[Spontaneous splenic rupture due to infectious acute mononucleosis: case report]. / Rottura splenica spontanea in corso di mononuleosi infettiva acuta: descrizione di un caso.

Infectious mononucleosis is an acute, viral, illness associated with a high incidence of splenomegaly. Spontaneous splenic rupture is a rare but life-threatening complication of infectious mononucleosis. The authors report the case of a 19-year-old patient with an infectious mononucleosis causing a spontaneous splenic rupture. When rupture occurs the mortality has been significant. The spleen may be vulnerable for the histopathologic changes that occur as a result of this illness. Two thirds of patients with infectious mononucleosis develop an enlarged spleen, but in only 0.5% of all patients will it rupture. Abdominal pain and tachycardia are unusual in uncomplicated infectious mononucleosis and should alert a doctor to the possibility of spontaneous splenic rupture. The diagnosis of splenic rupture may be confirmed in a variety of ways. In this patient ultrasound and Rutkow's criteria may aid in establishing the diagnosis. In patients with infectious mononucleosis suspected of having rupture of the spleen, a rapid but thorough assessment and prompt implementation of appropriate management should minimize the associated morbidity and mortality. On the basis of review of the medical literature and of our own experience, we advocate emergent splenectomy for spontaneous splenic rupture in patients with infectious mononucleosis.

[Atypical metastases from gastric carcinoma. A primary and isolated case localized in the abdominal wall]. / In tema di metastasi atipiche da carcinoma gastrico. Su un caso primitivo ed isolato localizzato alla parete addominale.

The authors report a rare case of gastric carcinoma metastasis localised in the anterior abdominal wall which was an isolated and primary sign of disease. After having underlined the rarity of the case, there is a brief discussion of aspects related to the spread of primary tumours in relation to other cases reported over the past decade; the most important reports of atypical secondary localisations are listed.

[Carcinoma of the cecum: is early diagnosis possible?]. / Il carcinoma del cieco: è possibile una diagnosi precoce?

Between 1982 and 1989, a consecutive series of 34 patients with cancer of the cecum were operated in our hospital. Overall, at 5 years the survival was 50%. We did not notice any correlation among symptom duration and survival. Patients admitted in the asymptomatic phase had the best survival rate (66.6%). Our study suggest that only neoplasm diagnosed in asymptomatic patients and treated promptly are related to a good survival rate. We, therefore, emphasize the importance and the necessity to investigate all patients with a suspected cecum cancer by means of colonoscopy.

[An unusual case of hydatid cyst with adrenal localization]. / Su un caso eccezionale di cisti idatidea a localizzazione surrenalica.

The paper reports a case of hydatid cyst with a primary adrenal location. Having underlined the rarity of this finding and reviewed the literature on the topic, the Authors discuss the epidemiological, pathogenetic and clinico-diagnostic aspects. In conclusion they underline the difficulty of arriving at a precise diagnosis prior to surgery in spite of the fact that new imaging diagnostic methods enable diagnostic hypotheses regarding this pathology to be advanced.

[Extra-ocular sebaceous carcinoma: report of a case]. / Il carcinoma sebaceo extra-oculare: a proposito di un caso.

The Authors streamed the rarity of this pathological entity for which the histologic diagnosis is even very difficult. Treatment is based on a wide surgical excision; the value of postoperative irradiation and chemotherapy is discussed. The prognosis is poor.