Renal artery pseudoaneurysm and arteriovenous fistula to the inferior vena cava: a late complication following laparoscopic cholecystectomy.

Major vascular injuries during laparoscopic procedures are rare but potentially life-threatening if not promptly diagnosed and treated. We report a case in which the placement of a trocar during a laparoscopic cholecystectomy caused damage to the right renal artery and led to the development of a pseudoaneurysm. The pseudoaneurysm of the right renal artery then eroded into the inferior vena cava resulting in an arteriovenous fistula that eventually caused right renal failure, systolic and diastolic hypertension, and congestive heart failure.

Clinical and laboratory follow-up in differentiated thyroid carcinoma.

Thyroid carcinoma is the most frequent endocrine malignant neoplasm even if a rare occurrence (0.5%-1.0%) of all human malignant tumors.

[Hepatic angioma: rational simplification of diagnostic procedures].

The contribution of various techniques to the diagnosis of hepatic angioma has been evaluated retrospectively in 32 patients. The features characterizing hepatic angioma in each technique (ultrasound, Doppler-ultrasound, computed tomography, angiography, scintigraphy, nuclear magnetic resonance) have also been evaluated. The results support the primary role of ultrasound for detecting hepatic lesions and for monitoring their evolution, because of the high sensitivity and of the easy availability of the technique.

Peritoneal mesothelioma in recurrent familial peritonitis.

A 39-year-old man had a 2-year history of fatigue, weight loss, drug-resistant ascites, and decreased intestinal motility. During adolescence he began to suffer frequent episodes of acute benign peritonitis that spontaneously subsided at age 35. The fact that his younger brother was taking colchicine for the same symptoms led us to diagnose familial Mediterranean fever (FMF).

Retroperitoneal cystic lymphangioma.

Two cases of retroperitoneal cystic lymphangioma (CL) are presented; the current literature on this rare, benign neoplasm of the lymphatic system is reviewed. This tumor consists of various numbers of cyst-like cavities filled with a serous, serosanguineous or chylous fluid. The histogenesis of CL is still uncertain.

Basilic transvenous biopsy for investigation of superior vena caval syndrome.

Percutaneous transvenous biopsy of an isolated obstructing mass of superior vena cava (SVC) is reported. Basilic vein access and King's endomyocardial bioptome have been successfully used. Metastatic cancer of SVC has been diagnosed and radiochemotherapy instituted, avoiding an undesirable thoracotomy.

[Constipation. New therapeutic trends].

Surgical treatment is warranted only once medical management has proved unsuccessful and should preferably be preceded by psychological evaluation of the patient. So far, surgery has yielded few convincing results in view of the high percentage of failures. After surgery, many patients complain of abdominal pain and diarrhea.

Usefulness of a hysteroscopic follow-up on patients with breast cancer in pre- and post-menopausal age.

Over the last years, the high incidence of multiple primary neoplasms has been of great interest. The association between carcinoma of the breast and endometrium has been particularly emphasized; it is based on similar epidemiological factors and common hormondependence in the two tumours. Following these assumptions, the Authors present the preliminary results of hysteroscopic and histological studies including 45 patients, 24 in pre-menopausal and 21 in post-menopausal age, who have undergone a mastectomy or quadrantectomy for breast cancer in the past 5 years.

[Simultaneous bilateral renal cell adenocarcinoma. One-stage surgical treatment].

Review of a very well documented case with a very complete iconography, and of the literature led to the following conclusions. First, it is preferable to treat these patients by a one-stage operation involving nephrectomy on one side and, if possible, conservative treatment to other kidney. Second, that the prognosis in synchronous bilateral renal cancer is much better than that of metachronous bilateral cancers (5-year survival 69% and 37.

Venous involvement by follicular carcinoma of the thyroid gland.

Involvement of the great veins by thyroid neoplasms is a rare event: to date 9 cases have been reported and only 2 of them have been surgically treated. The authors describe a case of follicular thyroid carcinoma involving the proximal tract of the left innominate vein at its confluence with the superior vena cava: a neoplastic bud was protruding into the lumen, but the endothelial lining appeared to be perfectly preserved. Full radicality was obtained by a major vascular procedure.

[Leiomyosarcoma of the inferior vena cava].

Leiomyosarcoma is a rare tumor of soft tissues. The inferior vena cava is affected infrequently, a literature review showing only 66 cases reported previously, 29 of these patients undergoing radical surgery. The case described was diagnosed during operation for gallstones, and the lesion was excised radically using an original technique.

Surgical approach to renal cell carcinoma extending into the right atrium through the inferior vena cava.

Successful management of a patient with an intracardiac tumor thrombus of renal carcinoma is described. This case and a few others in the literature have led us to consider the clinical signs of cavo-atrial obstruction, frequently silent and unspecific; the diagnostic methodology, especially based upon CAT scan and cavography, and the type of surgery and surgical technique called for, especially as regards the approach and the possible use of extracorporeal circulation (ECC).

[Cavoauricular thrombectomy under extracorporeal circulation and right superior lobectomy for paraneoplastic thrombosis in a case of lung cancer].

A patient with superior vena cava thrombosis from cancer of the right lung is described. The particular interest of this case resides in: The numerical scantiness of cases reported in the literature: 12 cases reviewed; The exceptional nature of the etiopathogenic mechanism: paraneoplastic thrombosis; and the more precise problems relating to the indication, technique and tactics with respect to surgery.

[Uncommon locations of celomic cysts: a possible cause of error in mediastinal radiology (author's transl)].

Five cases of uncommon locations of mediastinal celomic cysts are presented. All cases were surgically proved. The importance of these locations in the differential diagnosis of mediastinal masses is stressed.