Intermediate neoadjuvant radiotherapy for T3 low/middle rectal cancer: postoperative outcomes of a non-controlled clinical trial.

Background: The benefits of adjuvant radiotherapy in rectal carcinoma are well known. However, there is still considerable uncertainty about the optimal radiation treatment. There is an ongoing debate about the choice between very short treatments immediately followed by surgical resection and prolonged treatments with delayed surgery.

Effectiveness of neoadjuvant radiotherapy in the treatment of locally advanced rectal cancer: a single-center experience in 263 patients.

Aim: To determine the frequency of local recurrence (LR) and distant recurrence (DR) with 5-year survival analysis.

Methods: Patients with T3-T4 rectal cancer located within 10 cm from the anal verge. Radiotherapy protocol: 36 Gy, delivered in 12 daily doses of 3 Gy each for 5 days/week, followed by surgery after a 2-week break.

Splenic abscess secondary to penetrating gastric ulcer.

Splenic abscess is a rare disease whose diagnosis is difficult, though the use of modern imaging methods has increased diagnosed cases in recent years. We report a case of splenic abscess whose aetiology is unusual, namely, a gastric ulcer penetrating into the splenic artery and causing arterial thrombosis and septic embolism. Ultrasonography and ultrasound-guided puncture resolved any diagnostic doubt, and subsequent surgery confirmed the diagnosis.

Randomized trial of intraportal and/or systemic adjuvant chemotherapy in patients with colon carcinoma.

Background: 5-fluorouracil-based adjuvant chemotherapy after surgical resection of colon cancer is standard treatment. However, the choice of best delivery route--that is, systemic (i.e.

Randomized controlled trial of botulinum toxin versus laparoscopic heller myotomy for esophageal achalasia.

Objective: To compare laparoscopic cardia myotomy and fundoplication with botulinum toxin (BoTx) injection in patients with esophageal achalasia.

Summary Background Data: Although myotomy is thought to offer better results, recent studies have reported 80% success rates after 2 BoTx injections a month apart. No randomized controlled trials comparing the 2 treatments have been published so far.

A large family with hereditary MTC: role of RET genetic analysis in differential diagnosis between MEN 2A and FMTC.

Germline mutations of the RET proto-oncogene cause three different cancer syndromes: multiple endocrine neoplasia type 2A (MEN 2A), multiple endocrine neoplasia type 2B (MEN 2B) and familial medullary thyroid carcinoma (FMTC). In the absence of biochemical and/or clinical evidence of pheochromocytoma and hyperparathyroidism, patients with MEN 2A disease display the same phenotype of FMTC disease, although prognosis and clinical management in both affected and unaffected familial members are quite different. We studied a family with hereditary MTC, whose proband was referred to us because of enlarged cervical nodes and increased calcitonin serum levels 28 years after the total thyroidectomy for MTC.

Fatal ulcerative panenteritis following colectomy in a patient with ulcerative colitis.

A 37-year-old man, previously submitted to colectomy for ulcerative pancolitis unresponsive to medical therapy, presented with nausea, vomiting, epigastric pain, and bloody diarrhea. An upper gastrointestinal endoscopy revealed mucosal friability, petechiae, and erosions throughout the duodenum, whereas prestomal ileum showed large ulcers and pseudopolyps. Histologically, a dense inflammation chiefly composed of lymphocytes and plasma cells with few neutrophils was detected.

[Radio-surgical-histological procedure in the diagnosis and management of non-palpable breast lesions, suspected from mammography: experience of "Casa Sollievo della Sofferenza" Hospital in San Giovanni Rotondo].

The almost 4-year long experience of the IRCCS--"Casa Sollievo della Sofferenza" hospital (FG, Italy) dealing with 165 nonpalpable breast lesions mammographically detected is herein presented. According to a protocol based on the previously as well as relatively recent described guidelines for the clinico-pathological management of such lesions, the authors underline the necessity of a strict cooperation between the radiologist, the surgeon and the pathologist. They also emphasize the perspectives derived from such a new impact, among which the most impressive is the handling and sampling of this relatively new type of material with lesions which only rarely are grossly palpable ("pseudononpalpable lesions"), whilst often they are truly non palpable being of minute sizes ("microlesions") and even grossly "invisible" ("quasi-normal fibrofatty tissue").

[Preliminary results of preoperative radiotherapy schedule in the treatment of rectal tumors].

From March, 1988, to October, 1993, fifty-six consecutive patients with rectal adenocarcinoma in clinical stage T3NxM0, underwent preoperative radiation therapy at the "Casa Sollievo della Sofferenza" Hospital of San Giovanni Rotondo (Italy). The patients were treated with the four-field technique with 6 to 8 MV X photons on the pelvis. The dose given was 36 Gy in 12 fractions of 3 Gy each.

Plasma cell granuloma of the thyroid associated with Hashimoto's thyroiditis.

A patient was diagnosed with plasma cell granuloma (PCG) of the thyroid associated with a fibrous variant of Hashimoto's thyroiditis (HT), after total thyroidectomy. Immunoperoxidase staining of the mass in the left lobe revealed polyclonal lambda and kappa chains. A literature search was conducted to determine other cases of such an association.

[Surgical treatment of primary carcinoma of the female breast in geriatric age. Retrospective studies of 190 cases].

On the basis of a review of 190 cases of breast cancer in elderly patients, the Authors discuss clinical and anatomopathological features for a proper surgical strategy. After an accurate evaluation of the operative risk and stage of the neoplastic disease, conservative surgical techniques or as less demolitive as possible, i.e.

[Inflammatory pseudotumor of the breast. Report of a case and review of the literature].

Inflammatory pseudotumor (IPT) truly represents an enigmatic entity. A tumor-like lesion known with many synonyms according to the various patronymic authors who named it on the basis of the different observed morphological appearances. Among these names plasma cell granuloma, plasma cell/histiocytoma complex, xanthomatous pseudotumor, xanthoma, fibrous xanthoma, histiocytoma, xanthogranuloma, inflammatory myofibroblastic tumor, inflammatory myofibrohistiocytic proliferation are just the most renown.

[Primary splenic cysts. Report of 5 cases, 4 of which unpublished and review of the literature].

After a complete review of the literature with an amount of 280 previously reported cases, the authors report on five total cases of primary (true) cysts of the spleen one of which already published. All these cases occurred in pediatric age and were treated by total splenectomy. All were large solitary cysts (size ranged from 4.

Leukocytoclastic vasculitis of the colon.

Two cases of young patients with an acute abdomen caused by a necrotizing angiitis of the cecum and ascending colon are reported. The absence of any systemic disease and a history of medical treatment in both cases led to the diagnosis of hypersensitivity vasculitis by a serum sickness-like reaction. An extensive review of the literature is also presented.

Renal oncocytoma: a clinicopathologic study of a case with review of the literature.

A peculiar case of renal oncocytoma was studied by clinical, light- and electron-microscopic examinations. The neoplasm, which was first discovered 21 years ago, at operation turned out to be very large, well-circumscribed and lacking any feature of aggressiveness. Histologically, it was composed totally of oncocytes without relevant atypia or necrosis.