[Total versus subtotal thyroidectomy for multiple node goiter: experience with 350 surgically treated cases]. / Tiroidectomia totale vs tiroidectomia subtotale per gozzo plurinodulare: esperienza su 350 casi operati.

The surgical treatment of benign thyroid pathology and in particular the multinodular form is controversial. This controversy exists and one must choose either perform conservative surgical therapy such as lobectomy or sub-total thyroidectomy or total thyroidectomy. From January 1985 to July 1999, the Authors observed 534 cases of benign thyroid pathology. Of these 534, 330 were diagnosed with primitive goiter, and 20 with recurrent goiter; 13 cases of the primitive goiter type were found to have microfoci of carcinoma inside the goiter on the definitive histologic exam. There were 275 patients who underwent total thyroidectomy and the remaining 75 cases with ultrasound proven multinodular goiter were treated with lobectomy or sub-total thyroidectomy, depending on the appearance at the time of the operation as well as the macroscopic and microscopic exams of the integrity of the glandular parenchyma performed while in the operating room. The Authors demonstrated that in multinodular goiter there is a high percentage of cases with disease involving the entire gland. Many areas of apparently healthy tissue are found to be microscopically involved with a variable grade of chronic lymphocytic thyroiditis or follicular hyperplasia or even lobular dysplasia with the tendency to form nodules. These signs of disease of this organ tend to recur if not treated.

[Castleman disease: a clinical case report]. / Malattia di Castleman: presentazione di un caso clinico.

Castleman's disease is an enigmatic lymphoid disease of unknown etiology and has different clinical manifestations. The authors present a case of a young woman with cervical localization of Castleman disease, asymptomatic. The disease was misdiagnosed and was treated for five years as thyroiditis, diagnosis confirmed by ultrasonography, scintigraphy and cytology. The particular size of the neoformation and its constant growth leaded the authors to the surgical treatment. The thyroid was normal both macroscopically and with biopsy. The neoformation was 10 cm of diameter and covered the left side of the thyroid.

[Angiomyolipoma of the kidney]. / L'angiomiolipoma del rene.

The renal angiomyolipoma is a rare, benign, no epithelial neoplasm. It is frequently associated with tuberous sclerosis, above all in young patients. It may be under an asymptomatic form, especially if it deals of a small volume neoplasm, and sometimes it becomes evident only when it occurs an haemorrhagic complication. When we have a sure diagnosis and a small tumor, the treatment is preservative; on the contrary it is surgical either for big symptomatic neoplasms or haemorrhagic complications. The authors report a clinical case of renal angiomyolipoma in a pregnant patient, who had an haemorrhagic complication and was treated with nephrectomy.

[Intestinal tuberculosis--a clinical case]. / La tubercolosi intestinale--caso clinico.

The intestinal tuberculosis is a rare disease in Europe and in North America. It is an important disease because some patients can develop intestinal stricture or subacute intestinal obstruction and, sometimes, tuberculous peritonitis. It is often difficult differentiate intestinal tuberculosis from Crohn's disease or intestinal tumors. The treatment is controversial and may be medical or surgical, but the response to medical therapy is not clear, especially in complicated disease. The authors report a case of ileal tuberculosis treated with surgical therapy.

[A case of giant hamartochondroma of the lung]. / Su di un caso di amartocondroma gigante del polmone.

The authors present a case of pulmonary hamartochondroma of exceptional size, of which they give a clinical descrition and explain the surgical treatment. Next, aloso in the light of recent literature on the subject, they review the possible causes of this disorder in terms of several histopathogenetic hypotheses, and they discuss problems of differential diagnosis as well as the histopathological aspects of this rare, benign tumor of the lung. They conclude that even though malignant transformation of hamartochondroma is exceptional, these tumors should always be removed surgically as soon as they are diagnosed or reasonably suspected.