ABSTRACT
Hilar cholangiocarcinomas or Klatskin tumors have been classified in 1975 by French surgeons Henri Bismuth and Marvin B. Corlette and this remains largely used in clinical practice. The authors present the TNM classification and the changes introduced by the sixth and seventh edition of Union for International Cancer Control regarding the tumors of the proximal bile duct and describe Blumgart classification for tumors of this site. The usefulness of these systems is assessed considering the last six years experience of the service.
Subject(s)
Bile Duct Neoplasms/classification , Bile Duct Neoplasms/pathology , Bile Ducts, Intrahepatic/pathology , Cholangiocarcinoma/classification , Cholangiocarcinoma/pathology , Klatskin Tumor/classification , Klatskin Tumor/pathology , Aged , Bile Duct Neoplasms/surgery , Bile Ducts, Intrahepatic/surgery , Cholangiocarcinoma/surgery , Diagnosis, Differential , Female , Hepatectomy/methods , Hepatic Duct, Common/pathology , Humans , Klatskin Tumor/surgery , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Retrospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To assess the value of aggressive loco-regional surgery in desperate situations with locally advanced breast cancer. METHODS: In this study there were considered 31 patients with locally advanced breast cancer who underwent surgery in a 5-year period. 10 of them received 3 cycles of chemotherapy and radiotherapy before surgical intervention; the rest of the 21 patients had systemic or local contra-indications for neo-adjuvant therapy. We describe clinical aspects and technical difficulties. Surgical intervention focused on tumour removal and lymph node dissection. Skin defect was covered with flaps according to the Mortimer-Show technique. Postoperatively, the outcome was influenced in a favourable way by the use of Detralex, a micronized flavonoid; all but 2 patients received chemotherapy and locoregional radiotherapy. RESULTS: 25 patients survived free of disease; from 6 patients who suffered recurrence, 2 are still living and 4 have died. CONCLUSIONS: In some forms of locally advanced breast cancer, aggressive surgery offers improvement in the quality of life and increases survival.
Subject(s)
Breast Neoplasms/pathology , Breast Neoplasms/surgery , Mastectomy/methods , Neoadjuvant Therapy/methods , Neoplasm Invasiveness/pathology , Neoplasm Recurrence, Local/therapy , Adult , Aged , Aged, 80 and over , Breast Neoplasms/mortality , Chemotherapy, Adjuvant , Combined Modality Therapy , Female , Humans , Lymph Nodes/pathology , Lymph Nodes/surgery , Mammaplasty/methods , Middle Aged , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Postoperative Complications/therapy , Prognosis , Radiotherapy, Adjuvant , Retrospective Studies , Sampling Studies , Survival Analysis , Treatment OutcomeABSTRACT
Stromal gastric tumors represents an uncommon entity with difficult diagnosis, both preoperative and pathological. We present the case of a patient admitted for abdominal pain, with palpable tumor in epigastrium and right hypochondrium; abdominal echography, barium enema and abdominal CT-scan were not able to precise the involved organ. Operative exploration found at the level of horizontal portion of the stomach a solid tumor, which was resected, with good subsequent evolution. Pathologic diagnosis was stromal gastric tumor. We present latest news concerning diagnosis, prognostic and treatment for this type of tumor.
Subject(s)
Leiomyosarcoma/diagnosis , Stomach Neoplasms/diagnosis , Aged , Biopsy , Diagnosis, Differential , Female , Humans , Leiomyosarcoma/surgery , Stomach/pathology , Stomach Neoplasms/surgery , Treatment OutcomeABSTRACT
We treated in 2001 in our clinic two patients with upper limb ischemic disease. Both patients had chronic pain and cyanosis of the fingers, with trophic disorders and partial amputations of distal phalanges. They were previously submitted to medical treatment with no result. We present the technique used, resectional thoracoscopic sympathectomy including T2 and T3 ganglia. First of the patients was operated on bilaterally in two successive operations, the second one only on the right side. There was an uneventful postoperative evolution with good immediate and short term results.
Subject(s)
Fingers/blood supply , Ischemia/surgery , Sympathectomy/methods , Arm/blood supply , Forearm/blood supply , Humans , Male , Middle Aged , Thoracoscopy/methods , Treatment OutcomeABSTRACT
We present a case of thyroidian cancer and chronic granulocytic leukemia simultaneously found in a 28 years old patient. Initial surgical management consisted in total thyroidectomy and removal of the lymph nodes; local recurrence after 6 months required excision of the tumoral block by radical neck dissection. Hematological disease was controlled with Hydroxiureea, associated, when needed, with Busulphan and Cytosar. The patient is in acceptable general condition and free of any local recurrence or apparent metastases 2.5 years after the diagnosis.
