsy specimen narrowed the differential diagnosis to giant cell temporal arteritis and polyarteritis nodosa. Treatment with corticosteroids alone failed, and the child returned 1 month later with severe systemic illness and encephalopathy. MR studies showed multiple cortical and subcortical foci of increased T2 signal, and gyriform enhancement on T1-weighted images. Renal and mesenteric arteriograms showed innumerable tiny aneurysms at branch points in small and medium-sized vessels, typical of polyarteritis nodosa. We found no previous reports of this initial presentation in the pediatric population for either polyarteritis nodosa or giant cell temporal arteritis.

Technical report: CT-guided aspiration of anterior cruciate ligament ganglion cysts.

We describe computed tomography (CT)-guided percutaneous anterior cruciate ligament (ACL) ganglion cyst aspiration in three patients. In so doing, we review clinical technique, patient outcomes and discuss advantages of radiologically guided intervention relative to traditional surgical incision and drainage.