Appendiceal neuroendocrine neoplasia: analysis of 50 patients.

OBJECTIVE: The objective of this study was to investigate the clinical, surgical, and pathological findings of appendiceal neuroendocrine neoplasms (ANNs). MATERIALS AND METHODS: The demographic, clinical, surgical, and pathological characteristics of 50 patients with ANN were analyzed. The patients were also classified as Group 1 (< 40 years, n = 37) and Group 2 (≥ 40 years, n = 13), and compared each other in terms of all parameters. RESULTS: Acute appendicitis was the pre-operative clinical presentation in 48 (96%) patients. Appendectomy (94%) was the most common surgical procedure. Mean tumor size was 8.6 mm (1-70 mm). Approximately half of the tumors (46%) were T1. There was no lymphatic and distant metastasis. The patients in Group 2 (15.4 mm) had a higher mean tumor size than patients in Group 1 (6.3 mm) (p < 0.001). The two groups were similar in other characteristics (p > 0.05). CONCLUSIONS: ANNs are usually diagnosed after histopathological evaluation due to the lack of specific clinicoradiological signs. Therefore, carefull intraoperative examination of appendectomy specimens may increase the possibility of suspecting these tumors. The results also showed that ANNs were bigger in patients above 40-years-old. Although not statistically significant, ANNs tended to have higher grade and to be more located at the base of the appendix in this group of patients.

OBJETIVO: Investigar los hallazgos clínicos, quirúrgicos y patológicos de las neoplasias neuroendocrinas (RNA) apendiculares. MÉTODO: Se analizaron las características demográficas, clínicas, quirúrgicas y patológicas de 50 pacientes con RNA. Los pacientes también fueron clasificados como Grupo 1 (< 40 años, n = 37) y Grupo 2 (≥ 40 años, n = 13), y se compararon entre sí en términos de todos los parámetros. RESULTADOS: La apendicitis aguda fue la presentación clínica preoperatoria en 48 (96%) pacientes. La apendicectomía (94%) fue el procedimiento quirúrgico más común. El tamaño medio del tumor fue de 8,6 mm (1-70 mm). Aproximadamente la mitad de los tumores (46%) eran T1. No hubo metástasis linfáticas ya distancia. Los pacientes del Grupo 2 (15.4 mm) tenían un tamaño tumoral medio mayor que los pacientes del Grupo 1 (6.3 mm) (p < 0.001). Los dos grupos fueron similares en otras características (p > 0.05). CONCLUSIONES: Las RNA suelen diagnosticarse tras evaluación histopatológica debido a la falta de signos clínico-radiológicos específicos. Por lo tanto, el examen intraoperatorio cuidadoso de las muestras de apendicectomía puede aumentar la posibilidad de sospechar estos tumores. Los resultados también mostraron que las ANN eran más grandes en pacientes mayores de 40 años. Aunque no estadísticamente significativas, las ANN tendieron a tener mayor grado y estar más ubicadas en la base del apéndice en este grupo de pacientes.

Can mastalgia be another somatic symptom in fibromyalgia syndrome?

OBJECTIVE: The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome. METHODS: Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically. RESULTS: Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome. CONCLUSIONS: We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia.

Can mastalgia be another somatic symptom in fibromyalgia syndrome?

OBJECTIVE: The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome. METHODS: Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically. RESULTS: Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome. CONCLUSIONS: We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia.