[Mucinous cystic tumour of the pancreas. A case report]. / A proposito di un caso di tumore cistico mucinoso del pancreas.

Although cystic neoplasms and lesions of the pancreas are rare (5% of exocrine tumours), they have attracted a great deal of attention because of their potential curability. In contrast to serous cystic neoplasms, which are generally benign, the mucinous variant is known to have considerable malignant potential. Most authorities agree that no imaging technique (US, CT, MRI) is sufficiently accurate to differentiate between the multiple benign, premalignant and malignant lesions that can be visualised. We report a case of a young woman with a mucinous cystic tumour of the pancreas which was successfully treated surgically and compare our data with those emerging from a review of the literature. We observed a 26-year-old woman who presented with an abdominal mass and mild symptoms. CT scan suggested a mucinous cystic neoplasm of the pancreas. We treated the patient surgically, performing resection of the neoplasm with left pancreatectomy. The histological examination revealed a benign pancreatic cystadenoma. Mucinous cystic neoplasms of the pancreas have a substantial malignant potential and should be treated surgically with adequate resection margins. Moreover, in our opinion, even small lesions, especially if symptomatic or present in older patients, are likely to be malignant and warrant thorough exploration in patients whose condition permits it.

[Rupture of voluminous atherosclerotic superficial femoral artery aneurysm]. / Rottura di voluminoso aneurisma aterosclerotico dell'arteria femorale superficiale.

Atherosclerotic aneurysms of the superficial femoral artery are very uncommon. We report a case of a ruptured superficial femoral artery aneurysm which was successfully treated surgically, and compare our data with those emerging from a review of the literature. We observed a 74-year-old man who presented with a suspected rupture of a superficial femoral artery aneurysm. After confirmation of the diagnosis with angio-CT, we treated the patient by performing an endoaneurysmectomy and replacing the arterial aneurysmatic segment with interposition of a polytetrafluoroethylene prosthetic graft. There has been no evidence of complications in the short to medium-term. In our review of literature, we collected 43 cases of superficial femoral artery aneurysms. These aneurysms were diagnosed after rupture (30-46%) or thrombosis and embolism (12-46%). Other aneurysms are frequently concomitant (27-69%). The best treatment is based on replacing the aneurysmatic segment with a prosthetic graft which may be autologous (saphenic vein) or heterologous (polytetra-fluoroethylene). In patients with obstructive arteriopathies exclusion of the aneurysm by ligation of the proximal and distal artery may be enough. The high incidence of complications suggests that resection and grafting should be performed electively, and the frequent association with aortoiliac or peripheral aneurysms means that thorough investigation and follow-up are mandatory.