ABSTRACT
Intraoperative ultrasonography (I.US) has been introduced in order to overcome the limits of the preoperative imaging modalities (notably, ultrasonography and computed tomography), both in pancreatic cancer diagnosis and staging. The authors' experience encompasses 32 cases, selected according to the following criteria: lesions that could not be detected both preoperatively and at surgical exploration; lesions detected but not properly characterized, requiring differential diagnosis between cancer and pancreatitis; tumoral lesions with a perspective of radical surgery, in which the preoperative judgment of resectability had to be verified. In the only case of the first group, I.US allowed the identification of a small cancer in a jaundiced patient. In the 11 cases of the second group, I.US-guided fine-needle aspiration biopsy showed three cancers; however, among the other 8 lesions classified as pancreatitis there was one false negative diagnosis (a tumoral mass with liver metastases was demonstrated by computed tomography 6 mo later). Regarding the intraoperative staging of the proven cancers (20 cases of the third group; 4 cases of the first and second groups), I.US changed the planned surgical approach in 9 cases (showing vascular involvement or detecting liver metastases and enlarged lymph nodes not seen preoperatively); in 12 cases it confirmed the possibility of radical surgery. Finally, in the remaining 3 cases, I.US provided dubious information: only vascular dissection during surgery could achieve a correct evaluation, ruling out vascular involvement and thus allowing tumor resection.
Subject(s)
Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/surgery , Adult , Aged , Diagnosis, Differential , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Neoplasm Metastasis/diagnostic imaging , Neoplasm Staging , Pancreatic Neoplasms/diagnosis , Pancreatitis/diagnosis , Pancreatitis/diagnostic imaging , Tomography, X-Ray Computed , UltrasonographyABSTRACT
A 44-year-old male affected by mesenchymoma of the mediastinum was treated surgically. The neoplasm, localized in the postero-inferior mediastinum with prevalent development to the left, was found to consist of adipose, leiomuscular and myxoid tissue. The patient was asymptomatic. Complete removal of the neoplasm proved possible, and one year after surgery no signs of recurrence were present. Few cases of mediastinal mesenchymoma have been reported.
Subject(s)
Mediastinal Neoplasms/diagnosis , Mesenchymoma/diagnosis , Adult , Biopsy, Needle , Bronchi/pathology , Bronchoscopy , Humans , Male , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/surgery , Mediastinum/diagnostic imaging , Mesenchymoma/pathology , Mesenchymoma/surgery , Tomography, X-Ray ComputedABSTRACT
The authors consider their experience in male breast cancer. Making a review of the literature they point out the risk factors and the prognosis of this disease.
Subject(s)
Breast Neoplasms/diagnosis , Carcinoma, Intraductal, Noninfiltrating/diagnosis , Adult , Breast Neoplasms/epidemiology , Breast Neoplasms/surgery , Carcinoma, Intraductal, Noninfiltrating/epidemiology , Carcinoma, Intraductal, Noninfiltrating/surgery , Humans , Lymphatic Metastasis , Male , Middle Aged , Prognosis , Risk FactorsABSTRACT
The Authors show a case of a 68 year old woman underwent a successful operation for spontaneous stomach heavage. The linear solution of continuity, 5-6 cms long, was sutured on the small gastric curve. The treatment consisted in suturing the lesion and performing a decompressive gastrostomy.
