[Diaphragmatic eventration in the adult: repair with Gore-Tex surgical mesh]. / L'eventratio diaframmatica nell'adulto: riparazione con mesh in Gore-Tex.

The Authors report the case of a fifty-nine-year-old patient, affected by complete eventration of the left diaphragm and cranial stomach dislocation with axial volvulus, associated with an upward movement of part of the left colon and some jejunal loops. The subclinical condition had been occasionally discovered during a routine chest X-ray at the age of eighteen and the patient remained without symptoms up to five years ago, when he began to show significant digestive and cardiorespiratory symptoms. The patient has been successfully treated via thoracotomy with phrenic alloplastic using Gore-Tex patch and has obtained an immediate remission of the symptoms. Left diaphragmatic eventration of the adult is a rare pathology, either congenital or acquired, with few and definite surgical indications such as severe digestive and cardiorespiratory symptoms. Different surgical techniques including the use of patches are herein illustrated.

[Rare peritoneal tumors in the aged. Apropos of a case of Castleman's syndrome]. / Nell'ambito dei tumori rari retroperitoneali in età geriatrica. A proposito di un caso di sindrome di Castleman.

An unusual case is reported of the rare Castleman's disease localized in the retroperitoneal area in an elderly asymptomatic patient. A similar benign lymphoadenopathy of unknown etiology is generally found in the mediastinum and interests just one lymph-node that results abnormally hyperplastic. Histologically, most cases are of the hyaline-vascular type and much more rarely of the plasmacell variant. After a careful review of the literature the anatomical, pathological and clinical characteristics, the main etiopathogenetics hypotheses and diagnostic criteria are explained. The particular size of the neoformation is emphasized and also the impossibility to reach a correct preoperatory diagnosis owing to a suspect kidney parenchyma infiltration observed by RM. Also the intraoperatory report seemed to confirm the diagnostic hypothesis of a malign neoplasm infiltrating the lower pole of the kidney and which necessitated the total ablation of the retroperitoneal mass and left kidney. We concluded that the case which we have observed (the 32nd in world literature dealing with the retroperitoneal space) is not really comparable to those previously described by other authors. In fact the histopathological picture presents a series of ialino-vascular and plasmacell aspects which make any hypothesis of etiopathogenetic uncertain.

[Surgical treatment of primary carcinoma of the female breast in geriatric age. Retrospective studies of 190 cases]. / Il trattamento chirurgico del carcinoma primitivo della mammella femminile in età geriatrica. Studio retrospettivo di 190 casi.

On the basis of a review of 190 cases of breast cancer in elderly patients, the Authors discuss clinical and anatomopathological features for a proper surgical strategy. After an accurate evaluation of the operative risk and stage of the neoplastic disease, conservative surgical techniques or as less demolitive as possible, i.e. quadrantectomy with axillary lymphadenectomy, Madden or Patey's modified mastectomies, with respect for oncological radicality, are recommended in the elderly. The importance of an early diagnosis in reducing the frequency of locally advanced neoplasms (typical in the elderly) which if operable require Halsted's procedure, is furthermore emphasized.