Metaplastic squamous cell breast cancer: A case report and treatment strategy during covid-19 pandemic.

INTRODUCTION: Squamous carcinoma is a very rare breast cancer resulting from a differentiated squamous metaplasia. Its diagnosis is late due to the absence of specific clinical and radiological features. PRESENTATION OF CASE: The authors present the case of a 39-year-old patient with the clinical onset of an inflammatory cyst diagnosed with mammography and cytological examination. After segmentectomy, on histological examination was defined as: "squamous keratinizing aspect". In light of this report she was subjected to quadrantectomy with lymphadenectomy. She did not undergo radiotherapy treatment, which was delayed due to the ongoing pandemic. After a few months developed a local recurrence and underwent a mastectomy with multidisciplinary treatment. DISCUSSION: Squamously-differentiated metaplastic carcinoma of the breast is one of the rarest forms of breast cancer. Its etiopathogenesis is still unclear but some authors suggest that it originates from a squamous metaplasia deriving from the epithelium of cysts. This is a very aggressive and fast-growing tumour especially in young women, in fact the patient had a recurrence after a few months. She came to our attention 6 months after the initial surgery with a relapse at a local-regional level for which she was subjected to radical treatment and with a metastatic spread for which she was given the first-line chemotherapy treatment. CONCLUSION: There are no well-defined guidelines for the treatment of this rare form of cancer. The case illustrates how the rapid aggressiveness of the disease requires adequate and immediate multidisciplinary treatment from the very beginning.

Antiviral properties from plants of the Mediterranean flora.

Natural products are a successful source in drug discovery, playing a significant role in maintaining human health. We investigated the in vitro cytotoxicity and antiviral activity of extracts from 18 traditionally used Mediterranean plants. Noteworthy antiviral activity was found in the extract obtained from the branches of Daphne gnidium L. against human immunodeficiency virus type-1 (EC50 = 0.08 µg/mL) and coxsackievirus B5 (EC50 = 0.10 µg/mL). Other relevant activities were found against BVDV, YFV, Sb-1, RSV and HSV-1. Interestingly, extracts from Artemisia arborescens L. and Rubus ulmifolius Schott, as well as those from D. gnidium L., showed activities against two different viruses. This extensive antiviral screening allowed us to identify attractive activities, offering opportunities to develop lead compounds with a great pharmaceutical potential.

[Toxic megacolon. Apropos 3 cases]. / Il megacolon tossico. A proposito di tre osservazioni.

The authors describe their experience with three cases of toxic megacolon: two cases were complications of an ulcerative colitis and died after surgery; one case was a complication of Crohn's disease and recovered after medical resuscitation treatment. Diagnosis was based on clinical features and direct abdominal X-ray showing an evident dilatation of the colon. The authors think that intense medical treatment has to be carried out in all cases without urgent surgical indication: even if not always successful, a medical therapy will be an appropriate preparation for operation. The authors believe that the operation of choice is colectomy with ileo-rectal anastomosis plus upstream protective ileostomy or right terminal ileostomy plus left iliac sigmoidostomy with subsequent reconstruction of continuity.

[Gallbladder carcinoma today: light and shadow]. / Il carcinoma della colecisti oggi: luci ed ombre.

On the basis of 30 clinical observations, the authors discuss the clinical and diagnostic features of carcinoma of the gallbladder, which is observed just in an advanced stage in the most part of cases. They also confirm its often poor prognosis. To-day echography and computed tomography play an important role in the preoperative diagnosis.

The experimental systemic perfused lung: histological observations in the dog.

An experimental model of pulmonary hypertension was obtained in the dog implanting the left main pulmonary artery in the descending thoracic aorta. The main histological lesions consisted in an increased muscularity of the pulmonary artery itself and of its lobar branches.

[The clinical picture of pseudomyxoma peritonei]. / Il quadro clinico dello pseudomixoma peritoneale.

The authors describe two cases of pseudomyxoma peritonei, one of which with a lengthy clinical course and the other with a rapidly fatal outcome. The clinical picture in pseudomyxoma peritonei is associated with a variety of benign or malignant mucus-secreting tumours, mainly originating in the appendix or ovaries. Survival is generally long owing to the lack of visceral invasion or metastases. An accurate prognostic assessment can only be achieved on the basis of identification of the primary tumours and its degree of malignancy.

[Traumatic lesions of the diaphragm (experiences with 36 cases)]. / Le lesioni traumatiche del diaframma. (Esperienza su 36 casi).

The Authors report on their experience with 36 cases of traumatic lesions of the diaphragm. Such lesions should be suspected in all cases of thoraco-abdominal trauma. The possibility of a preoperative diagnosis depends entirely on thorough chest x-rays and administration of contrast medium via a nasogastric tube. In emergency surgery, lesions of the diaphragm are treated by the laparotomy route, which allows complete exploration of the abdominal cavity. The morbidity and mortality of such lesions depend on the associated lesions, on prompt diagnosis and surgery and on appropriate postoperative treatment.