1,720,986 research outputs found
Infraclavicular subpectoral lipoma causing thoracic outlet syndrome
No full texttINTRODUCTION: Thoracic outlet syndrome (TOS) includes a group of disorders caused by extrinsic com-pression of neurovascular structures between the 1st rib and clavicle. It usually presents as an enlargingneck mass, with shoulder or upper limb pain, weakness, paresthesias and impalpable radial pulse (Ray-naud’s phenomenon). PRESENTATION OF CASE: We report a rare case of TOS caused by an infraclavicular subpectoral lipomathat, although challenging because of limited access and proximity of vital neurovascular structures,was successfully removed through a simple transaxillary incision with an excellent esthetic result. Thepatients is symptom-free 6 months after surgery. DISCUSSION: Multiplicity of symptoms makes causes, diagnosis, and treatment of TOS controversial.Accurate diagnosis of TOS can be a substantial challenge in practice, because of a lack of physician aware-ness, overlapping of clinical features, and an absence of clearly defined diagnostic criteria. TOS may beassociated with the presence of a benign subpectoral mass like lipomas, that seldom have an irregulardistribution that involve neurovascular structures. CONCLUSION: Although benign soft tissue tumors infraclavicular subpectoral lipomas may exert pressureon neurovascular surrounding structures during their progressive expansion and cause TOS. Therefore,a thorough preoperative study by radiological imaging such as MRI or neurophysiological test shouldalways be performed in order to prevent unintentional lesions of the involved axillo-subclavicular plexusand plan correct surgical procedure
Preservation and peeling of the inferior mesenteric artery in the anterior resection for complicated diverticular disease.
No full textThe authors, on tbe basis oJ 3 cases oJ complicated
diverticular disease, discuss the indications to surgery,
considering the advantages and disadvantages oJ the various
surgieal teehniques and examining injartieular the rules flr
a eorreet operation with reseetion an primary or seeondary
anastomosis. As they performed a reetosigmoideetomy with
primary high eoloreetal anastomosis, they report the reasons
why they adopted the preservation and peeling of the inferior
mesenterie artery (IMA)
Subtotal colectomy with ceco-rectal anastomosis
No full textA case o/ subtotal colectomy cecoproctostomyfor multiple
lesions 0/ the colon is introduced This procedure has aduantages
over ileoproctostomy because it spares the terminai
ileum, ileocecaljunction and cecum. Due to the high incidence
0/ bou/el movements after tbe ileoproctostomy operation,
the authors recommend cecoproctostomy as a valid
choice in a selectioned group o/ patients wiih multiple or
extended lesions that spares cecum and rectum
Ovarian endometriosis involving the intestine with "ab estrinseco" stenosis of the sigmoid
No full textThe Authors report a case of ovarian endometriosis causing an "Ab extrinseco" sigmoid stenosis. The histogenesis as well as different possibilities of treatment, i.e. medical and surgical, are discussed
A case of ileocecocolic intussusception from cecal carcinoma
No full textThe authors present a case oJ ileocecocolic intussusception by
carcinoma o/ the caecurn. They stress the most peculiar aspects
oJ this condition: rare etiology; complete invagination oJ
caecum appendix and ileum; tipical clinical presentation
caracterized by variable dimensions o/ the mass and symptoms
not ascribing to occlusion, no Ìesionsat endoscopy; evidence
o/ a typical «target rnass» visualized at T C
The colorectal adenoma-carcinoma sequence: the limits between polypectomy and intestinal resection
No full textAccording to a clinic case, the Authors pointed out tbe role
oJ histological diagnosis in the therapheutica;proch oJ large
intestinal adenomas. In order to identijy those lesions
which can methastatize, having exceeded tbe muscolaris
nucosae and having invaded the submucosa, rigorous bisiological
standards must be perJormed.
Intestinal resection versus polipectomy is determined only
according to tbe involvement or not oJ the muscolaris mucosae
Perianal Paget's disease: clinical observation and review of the literature
No full textThe autbors present a case o/ PPD, stressing the
importance to distinguish «true» PPD /rom pagetoid
spread, flr correct diagnosis and appropriate treatment.
This distinction is possible by using imrnunobistochemicaf
stains, with particufar regarding Ab - GCDFP-15,
considered specific marker flr Paget's cel!
Bilateral carcinoma of the breast: treatment and prevention, Review of the literature
No full textAuthors analize 256 patients admitted in III Clinica Chirurgica
o/ University o/ Rome «La Sapienza» for breast cancer,
/rom 1982 to 1992; 16 o/ them had later deueloped another
neoplasm in the opposite breast.
After a retrospectiue study o/ the clinical bistory o/ ali patients
they came to the conclusion that bilateral neoplasm
frequency is similar to that reported in world litterature (1-
18%) (23, 9, 2).
Moreover, are analized the primary risk factors 101' a bilatel'al
carcinoma, and tbey consider the utility 01 the propbylactic
surgical treatment 01 the opposite breast
Anorectal neuroendocrine carcinoma: observations on a case and review of the literature
No full textCarcinoid tumours o/ the anorectum are rare (0,7% o/
malignant rectal tumours).
Because o/ this rarity several aspects o/ the management o/
these tumours remain controversia!.
Diagnosis may be delayed because o/ fa ilu re to recognize
their morphological characteristics and histological appearance
may not reflect their biological behaviour.
lmmunocytochemistry flr neuroendocrine-cells are essential
to identi/y different types o/ carcinoid tumours and to do
diffirential diagnosis from other malignant tumours. All
that allow an exact therapeutic approach to these tomours.
The tumours less than cm l in diameter can be safèly treated
by local excision; the tumours more than cm 1 in diameter
are treated by radical surgery (AAP)
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