[Treatment of hot thyroid nodule with percutaneous ethanol injection. Our experience]. / Trattamento del nodulo caldo tiroideo mediante iniezione percutanea di etanolo. Nostra esperienza.

Thyroid nodule is defined as "hot" on the bous it scintigraphic appearance. It can be defined like benign nodule with autonomous functionality. On scintiscan it shows high captation because there's an increase of production and secretion of thyroid hormones with total inhibition of TSH and suppression of extranodular tissue. Generally the treatment of hot thyroid nodule was surgical or with radio-metabolic therapy. Percutaneous ethanol injection (PEI) in the treatment of hot thyroid nodules has been suggested recently. The aim of our study was to value therapeutic effects of PEI under guidance by means of ultrasound in patients with hot nodules in toxic or pretoxic phase. 36 patients with autonomous thyroid nodules of 1.8-6 cm in diameter received sterile ethanol at 95% that has been injected with a 22-gauge needle and a probe with a guide device. The administrated dose varied from 1.2 to 1.5 ml for cc of tissue in 5-12 sessions. Ethanol injection was performed in a single site in nodules with diameter < 3 cm and in double sites in nodules with diameter > 3 cm. The patients were checked after treatment and then 3 and 6 months. Our experience confirms an excellent response to PEI in these patients. In fact after therapy symptoms of hyperthyroidism and hormonal levels become normal; no patient has even reached the range of subclinical or clinical hypothyroidism. Scintigram showed that previously suppressed thyroid tissue resumed functioning; at ultrasound all nodules had shrunk: thyroglobulin levels increased during treatment because ethanol induces coagulative intranodular necrosis with release in systemic circulation of this glycoprotein.(ABSTRACT TRUNCATED AT 250 WORDS)

Hürthle cell neoplasm.

Hürthle cell neoplasms (HNC) of the thyroid gland are uncommon, but potentially malignant lesions. Opinion is divided as to their most suitable surgical treatment. In the ten-year period between 1976 and 1986, 46 patients with Hürthle cell tumor underwent surgery in our Department. Preoperative diagnosis was made by fine needle biopsy. In all cases but six, total lobectomy plus isthmusectomy was performed. In our experience HCC can be differentiated from benign forms by careful evaluation of invasive malignancy criteria performed by an experienced thyroid pathologist and by electron microscopy. In agreement with Bondeson et al. we found that lesions larger than 2 cm should not be considered potentially malignant, and do not warrant aggressive surgical treatment. Therefore, on the basis of our experience, we initially treat Hürthle cell tumors with hemithyroidectomy and isthmusectomy, and only if biopsy tissue shows histologic and electron microscopic signs of malignancy, do we resort to total thyroidectomy.

[Echotomography in scrotal pathology]. / L'ecotomografia nella patologia scrotale.

The authors reviewed their experience on 94 cases of patients suffering from scrotum diseases. This study was carried out either by means of grey-scale or real-time ultrasonography. They consider ecotomography to be an essential diagnostic aid in the clinical investigation of patients affected by this pathology, being a non invasive method and characterized by very high reliability.

[Hyperthyroidism as a rare cause of "false acute abdomen"]. / L'ipertiroidismo quale causa rara di "falso addome acuto".

4 patients affected by hyperthyroidism presenting a feature of "false acute abdomen" as main clinical sign are presented. The low incidence of that association, according to the literature, and the difficulties of a correct diagnosis, which could lead to a useless laparotomy is pointed out. The conclusion is drawn that tests of thyroid functions should be done whenever the feature of acute abdomen presents without any past history of gastro-enteric lesions.