[Pulmonary hamartoma: a case report]. / L'amartoma polmonare: contributo casistico.

The authors describe a case of lung hamartoma recently observed. Diagnosis occurred by chance through routine chest X-rays. A stationary radiological aspect of the hamartoma, regularly followed up, suggested to defer surgery up to the moment of a visible radiologic enlargement of the lesion.

Analgesia with epidural calcitonin in cancer patients.

We evaluated the analgesic effect of salmon calcitonin (sCT) on 14 patients with intractable cancer pain. The drug was administered by epidural infusion (4-8 bolus administrations in 48 h); the dosage was 100 IU/48 h in 5 patients and 400 IU/48 h in 9 patients. Significant, although limited, pain relief and nocturnal pain relief were obtained; the requirement for conventional analgesic drugs was substantially reduced. The treatment was well tolerated and no side effect was recorded. However, only in 3/14 patients did pain relief result in improvement of mobility, with two patients becoming able to ambulate; no patient experienced absence of pain. In general, the treatment produced only limited benefit and subsequent morphine treatment was required in all instances. Widespread use of epidural sCT in intractable cancer pain is not justified as a routine procedure and more substantial evidence is required to support the clinical utility of such an approach.

[Adrenal metastasis: clinical and pathological aspects]. / Metastasi surrenaliche: aspetti clinici e patologici.

The clinical and autopsy records of 91 patients who died of various malignancies in January 1980-December 1985 were reviewed with regards to metastatic involvement of the adrenal glands. Metastatic involvement was found in 28/91 i.e. 30.7% of all cases, and in 17/30 cases of lung cancer (56.6%). Although in the majority of cases adrenal metastases were associated with widespread metastatic (terminal) disease, thus questioning the utility of clinical surveillance, in 4/17 cases with lung cancer the adrenals were the only visceral site of metastasis. Symptoms were rarely seen and were in all instances aspecific and attributable to the underlying cancer. Early and accurate identification of suprarenal metastasis would, at least in these cases, be a great help in deciding on the therapeutic approach. Unfortunately our ability to diagnose these metastases is somewhat limited partly because the symptoms are few and aspecific, partly because we lack efficient and economical diagnostic techniques. In fact the simpler laboratory techniques cannot identify early metastatic lesions. However assessment of the adrenals should be part of routine staging and restaging procedures in some neoplasias, for the frequency and clinical relevance of these lesions.