[The surgical treatment of ovarian cancer metastasis between liver and diaphragm: a report of 83 cases].

Objective: To explore the safety and feasibility of associating diaphragm resection and liver-diaphragmatic metastasis lesions resection for patients with advanced ovarian cancer. Methods: Retrospectively analysis 83 cases(98 times) of advanced ovarian cancer with liver-diaphragmatic metastasis between January 2012 and December 2016 at Department of Liver Surgery, Peking Union Medical College Hospital.The patients were aged from 19 to 75 years.Surgical procedure included metastatic lesions resection(43 times) and stripping(55 times). Operation status, post-operative complications, pathology results and follow-up of the patients were analyzed. Results: Fifteen patients received twice surgical treatment and 68 patients received one time surgical treatment. Postoperative hemorrhage in chest and between liver and diaphragm was not occurred in all cases.Dyspnea and low oxygen saturation were occurred in two cases of stripping patients and 1 case of metastatic lesions resection patients.Results of CT examination indicated that there was medium to large amount of ascites in right chests.The symptoms were relieved after placing thoracic closed drainage.Other patients were recovered smoothly.All patients were diagnosed as ovarian cancer by pathological examination. Conclusion: Associating diaphragm resection is safe and feasible for liver-diaphragmatic metastasis lesions from ovarian cancer.

Ultrasonography and needle aspiration cytology in the diagnosis and management of parathyroid lesions.

To elucidate the diagnostic value of fine needle aspiration (FNA) cytology of ultrasonically suspected parathyroid lesions, we reviewed a series of 17 cases seen over the past two years. Patients with biochemically proven primary or secondary hyperparathyroidism were examined by ultrasonography using a 7.5-MHz linear transducer. Ultrasound-guided FNA cytologic examinations with Riu's stain were performed on 13 patients who had questionable ultrasonographic patterns. The aspirates were considered adequate in nine out of 13 cases (69%). The cytologic patterns, characterized by tight cohesion of naked nuclei with indistinct cell border showing hypermonomorphism and overlapping of nuclei, were noted in adenomatous and hyperplastic lesions. There were several different findings noted in the case of parathyroid carcinoma, including loose cohesion of nuclei, larger nuclear size, and prominent anisokaryosis. One patient with secondary hyperparathyroidism who previously had a neck exploration, received an ultrasonically-guided percutaneous alcohol injection to the parathyroid lesion after cytologic verification. The result was remarkable both in volume reduction and in clinical improvement. The results suggest that ultrasound-guided FNA cytologic examination with Riu's stain is safe, simple and helpful in the localization of parathyroid lesions prior to surgery or percutaneous alcohol ablation therapy.