Intramuscular myxoma of the deltoid muscle: report of a case.

Intramuscular myxoma is a rare, benign lesion of mesenchymal origin, affecting the skeletal muscles. We report the case of a 75-year-old woman presenting with a mass of the right deltoid region. On the MRI examination it was interpreted as a lipomatous lesion. She underwent marginal excision. The pathological examination revealed the diagnosis of intramuscular myxoma.

Small bowel intussusception secondary to inflammatory fibroid polyp of the ileum: report of a case.

Inflammatory fibroid polyps are rare benign lesions of uncertain origin, that may occur in many different locations in the gastrointestinal tract, the gastric antrum being the most common site, followed by the small bowel. These lesions can cause abdominal pain, gastrointestinal bleeding, intestinal obstruction or intussusception. In the case of a gastric inflammatory fibroid polyp in the presence of Helicobacter Pylori infection, the patient can benefit from pharmacological eradication of Helicobacter Pylori. In case of an intestinal inflammatory fibroid polyp causing acute abdomen, the treatment is surgical. In this paper we report a case of an adult male patient with ileal intussusception due to an inflammatory fibroid polyp. A 62-year-old male patient presenting with acute abdomen underwent an exploratory laparotomy. At surgery an ileal tumour 15 cm from the ileocecal valve causing ileoileal intussusception was found. The intussuscepted segment was resected and an end-to-end anastomosis was carried out. The postoperative period was uneventful and the patient was discharged 5 days after the surgery. After 6 months, he is doing well and back to normal life. Even if inflammatory fibroid polyps are benign lesions, surgical treatment is the only solution when they present with intestinal intussusception. Preoperative diagnosis of inflammatory fibroid polyps is often difficult, and confirmation can only be obtained by histological and immunohistochemical examination. Since they can mimic malignant stromal lesions, the differential diagnosis must be done very carefully.

Thyroidectomy for Graves' hyperthyroidism. Retrospective study of patients' appreciation.

AIM OF THE STUDY: To retrospectively investigate the patients' views of surgical treatment of Graves' hyperthyroidism. METHODS: One hundred two patients were included in the study and submitted to extensive subtotal thyroidectomy or total thyroidectomy between 1993-2003. Data were acquired from the responses to a questionnaire, that was completed by 83 patients. RESULTS: Before the operation the working/studying ability and the social/emotional relations were impaired in 20% and 22% of cases. Preoperative information was adequate for 84% of patients. The perception of the hospital efficiency was favourable in 89% of cases, and the interpersonal relations with clinicians and nurses were very positive for 96% of patients. After the operation, all patients were hypothyroid on levothyroxine (l-T4); unexpected problems with l-T4 therapy occurred in 6% of cases. Voice changes or neck discomfort were reported by 29% and 8% of patients. The aesthetic appearance of the scar was very satisfactory for 70% of patients, but 11% were unsatisfied. The working/studying ability and the social/emotional relations improved in 63% and 59% of cases. Eye symptoms improved in 71% of the patients with endocrine ophthalmopathy, but got worse in 60%. The quality of life, expressed with a 0 to 10 scale, improved from a mean preoperative score of 4.7 to a mean score of 7.9 (P = 0.000). Only 5% of patients expressed hesitation to recommend surgery to a friend with similar disease. CONCLUSIONS: Surgery is an effective therapy for selected cases of Graves' disease and meets the expectations of the majority of patients. Nevertheless some possible factors for dissatisfaction are pointed out.

Valor prognóstico da morfometria no carcinoma folicular da tireóide / Prognostic value of morphometry in follicular thyroid carcinoma

Tendo em vista a escassa literatura a respeito de correlação entre a histometria dos carcinomas de tireóide e o prognóstico desses tumores, objetivou-se, nesta pesquisa, correlacionar parâmetros histométricos do carcinoma folicular da tireóide com o tempo de sobrevida após tratamento. Em carcinomas foliculares da tireóide de 60 pacientes foram realizadas medições no núcleo das células malignas (área, perímetro, diâmetro máximo, diâmetro mínimo) e calculados índices (razão dos diâmetros, fator de forma e índice de atividade mitótica). Esses parâmetros foram correlacionados com o tempo de sobrevida. Por outro lado, parâmetros clínicos e patológicos (sexo, idade, extensão local, comprometimento linfonodal, grau de diferenciação celular) também foram correlacionados com o prognóstico. Foram realizados cálculos autuariais e análise estatística uni e multivariada. Constatou-se que a sobrevida foi significantemente influenciada por variáveis clínicas e patológicas, tais como a idade dos pacientes e a extensão loco-regional do tumor. Nenhuma correlação estatisticamente significante pôde ser demonstrada entre parâmetros morfométricos e sobrevida, apesar dos resultados sugerirem associação entre o tamanho do núcleo das células malignas e a agressividade do tumor