[Congenital cyst of the choledochus. A case report and review of the literature]. / Cisti congenita del coledoco. Osservazione di un caso e revisione della letteratura.

Congenital cysts of the choledochus and of the glandulae mucosae biliosae are rare anomalies generally observed in pediatric age: it is in fact exceptional to detect them in adults. There seems also to be a difference in the occurrence among the various races since the disease is more frequently seen in the Japanese and in women. In the Western world the incidence of this pathology has rated to be 1 out of 26,000 hospitalizations, consequently the personal experience and familiarity of every surgeon with this disease will be naturally limited. The authors describe the case of a women, aged 21, under observation as carrier of cystoduodenostomy after congenital cyst of the choledochus. A calculosis of the common hepatic duct as well as the stenosis of the previous cystoduodenostomy are also discovered. The abscission of the cyst and the confection of a Roux's en Y loop hepaticojejunostomy with the separation of the previous gastrojejunostomy are then performed. According to the authors, the complete abscission of the cyst and the Roux hepaticojejunostomy should be considered the surgery of choice when the local situation and the patient's general condition allow it because this treatment reduces the occurrence of late postoperative accidents such as lithiasis and cholangitis and the possibility of malignant degeneration of the cyst. Two years after the operation, the patient is in excellent health conditions.

[Role of surgery in the treatment of pleural mesothelioma]. / Il ruolo della chirurgia nel trattamento del mesotelioma pleurico.

The authors present a review of the cases of pleural mesothelioma diagnosed and treated in the Institute of Special Surgical Pathology of the University of Ancona. They confirm the causative role of asbestos in the aetiology of this disease and indicate that the surgical approach is the best diagnostic means available via open biopsy and that the only curative procedure is pleuropneumonectomy. Such surgery, however, is confined to patients properly studied according to the scheme proposed by Butchart, namely stage I patients in excellent physical condition.

[A case of malignant pancreatic apudoma producer of serotonin and pancreatic polypeptide]. / Su un caso di apudoma maligno pancreatico a produzione di serotonina e polipeptide pancreatico.

Taking as their starting point the observation of a pancreatic malignant endocrine neoplasm with mixed production of serotonin and pancreatic polypeptide, the authors go on to review the literature on the diagnosis and treatment of pancreatic apudomas. The possibility of performing an extempore intraoperative histological examination makes it possible to obtain a correct diagnosis of endocrine neoplasm and thus to proceed with surgery which could not be contemplated in adenocarcinomatous forms at an equivalent stage. Chemotherapy may then provide additional therapeutic possibilities, using specific markers for malignancies of the APUD system in order to detect possible recurrences.

[Primary lymphomas of the gastro-intestinal tract]. / I linfomi primitivi del tratto gastro-intestinale.

The authors considered a series of 13 patients undergone surgical operation for primary malignant lymphoma of digestive system, with gastric, gastro-jejunal, jejunal, ileal and colic localization. They examined diagnostic and therapeutic features and the follow-up data. According to literature, the authors remark the importance of roentgenology and endoscopy, that together with bioptic data may reach a definite and early diagnosis; an elective and wide surgical exeresis seems useful in early stages, showing a better prognosis and epithelial malignancies. IV stage patients, however, had a very poor survival; a quick management appears today the only factor affecting long-term results in these patients.