Intraductal papillary carcinoma of the parotid gland with low malignancy.

A peculiar case of papillary carcinoma arising in the parotid gland is reported. A 68-year-old woman presented with a right, painless, parotid mass, measuring approximately 3 cm in greatest diameter. A conservative parotidectomy was performed. Histologically, the neoplasm showed exophytic papillary projections into a cavity. The cells were focally suggestive of epidermoidal differentiation, whereas a transitional differentiation was noted in other portions, as in bladder papilloma. Immunohistochemical studies showed strong positivity of the neoplastic cells for cytokeratin and weak positivity for PCNA and Mib-1. We classified this neoplasm among the papillary tumors with a low-grade of malignancy.

[Small cell carcinoma of the esophagus: a case report]. / Il carcinoma a piccole cellule dell' esofago: descrizione di un caso clinico.

The authors present the case of a primitive small cell esophageal carcinoma. It is a rare and biologically aggressive neoplasm which occurs mainly in the elder male. The case observed concerns a 69 year old female treated with surgical therapy consisting in esophagectomy and intrathoracic esophagealgastrictype plasty. Diagnostic problems either histological or immunohistochemical and the choice of the following treatment are discussed. The cases of patients treated in other Surgical or Oncological centers are reported. Therapeutic orientation adopted by our group is stressed. In this case we have chosen surgical therapy because a sure diagnosis come be given only on the base of the attent histological examination of the entire specimen (endoscopic biopsies are not sufficient); survival data reported are in favour of surgical treatment where secondary metastases are not evident in the respect of antiblastic therapy and/or radiotherapy. Neoplastic recurrence occurred ten months after and a metallic endoscopic esophageal prothesis was positioned. The patient died 1 year after surgery by mediastinal syndrome.

[Terata catydidymus dicephalus: description of a case]. / Terata catydidymus dicephalus: descrizione di un caso.

Conjoined twinning is the result of an abnormal developmental process of "twinning" in which two similar weighted and sized twins are partially conjoined and show a total symmetry independently from the pattern of conjunction. They are classified in three groups: Terata Catydidymus, Terata Anadidyma and Terata Anacatadidyma. Among Terata Catydidymus the dicephalus subtype is a rare abnormality with a severe prognosis compared to other subtypes as: diprosopus, pyophagus and ischiopagus. We report the case of a fetus at the 15th weeks of pregnancy. The external examination revealed severe diffuse somatic malformations consisting of dicephalia with a double neck in conjunction to a single chest, a single abdomen, a double spine conjoined distally near the sacrum, buds of ribs in between the two spines with mid clavicular and scapular fusion following the major axis of the two bones. Arms and legs revealed no abnormalities. Central nervous system structures were normally developed and the two hemispheres seemed completely separated and independent one to the other. We believe that the case described is interesting being Terata Catydidymus a rare phenomenon, being the dicephalus subtype still lesser frequent and its occurrence in males quite exceptional.

[Merkel cell carcinoma of the skin. Two clinical cases]. / Carcinoma a cellule di Merkel della cute. Considerazioni su due casi clinici.

In this study are described two clinical cases of Merkel cell tumor treated in the first half of 1991. The MCC is a rare primary skin tumor with an aggressive biologic nature. The elective therapy of primary sites is surgical management with lymphadenectomy although this kind of treatment is debated. Local recurrence high incidence requires a frequent and careful follow-up with possibility of second surgical treatment in the cases without metastasis and a radiochemotherapy in the patients affected by systemic recurrences.

[Hydatid choleperitoneum: a rare complication of hepatic hydatid disease]. / Idatidocoleperitoneo: rara complicanza della idatidosi epatica.

The authors report their experience relative to hydatid choleperitoneum which is a rare complication of hydatid hepatic disease (one case of 236 operated). They underline how such pathology constitutes a clinic and anatomopathological case, well characterized and different from those offered by other complications of this hepatic disease. They draw attention moreover on how preoperative diagnosis is often difficult and consequently how the surgical therapeutic technique requires a very careful examination of anatomic relations of the lesion and recognize, as a chiefly foundation, a radical treatment of hepatic disease and whenever possible, the removal of the pseudomembrane of encystment.

[Use of the omental mesh graft in protecting intestinal anastomoses. Experimental research]. / L'uso dell'innesto omentale a rete nella protezione delle anastomosi intestinali. Ricerca sperimentale.

The faultless seal of the intestinal anastomosis makes up a very important event of abdominal surgery. This work proposes an original experimental method to reinforce the intestinal anastomosis and to prevent the complications due defective seal of the sutures. The results obtained show that this method reduces remarkably the possibility of peritonitis due to the filtration or dehiscence of reinforced anastomosis as regards a control group not treated with omental mesh graft.

[Perforation of the colon]. / Le perforazioni del colon.

The paper reports personal observations relating to 111 cases of colonic perforation. Etiopathogenesis and different surgical approaches are discussed and results are compared. Hartmann's operation is identified as the best solution in cases of colonic perforation with diffuse peritonitis. In cases of localized peritonitis, excellent results may be obtained by operating immediately.

[Emergency surgery in icterus]. / Chirurgia d'urgenza negli itteri.

Obstructive jaundice may be, still today, a surgical emergency. After the analysis of the serious syndrome following a persistent cholestasis, the authors discuss new technological diagnostic procedures and indications, pros and cons of the use of P.T.D. (Percutaneous Transhepatic Drainage). Finally, they underline emergency cases and proper surgical management, on the basis of their personal experience, as well.

Management of liver trauma.

A ten-year experience with the management of liver trauma is reported. The diagnostic approach is examined, stressing the role of selective arteriography. The management of the 78 observed cases is described. The need for biliary drainage to prevent postoperative leakages, is supported. Overall mortality in this series was 16.6%.