[Schwannoma of the ultimate ileal loop. Case report and review of the literature]. / Schwannoma dell'ultima ansa ileale. Case report e review della letteratura.

The paper reports a rare case of malignant ileal schwannoma. A review of the most recent literature confirms the diagnostic and therapeutic procedures used by the authors. Minimal resection or necessary resection in relation to the site and local situation are the only real therapy apart from palliative surgery. It is vital to identify any possible polycentric manifestation since schwannoma is often associated with Recklinghausen's disease. Radiotherapy and chemotherapy are completely ineffective. Responses were obtained in around 30% of cases in the most common trials; the gastrointestinal localization also appears to be even less responsive. The most active drugs are decarbazine, doxorubicin and ifosfamide, associated with CIVADIC or MAID polychemotherapy protocols. It is often difficult to diagnose malignancy; the overall survival rate (taking grading into account) is 7-10% after 10 years and 50% after 5 years for those forms with the lowest degree of malignancy. Antoni classified schwannoma into: type A with a solid component, and type B with a microcystic component. Treatment and prognosis are identical.

[A rare complication of obstetric pathology: uretero-uterine fistula]. / Una rara complicanza in patologia ostetrica: la fistola uretero-uterina.

Accidental iatrogenic injuries of ureters and bladder in patients with abdominal and pelvic pathology are described as a possible lesion of a surgical or gynaecologic treatment. The ureteral lesion is less frequent in obstetric surgery, but the young age of the patients and the gravity of the consequences, impose a very serious problem for a early diagnosis with a conservative surgical treatment. On the contrary, this important injury, bears an important surgical management with possible functional damage of the reno-urinary tract. The Authors report the experience about the observation and treatment of a case of a young woman, 29 years old, who had a uretero-uterine fistula, after a cesarean section for the first pregnancy.

[Breast carcinoma in the elderly patient: which treatment?]. / Carcinoma mammario nell'anziano: quale trattamento?

We here describe our experience of the treatment of "breast cancer" in the elderly. The results in this group of patients (37 over 75 years) are like the younger group if: the local control is done; hormonotherapy is prescribed; chemotherapy is done even in the 70-80-year-old group. If a radical mastectomy isn't impossible in the patients over 80, even a simple mastectomy is safe. In this patients a conservative local treatment of the breast is not mandatory. Our over-75-year-old patients have no psychological problem related to mastectomy. They often don't accept obligatory radiotherapy after the conservative treatment of breast cancer, and moreover the breast cancer in the elderly is usual smaller, fibrotic and bigger than 3 cm. Lymph nodal status isn't important for overall survival, but only for the eventual chemotherapeutic treatment, so in patients over 80 year-old simple mastectomy is sufficient because we don't use chemotherapy for the general conditions of the same. The local control of axillary lymph nodes is obtained with radiotherapy if necessary. Screening for breast cancer must also include 70-75-year-old patients. Why is the breast cancer in elderly like the others patients? Some authors have seen that the immuno-reaction around the cancer in elderly is less than the same reaction observed in younger patients. So in the elderly there is a smaller production of "growth factors" important for the growth of the tumor and of "angiogenesis factor", fundamental for the initial growth of the cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

[Interpretation of laboratory data related to the determination of tumor markers]. / Interpretazione dei dati di laboratorio relativi alla determinazione di alcuni markers tumorali.

The Authors consider the quantity of CEA-AFP-MCA-CA 125 measurements performed by their laboratory during ten months in 1989-90: 1.000 for CEA, 500 for AFP, 52 for MCA, 36 for CA 125. The observation of scarce significance (especially for CEA and AFP) has, in this case, only a statistical sense, depending on the unknown motivation of the analysis requests. They also observe greater significance of MCA and CA 125 measurements, and they underline the necessity to correlate requests, clinical situations and results, according on their peculiar purpose: to verify the reliability of the demands in order to value the validity of the markers, avoiding useless and not specific data for a better monitoring of the neoplastic patient.

[The pre- and postoperative and follow-up use of the tumor markers MCA, CA-125 and CA-19-9]. / Utilizzazione pre- e postoperatoria e nel follow-up dei markers tumorali MCA, CA 125, CA 19,9.

The paper describes the authors' personal experience of the use of tumour markers, above all during postoperative follow-up as well as during the evaluation of the response to adjuvant and other forms of chemotherapy. The authors affirm that the use of these markers is fundamental for a correct evaluation and rapid treatment, above all in the identification and treatment of recidivation.

[Psychologic and psychiatric environment in the correction of facial dysmorphism]. / Environnement psychologique et psychiatrique dans les corrections des dysmorphies faciales.

Stomatologists well know that phenotype can reproduce a lot of abnormal genotype aspects, in facial growth. These vitiations are bound to abnormal behaviours during such functions as: deglutition, breathing, oral expression. It is important to know if "wrong para-functions" adopted in such praxies are psychologically significant. Very often, the psychiatrist only, will be able to confirm or oppose contra-indication about the surgical treatment of facial abnormalities in such special cases, known or unknown.