Cutaneous melanoma with neurofibromatosis type 1: rare association? A case report and review of the literature.

Neurofibromatosis (NF) is a relatively common disorder characterized by cutaneous pigmented maculas, multiple neurofibromas and Lisch nodules (pigmented iris hamartomas). This disorder is retained being a neurocristopathy. Melanocytes are neural crest derivates too. Twenty-six patients with neurofibromatosis associated to cutaneous malignant melanoma have been reported till now, but data on association between these two pathologies are lacking. One more case of malignant cutaneous melanoma in a patient with neurofibromatosis is reported and the hypothesis of a more frequent association than usually believed of these two pathologies is discussed.

[Desmoid tumor of rectus muscle of abdomen in a woman of childbearing age: what can we do?]. / Tumore desmoide della parete addominale in una donna in età fertile: cosa possiamo fare?

The desmoid tumor (DT) is a soft tissue neoplasm most frequently localized in the anterior abdominal wall typically in females of childbearing age. Because its particular incidence in women who had recently been pregnant, it was correlated with delivery's trauma stimulating proliferation of muscolo-aponeurotic tissues. Complete surgical resection is the recommended treatment approach to prevent recurrence. Many authors emphasize the role of radiotherapy in regression of DT and in controlling local recurrence in patient who had incomplete resection. Many others emphasize the role of chemotherapy or antiestrogenic compounds, even though tumour does not express estrogen receptors. DT, otherwise, is neoplasm with high rates of recurrence after surgery but it never develops distant metastases, so that function and structure-sparing surgery may be a reasonable choice in young women when possible without leaving macroscopic residual disease. Furthermore literature data suggest that the presence of incomplete histological surgical resection does not correlate with local recurrence and that pregnancy does not represent a risk factor. In women of childbearing age, even after non radical histological DT primary resection, adjunctive radiotherapy, chemotherapy or antiestrogen therapy could be avoided and clinical observation alone may be considered.

[Appropriate hospital utilization in emergency surgery: application of the Appropiatness Evaluation Protocol]. / Uso appropriato della struttura ospedaliera in chirurgia d'urgenza: applicazione dell'Appropriateness Evaluation Protocol.

UNLABELLED: The Authors developed and tested a new version of the Appropriateness Evaluation Protocol (AEP) to review 160 clinical records of the Emergency Surgery Department of Policlinico Umberto I-Rome. The modifications to the AEP also allow to evaluate the appropriate ward of hospitalization of acute patients (Surgery, Orthopedics, Head & Neck, Burns). RESULTS: 26 (16%) out 160 admissions failed the AEP criteria; 85 of the remaining admissions were judged appropriate in the Emergency Surgery Department (53% of the whole sample), 14 (9%) in the Head & Neck Department, 10 (6%) in the Orthopedic Department, 25 (16%) not in an Emergency Surgery Department. Only 63% of the appropriate admissions has been judged adequate in the Emergency Surgery Department. The Authors conclude that it is necessary to improve the primary "filter" of the hospitalization (the ambulatory care component of the National Health System). Finally, this version of the AEP was shown to be reliable, an useful tool in the hands of trained physicians.