Biomedical subjects

Armando Malloci

Publications and source records attributed to Armando Malloci.

4 recordsLinked to original sources

PubMedDate not supplied

[Differentiated thyroid carcinoma and hyperthyroidism: a frequent association?].

The relationship between hyperthyroidism and thyroid carcinoma remains controversial. In hyperthyroid patients the incidence of thyroid cancer varies considerably from 0.1% to 21%. We analyzed the frequency of coexisting hyperthyroidism and thyroid malignancy in our experience. From September 2002 to June 2004, 450 patients were submitted to total thyroidectomy in our surgical department. Hyperthyroidism was observed in 71 cases and thyroid carcinoma in 110 (107 differentiated). The association of hyperthyroidism and thyroid cancer was observed in 15 patients (14% of differentiated carcinomas and 21.1% of hyperthyroid patients). All patients were submitted to total thyroidectomy and are alive and disease-free. Seven cases of transitory hypoparathyroidism were observed (46.6%). There was no other morbidity. The association of thyroid cancer and hyperthyroidism is by no means rare. Careful exami- nation of hyperthyroid patients is always necessary to exclude the presence of carcinoma. These results confirm that the operation should be total thyroidectomy when surgery is performed in patients with hyperthyroidism.

Adult↗

PubMedDate not supplied

[Umbilical endometriosis. A case report].

The Authors present a case of umbilical endometriosis. A 38-year-old female presented with a nodule in her umbilical region. The nodule was brownish in colour and had enlarged slowly, reaching a size of 2 cm in diameter over the previous 7 months. The patient had no symptoms and there was no bleeding or pain during menstruation. The nodule was removed under local anaesthesia and histological examination was diagnostic for umbilical endometriosis. No recurrence occurred over a follow-up period of 7 months and the patient is in good general condition. Umbilical endometriosis is a very rare disease, but should be borne in mind in the differential diagnosis of umbilical lesions.

Adult↗

PubMedDate not supplied

[Substernal goiter: personal experience].

AIM OF THE STUDY: The Authors report on their experience in the surgical treatment of substernal goiter. MATERIAL AND METHODS: Between 1972 and 2004, 222 patients with substernal goiters were observed among 2720 patients undergoing surgical treatment for various thyroid diseases (8.16%). Seventy patients underwent subtotal thyroidectomy and 152 total thyroidectomy. A cervical approach was employed in 213 cases, a sternotomy was required in 7 patients while a thoracotomy was necessary in 2 cases. Postoperative complications were definitive hypoparathyroidism in 9 cases (4%), recurrent laryngeal nerve palsy in 5 patients (2.2%) and postoperative bleeding in 4 cases (1.8%); there was no intraoperative mortality. CONCLUSIONS: In substernal goiter it is necessary to define its exact relationship to neck and mediastinal structures in order to establish the most appropriate surgical approach. In the majority of the cases total thyroidectomy is possible through a cervical approach with an acceptable morbidity rate. When dissection of the substernal goiter is difficult and recurrent laryngeal nerve is not clearly identified, partial sternotomy is required to enable a better control of the nerve and the vessels with only a minimal morbidity rate. Thoracotomy is rarely necessary.

Adult↗

PubMedDate not supplied

[Emergencies in thyroid surgery. Our experience].

The rate of complications after thyroid surgery is about 5% and among these real emergencies account for less than 1%, consisting in intraoperative and postoperative bleeding, bilateral recurrent palsy, severe hypoparathyroidism and, rarely, laryngeal oedema and tracheomalacia. Between 2000 and 2004 849 patients were submitted to total thyroidectomy for various thyroid pathologies in our institution. Complications observed were postoperative bleeding in 13 patients (1.5%), laryngeal recurrent nerve palsy in 18 (monolateral in 14 - 8 transient and 6 permanent - and bilateral in 4, 3 of which transient), transient hypoparathyroidism in 390 (45.9%), permanent hypoparathyroidism in 10 (out of 400 patients followed up for more than one year = 2.5%). Tetanic crises were observed in 33 patients (3.9%). One patient, on treatment with heparin, showed a glottic haemorrhagic oedema (probably caused by trauma after endotracheal intubation) treated by an emergency tracheotomy on postoperative day two. Thyroid surgery is today very safe and morbidity is rare. Anatomical knowledge and accuracy of surgical indications are the main factors capable of reducing the number of complications. Experience in performing thyroid surgery is essential for the best outcome with the fewest complications. Complications of total thyroidectomy can be minimised with increasing experience and refinement of surgical technique.

Emergencies↗