Chyle fistula in right cervical area after thyroid surgery

Thoracic duct injury is an infrequent (1-2.5%) but severe complication after neck surgery, leading to nutritional, metabolic and immunologic deficiencies. We report a case of a 34-year-old woman with a right thoracic duct injury after surgery of a thyroid medullar cancer effectively treated with conservative management (parenteral nutrition and intravenous somatostatin). Optimal treatment of these patients is unclear, without a clear limit between conservative and surgical treatment (AU)

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Conservative treatment for infiltrating breast cancer. Ten years follow-up experience

INTRODUCTION: We retrospectively analyze our experience in conservative treatment for infiltrating advanced breast cancer before implementation of selective sentinel node biopsy, specially focusing on characteristics, incidence, treatment and evolution of local-regional recurrences, disease-free survival time, overall survival and patient's satisfaction. MATERIAL AND METHODS: From January 1984 to 31st December 1998, 739 female patients were operated in our institution, diagnosed as having infiltrating breast cancer. One hundred and eighty-eight patients (25.43%) received conservative treatment and they were followed up until December 2003. RESULTS: Average age when diagnosed was 50.42 years old (24-87 years). 53.19% of the patients were premenopausal. After a median follow-up of 129 months (60-198 months), 13 women (6.91%) presented local -regional recurrence and the disease-free time was 48.4 months (8-108 months). Global survival rate was 83.5% and disease free survival rate was 80.85%. CONCLUSIONS: The management of choice for early stage (I and II) infiltrating breast cancer is nowadays conservative, with a low local-regional recurrence rate and survival rate that are comparable to radical mastectomy, according to the literature. It's a safe and efficient method that let us preserve the breast with a good esthetical result. In selected cases, when a regional recurrence occurs, a second conservative management is possible with a good control of the disease, although the most widely accepted treatment in these cases is total mastectomy (AU)

Mammary hamartoma.

INTRODUCTION: Mammary hamartomas are rare benign breast lumps. They are usually painless, wellcircumscribed, mobile and with no adherence to skin or muscle, composed of varying amounts of fat, glandular and fibrous tissue. Mammary hamartoma has been classically considered as an underdiagnosed pathology, but with the increasing use of diagnostic procedures in breast tumours, the number of hamartomas has increased in the last years. Because there is no distinct pathological feature, a correlation with the clinical findings and image techniques is necessary in order to achieve a correct diagnosis of the pathology. MATERIALS AND METHODS: The clinicopathological features of 8 mammary hamartomas are reported here. RESULTS: The patients are ranged in age from 34 to 67 years. The initial manifestation was in all cases a well-circumscribed, soft, palpable breast lump. Mammography was performed in all patients. Other diagnostic procedures used in the diagnosis were Ultrasound, Fine Needle Aspiration Cytology and Needle Core Biopsy. Treatment was tumorectomy. We describe a case of recurrence after excision of the lump in a more aggressive histological form and one patient who presented the coexistence of a mammary hamartoma and an invasive ductal carcinoma. CONCLUSION: Mammary hamartoma is an uncommon breast tumour. It is necessary the correlation between pathology and clinical and radiological findings. We express our management plan for these lesions.

Mammary hamartoma

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Introduction. Mammary hamartomas are rare benignbreast lumps. They are usually painless, wellcircumscribed,mobile and with no adherence toskin or muscle, composed of varying amounts offat, glandular and fibrous tissue. Mammary hamartomahas been classically considered as an underdiagnosedpathology, but with the increasing use ofdiagnostic procedures in breast tumours, the numberof hamartomas has increased in the last years.Because there is no distinct pathological feature, acorrelation with the clinical findings and imagetechniques is necessary in order to achieve a correctdiagnosis of the pathology.Materials and methods. The clinicopathologicalfeatures of 8 mammary hamartomas are reportedhere.Results. The patients are ranged in age from 34 to67 years. The initial manifestation was in all cases awell-circumscribed, soft, palpable breast lump.Mammography was performed in all patients. Otherdiagnostic procedures used in the diagnosis wereUltrasound, Fine Needle Aspiration Cytology andNeedle Core Biopsy. Treatment was tumourectomy.We describe a case of recurrence after excision ofthe lump in a more aggressive histological formand one patient who presented the coexistence of amammary hamartoma and an invasive ductal carcinoma.Conclusion. Mammary hamartoma is an uncommonbreast tumour. It is necessary the correlationbetween pathology and clinical and radiologicalfindings. We express our management plan forthese lesions