Foraminal disc herniation Th9-Th10 mimicking abdominal pain.

Thoracic disc herniations (TDH) requiring surgery are rare. They usually present with pain and/or myelopathy. Only 6% are wide lateral, either intraforaminal or extraforaminal. A 52-year-old patient presented with chronic mid-thoracic pain, radiating along the left 9th and 10th ribs. After nephrologic and pancreatic diseases had been excluded, a CT-scan showed a far-lateral calcified TDH in the left Th9-Th10 neuroforamen, compressing the nerve root. Through a paramedian muscle-splitting approach, microscopic drilling of the medial part of the Th9-Th10 facet joint was performed, allowing exposure of the nerve root and removal of a soft hernia, a mix of degenerative debris and harder calcified aggregates. Postoperatively, the pain disappeared immediately. The authors conclude that intraforaminal TDH may be misleading and mimick pain from abdominal origin. Even if calcified, these lesions may be soft, not adherent and thus easily resectable: this may allow a simpler approach. A microscopic transfacet route offers a minimally invasive approach to the neuroforamen.

Expression of galectin-3 in primary and metastatic melanoma: immunohistochemical studies on human lesions and nude mice xenograft tumors.

Galectins are a large family of proteins which bind galactoside-containing glycans. Their role in cancer seems to be important since members of the family may mediate cell adhesion and modulate cell growth. Galectin-3 (Gal-3) is expressed in the nucleus, in the cytoplasm and on the cell surface, and can also be secreted into the extracellular matrix. A series of experimental and clinical data have been reported which indicate that Gal-3 may play a putative role in carcinogenesis, cancer progression and the process of metastasis. To study the possible correlation between Gal-3 expression and malignant potential in primary melanoma lesions, we conducted an immunohistochemical study with monoclonal anti-Gal-3 antibody in a series of primary and metastatic melanoma lesions as well as benign skin pigmented lesions. We also developed a xenograft melanoma model in nude mice with two melanoma cell lines (ATCC G-361 and ATCC HT-144) and assessed staining with the Gal-3 antibody in the xenografts and the metastases. The expression of anti-Gal-3 staining was determined semiquantitatively. The expression of Gal-3 was higher in thin primary melanoma lesions than in benign pigmented skin lesions or metastases and seemed to correlate inversely with the aggressiveness as estimated by the Breslow index which is recognized as the main prognostic factor in melanoma. We propose Gal-3 expression in melanoma as a diagnostic and/or a prognostic parameter and suggest that further studies of such a role for Gal-3 are warranted.