A rare case of giant papillary adenoma of the breast.

The authors present a case of giant papillary adenoma of the breast and discuss their therapeutic strategy. The patient subsequently returned due to a local recurrence, which was treated with oncoplastic surgery, with satisfactory aesthetic results. The authors conclude by stressing the considerable rarity of this disease and the need for effective cooperation between surgeons and pathologists.

[Adrenal incidentaloma in elderly patients]. / Gli incidentalomi surrenalici nell'anziano.

The adrenal incidentaloma is a disease that, thanks to the progress of the modern diagnostic, means for the longer and more high quality of life, has given a progressive increase in its impact, which has become more apparent in the elderly population. The authors after a review of literature on the impact and diagnostic, troubleshooting data endocrinology and imaging, these adrenal gland silent tumor clinically poses, envisage a therapeutic for use in older patient protocol.

[Carotid body tumor. An often misdiagnosed disease]. / Chemodectoma carotideo. Una entità spesso misconosciuta.

Chemodectomas are uncommon neoplasms, born by glomic cell of extra-adrenegic system. Usually, these neoplasms are benign and non functioning, but when they are more than 4 cm can induce a neuro-vascular compressive syndrome. In this study the Authors propose the guidelines for diagnostic, clinical and therapeutic management, of these tumors according to their experience.

[Differentiated thyroid cancers]. / I carcinomi tiroidei differenziati.

The Authors, after a review of the topic of thyroid cancer, focus on the epidemiology, aetiology and diagnosis of well-differentiated thyroid cancers. They then describe their own case series and their many years' experience in treating the patients affected by this pathology, which is generally regarded as having low malignancy. Nowadays the Authors consider the treatment of choice the total thyroidectomy with central compartment lymphectomy, eventually associated with metabolic radiotherapy.

[Radio-guided parathyroidectomy]. / La paratiroidectomia radioguidata.

The Authors, after a careful review of literature about the instrumental diagnostic techniques (with particular attention to the nuclear-medical ones) and the surgical therapy of parathyroid diseases, report their experience on the use of the radio-guided mininvasive surgery with MIBI and gamma-probe for intraoperative localization of pathological glands. Once exposed their experience, the Authors conclude asserting that this technique is fast, slightly invasive and expensive, and certainly useful for the detection of pathological or ectopic glands. It can be widely employed because, in comparison to its numerous advantages, such as the reduction of the operating time and of the hospital-stay, the greater radicality and the possibility to use mininvasive techniques, it does not present significant technical limitations and/or radio-protectionistic problems.

[Hyperparathyroidism from mediastinal parathyroid adenoma. Case report]. / Iperparatiroidismo da adenoma paratiroideo a localizzazione mediastinica. Caso clinico.

The authors, after reviewing parathyroid gland diseases, their location, and the modern strategies that can be used for their pre-operative detection, describe a case of primary hyperparathyroidism which recently came to their attention. The use of a combination of instrumental techniques (US, scintigraphy and SPEcT) enabled them to establish, prior to surgery, the mediastinal ectopic site of the parathyroid adenoma. Mini-invasive surgery proved to be the optimal technique to performing a targeted surgical excision that reduced the operative time and the hospitalisation.

[Surgical treatment of uninodular gotter. Personal experience]. / Trattamento chirurgico dei noduli unici della tiroide. Esperienza personale.

The Authors report their surgical experience in patients with uninodular goitre, and stress the trends in management benign and malignant lesions. The total thyroidecromy is the first choice. In some well selecrioned cases it is possible a videoassisted approach.

[Riedel's thyroiditis. Personal experience]. / La tiroide di Riedel. Esperienza personale.

The Riedel's thyroiditis, also called "wood's thyroiditis", is a rare chronic "inflammatory" disease of unknown etiology, relatively frequent in female >45-50 years, characterized by a fibrotic process that pervades thyroid and neighbouring structures (vessels, muscles, oesophagus, trachea upper- mediastinum). The authors discuss about three cases of Riedel's thyroiditis and report the outcome after total thyroidectomy in two cases and sub-total resection in the other one.

[Digestive hemorrhage in portal hypertension: role of sclerotherapy]. / Le emorragie digestive da ipertensione portale: ruolo della scleroterapia.

Haemorrhage is perhaps the most terrible complication of portal hypertension whatever is the etiopathology. The authors point out how sclerotherapy of the varices is either a prophylaxis and a therapeutic procedure with a low rate of local and systemic complications. Even if they are supported by good results in personal experience, the authors notice as important is to tailor the treatment for each patient.

[Informatics in a surgery department]. / Informatizzazione di un reparto di chirurgia.

In this paper the Authors describe their own experience in applying informatics at the Surgical Division III of Azienda Policlinico Universitario of Messina. After a discussion about existing hardware (LAN of PC) and daily used software (commercial suite) for managing the clinical reports and correlated data (images, medical prescription, reservations, and so on), their conclusion is that a great development on this way will be possible with extension of the services to all the business network and then to WAN as Internet.