Thrombectomy of the inferior vena cava from recurrent low-grade endometrial stromal sarcoma: case report and review of the literature.

We report a rare case in which a patient successfully underwent surgical removal from the inferior vena cava of a neoplastic thrombus induced by a recurrent low-grade endometrial stromal sarcoma. The patient was admitted with severe acute renal failure and a large edema on the right lower extremity. One year previously she had undergone hysterectomy and adnexectomy due to an endometrial stromal sarcoma with involvement of the tuba. Because of complete thrombosis of the right internal and common iliac veins and the inferior vena cava, she underwent thrombectomy of the inferior vena cava. The postoperative course was complicated by hydruric renal failure induced by a acute tubular necrosis. At 6-month follow-up, the patient was asymptomatic with normal renal function. The ileocaval axis was patent on magnetic resonance imaging. Only 5 cases of intracaval extension of endometrial stromal sarcoma have been reported. Surgical treatment is viable due to excellent prognosis of the low-grade endometrial stromal sarcoma (80-100% 5-year survival) and likely fatal heart failure in untreated cases.

[Contribution to the knowledge of pseudoneoplastic pathology of the breast. Cyto-steatonecrosis]. / Contributo alla conoscenza della patologia pseudoneoplastica della mammella. La citosteatonecrosi.

The authors, from the observation of a case of mammary fat necrosis (BFN), observe the problematic nature of this rare pathology, and describe the clinical anatomy and the main epidemiological, etiological, radiographical, and echographic aspects. They dwell upon the anatomical pathology phase of the fibrous substitution and the fibrosclerosis of the liponecrotic area, in which the BFN assumes a pseudoneoplastic importance, responsible for a clinical summary (hard nodule, of indistinct limits, with frequent cutaneous retractions), a radiography (opacity with faded and irregular or spicular outlines, with or without the thickening and the retraction of the skin above; stick-like or angular dentitrical microcalcifications) an echography ( hypoechogenous nodule that may or may not absorb ultrasounds) that are indistinguishable from those of a carcinoma, or are difficult to interpret in cases of granulomatous substitution not yet evolved into retracted fibrosis. They conclude by emphasizing the role of surgical excision biopsy, with an extemporaneous histological examination, the results of which decide either the immediate closure of the surgical incision, or the adoption of another type of operation.

[Short-stay in patients surgically treated for thyroid disease]. / Sull'invio precoce a domicilio del paziente operato per tireopatia.

The improvement in anesthesiology and greater experience of medical staff have permitted short-stay surgery. The authors in this pages report their knowledge of thyroid short-stay surgery. Their series numbers twenty-two lobectomies for uninodular the thyroid disease and one enucleoresection for a nodule of pyramidal lobe. Short-stay surgery has been proposed to euthyroid patients, selected according to age, residence and health (lack of associated pathologies such as cardiopathy, bronchopathy, hepatopathy, nephropathy, allergy, calcemic disorders and dysphony) and confirmed in the presence of histological extemporary diagnosis of "adenoma" (21 cases). The histological extemporary diagnosis of "carcinoma" has lengthened hospital stay. Among the lobectomies, 21 were executed in general anaesthesia and 1 in acupuncture. The enucleoresection was executed in local anaesthesia. Only in eighteen cases was a "Penrose" deainage used, removed after 24 hours. The choice of thyroid short-stay surgery, particularly in day-hospital, must arise from a careful selection of patients. Besides, this surgery requires an administrative and sanitary structure which permits a constant patient's check at hare too.