[Clinical study of metastasis of thyroid differentiated carcinoma]. / Studio clinico sulle metastasi da carcinoma differenziato della tiroide.

The Authors report 5 cases of distant metastases of well-differentiated thyroid carcinoma over a number of 114 patients operated for thyroid neoplasm (4.3%). In 101 pts was total thyrodectomy performed, in 13 pts underwent istmo lobectomy. Distant metastases were verified in 3 patients with follicular and in 2 patients with papillary carcinoma. In 2 cases the metastases were in lungs, in 2 cases are the bone, and in one patient in lungs and bones. In 3 patients istmolobectomy had been performed at first operation. All the patients were treated with radioiodine. Three patients were alive after 3, 5 e 10 years from the diagnosis of metastases, 2 of them are presently disease free.

[Reoperations in thyroid surgery]. / Reinterventi in chirurgia tiroidea.

The Authors examine etiology, incidence and hazards related to reoperation in thyroid surgery either for benign either for malignant pathology. The Authors present, then, 26 secondary operations performed in the Unit of Surgical Pathology of the Department of Surgical Sciences Chieti University: 15 for benign, 11 for malignant pathology. In the cases of thyroid malignant pathology, in 2 patients (operated in different hospitals) there was a parenchimatous recurrence, in 2 patients a lymphnodal recurrence. In all the patients a total thyroidectomy was performed, in one patient associated with lymphadenectomy. In the patients with lymphadenomatous recurrence a functional laterocervical lymphadenectomy was performed.

[Our experience regarding biologically inactive gastroenteropancreatic neuroendocrine tumors]. / La nostra esperienza in tema di: tumori neuroendocrini gastroenteropancreatici biologicamente inattivi (GEP-BINT).

The Authors present 9 cases of gastro-enteropancreatic neuro-endocrine biologically inactive tumors. In 5 cases the tumor site was appendicular. In 4 patients an appendectomy was performed, in one patient a right hemicolectomy and the patients after a period of 3-9 years are well and disease free. In a patient with a gastric carcinoid and a single hepatic metastasis a total gastrectomy with an hepatic metastasectomy were performed but the patient died 16 months thereafter. In a case localized to the right colon with a single hepatic metastasis a right hemicolectomy was performed with a metastasectomy but the patient died after 12 months. In a case localized to an ileal loop a segmental resection was performed followed by a medical therapy with octreotide and the patient is well and disease free after 3 years. In a case localized to the pancreas with widespread lymphatic metastasis it was performed a simple biliary diversion (coledocho-duodenostomy) followed by medical therapy with octreotide. Surprisingly after 4 years the patient is alive and a TC control shows a decrease of the pancreatic tumor and of the lympho glandular tumefactions.

[Isolated cystic cervical lymphatic metastasis from occult papillary carcinoma of the thyroid: unusual and rather difficult diagnosis]. / La metastasi cistica linfonodale cervicale isolata da carcinoma papillare occulto della tiroide: una diagnosi rara e talvolta difficile.

Thyroid papillary carcinoma, exceptionally, can appear with cervico-lateral metastases in absence of thyroid evident disease. In that case we can have an infected branchial cyst, therefore is very important a correct preoperative diagnosis with FNAB. In literature were described 30 cases of cervico-lateral cystic masses that the histology revealed as occult papillary carcinoma metastases. Our experience is about 80 cases of papillary carcinoma, in only 2 cases the cancer was evident as a tight-elastic tumour in cervico-lateral region, hypoechogenic to the US scan with irregular and thick wall: one of the patient had multinodular goiter; the other one didn't have clinical of US scan character of thyroid disease. FNAB on lymph nodes shows doubtful cells evidence. Both patient had a total thyroidectomy with functional cervico-lateral and MAS lymphadenectomy. In one patient histology showed a papillary carcinoma of 4 mm in the right lobe, in the other patient the cancer was unknown. FNAB, in all doubtful cases, is the most important diagnosis test.

[Our experience with pheochromocytoma]. / La nostra esperienza in tema di feocromocitoma.

The authors report cases of pheocromocytomas operated in the period 1991-1997. 16 of these patients presented a monolateral pheocromocytoma, 1 a bilateral. A patient had a malignant evolution, one patient presented an extrasurrenal para-aortic localization. All the patients were operated by a middle longitudinal laparotomy. There was no mortality, neither significant morbility. In all the patients, who presented pre-operatory arterial hypertension, there was a regression of the symptomatology.

[Clinical study on transient hypocalcemia subsequent to thyroid excision interventions]. / Studio clinico sui quadri di ipocalcemia transitoria conseguente ad interventi di exeresi tiroidea.

The Authors have examined 30 patients post-total thyroidectomy and registered a transient decrease of calcemia in 9 and a decrease of PTH in 11. Serum albumin and calcitonin were always normal. In all the patients calcemia and PTH returned to normal values in 7 days except in 2 patients in whom the values were normalized after one month.