Choroidal metastasis from lung adenocarcinoma: a rare case report.

The choroid is the most common site for intraocular metastatic di sease. Orbital metastasis as metastatic site of lung adenocarcinoma is very rare and in literature a very exiguous number of cases is present. This is a case report of a woman with history of lung adenocarcinoma and, after surgery, detection of a choroidal mass described as lung metastasis, responding to Gefinitib therapy. However a biopsy was not performed. After two years there was a great dimension decrement of the lung metastasis but she is still suffering from recurrent pleural effusion, with pleural thickenings biopsied and diagnosed as recurrences of disease.

Deep SSI after mesh-mediated groin hernia repair: management and outcome in an Emergency Surgery Department.

AIM: Mesh-mediated groin hernia repair is considered the goldstandard procedure. It has low recurrence rate. Rarely a deep Surgical Site Infection (SSI) is seen when a synthetic prosthesis is used. CASE REPORT: We describe a rare case of bilateral deep SSI after mesh-mediated groin hernia repair. Diagnosis was performed through the physical examination and radiological exams. Microbiological samples identified a methicillin-resistant Staphylococcus aureus responsible of the infection. Target therapy was performed and re-operation performed in order to remove the infected prosthesis and to apply a biological one to create the fibrous scaffold. During follow-up time, right side recurrence was observed. Tru-cut biopsy of fascia was obtained in order to identify the responsible of the recurrence. CONCLUSION: Combination of antibiotic therapy and surgical reoperation seems to be the correct way to approach the deep SSI after mesh-mediated groin hernia repair. The use of biological mesh after synthetic removal seems to improve the final outcome.

Terminal or truncal ligation of the inferior thyroid artery during thyroidectomy? A prospective randomized trial.

INTRODUCTION: Thyroidectomy is a common procedure in general and endocrine surgery. The technique of ligation of inferior thyroid artery (ITA) has been invoked as a possible cause of appearance of postoperative hypocalcemia. METHODS: We performed a prospective randomized study involving 184 patients undergoing total thyroidectomy to evaluate the differences of truncal ligation versus distal ligation of ITA in terms of postoperative hypocalcemia, vocal fold palsy, voice and swallowing impairment. The patients were divided into group A (trunk ligation of ITA) and group B (terminal branches ligation of ITA). RESULTS: We evaluated postoperative PTH and calcemia (immediate, 6 and 12 months after thyroidectomy), postoperative day of discontinuation of calcium and vitamin D supplementation, voice and swallowing complaints, evaluated by mean of two specific tests available in literature, day of hospital discharge. CONCLUSION: The only significant differences between the two groups were a higher immediate postoperative calcemia and a greater number of patients discharged without calcium and vitamin-D supplementation in the group B. In conclusion, no substantial differences were found between the two groups. The choice depends on the experience of the surgeon.

[B-cell lymphoma (MALToma) of the stomach and Helicobacter pylori infection]. / Linfoma a cellule B (maltoma) dello stomaco ed infezione da Helicobacter pylori.

The authors, after illustrating physiopathologic aspects of gastric MALTomas, examine the H.P. infections and the possible relations between this kind of bacterium and gastric MALTomas. They hypothesize that H.P. infection represents an important predisposition to gastric lymphoma, due to anatomopathological modifications over gastric mucosa. They conclude that a decreasing of gastric lymphoma could be correlatable an opportune eradication of H.P. despite of at moment it's impossible hypothesize a marked decreasing of lymphoma by an eradication of H.P.

[Synchronous carcinoma of the colorectum]. / Il carcinoma sincrono del colon-retto.

The incidence of synchronous carcinoma of the large intestine is rising in relation to a greater oncogenic environmental charge and increased average life expectancy. There is also a constant risk of not recognising the disease, especially in the case of small carcinoma and, to a greater extent, in patients operated during the occlusive phase. Having underlined the diagnostic value of a correct preparation of the colon prior to instrumental tests, the authors emphasise the importance of a careful intraoperative exploration of the viscera, its preliminary confinement in occluded subjects and repeated surgery in the event of doubts regarding the monolocation of the tumour. Lastly, they underline the importance of postoperative radiological and endoscopic controls since these tests mark both the successful outcome of treatment and the start of follow-up.