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C Caracò

Publications and source records attributed to C Caracò.

53 records · Page 3Linked to original sources

[131I-meta-iodobenzylguanidine scintigraphy in patients with a suspected pheochromocytoma. A comparison with CT and biohumoral parameters].

The results of 131I metaiodobenzylguanidine (MIBG) and Computed Tomography (CT) scans in a group of patients with clinically suspected pheochromocytoma were evaluated and compared with biohumoral parameters. We studied 24 consecutive patients (7 M and 17 F; age range 20-66 years). 131I-MIBG scintigraphy and CT were in agreement in 19 patients (79%): of them 7 cases were true positive, and 12 were true negative. Disagreement between the two imaging techniques was observed in 5 patients (21%). In this group, one patient, with positive CT scan, had false negative MIBG study, while 4 patients with negative MIBG scan, had false positive CT. MIBG showed significantly higher (p less than 0.05) specificity (100%), positive predictive value (100%), and accuracy (96%) than CT (75%, 67%, and 83%, respectively). 131I-MIBG scintigraphy is an accurate, noninvasive technique for localizing pheochromocytoma and providing direct tissue characterization, while CT provides more accurate spatial information. In conclusion, CT and MIBG studies are complementary in the evaluation of patients with suspected pheochromocytoma.

3-Iodobenzylguanidine↗

Sentinel lymph node biopsy to stage patients with cutaneous melanoma at the National Cancer Institute of Naples. Results from 240 sentinel node biopsies.

AIMS AND BACKGROUND: The presence of lymph node metastases in patients with cutaneous melanoma represents the basis for correct therapy planning and is the most powerful prognostic factor to evaluate overall survival at diagnosis. METHODS AND STUDY DESIGN: Since 1992, when Dr. Morton published his first experience, the sentinel lymph node (SLN) biopsy technique seems to have resolved this matter by correctly staging patients. We analyzed our data from 240 SLN biopsies performed in the last five years at the National Cancer Institute of Naples, evaluating the total identification rate and the nodal recurrence rate, and compared them with the preliminary data of the MSLT (melanoma sentinel lymph node trial). RESULTS: Of all SLNs evaluated 18.5% were micrometastatic and 14% were identified by immunohistochemical staining. Forty-one patients had metastatic SLNs and nodal dissection of the positive basins revealed no other tumor-positive lymph nodes in more than 80% of them. All patients with a Breslow thickness of less than 2 mm had micrometastases only in the SLN, while with increasing thickness two, three or more positive nodes were found. Among SLN-negative patients nine (4%) developed lymph node recurrence in the previously treated basin and were therefore considered as false negative SLN biopsies. CONCLUSIONS: The prognostic value of SLN biopsy needs to be confirmed by the final results of the MSLT evaluating the therapeutic use of this procedure in patients with a Breslow thickness of less than 2 mm and its possible impact on the course of the disease.

Adolescent↗

Anti-CEA and other antibodies in the study of gastrointestinal tumors.

Localization of gastrointestinal tumors by means of labeled monoclonal antibodies is a new, sensitive and suitable technique currently used in several centers. Encouraging results have been documented with several monoclonal antibodies by different authors. This article reviews our experience with radioimmunoscintigraphy in 59 patients with colorectal cancer in follow-up, using 131I and 111In labeled B72.3, and in 16 patients with primary gastrointestinal tumors using 99mTc anti-CEA monoclonal antibody (type F023C5). The sensitivity of both B72.3 and anti-CEA was greater than 70% either for primary tumors and abdominal recurrences or distant metastases except hepatic ones. A significant gradient in antibody uptake was measured on surgical biopsies between tumors and normal tissues allowing a good in vivo contrast for gamma detection. We have defined the impact of some factors affecting in vivo tumor targeting. In fact, pharmacodynamics of MAbs, percentage of injected dose bound to tissues were measured, and in particular antigenic content in tumor nodules was quantified. Furthermore, the results of RIS were compared to those obtained by CT and other imaging modalities.

Carcinoembryonic Antigen↗

[Lung metastases from follicular thyroid cancer: a report of a clinical case and a review of the literature].

The authors report a case of follicular thyroid cancer in "hot nodule" with micronodular synchronous lung metastases. The treatment consisted in TT associated with radioiodine therapy at the dose of 170 mCi with remission of cancer after six months of follow-up. Follicular variant is a prognostic unfavorable factor such as synchronous or metachronous pulmonary metastases. In those patients prognostic unfavorable variants are also age over 40 years, a poor radiofixation capacity, and a lesion of diameter up 1 cm. A strictly instrumental follow-up is mandatory to obtain diagnosis in a subclinical stage. In such cases the radiometabolic therapy agree to a remission of cancer with high survival after many years. TT yet represents a "minimal" surgical treatment for an accurate radioisotopic diagnosis.

Adenocarcinoma, Follicular↗

[Surgical treatment of secondary hyperparathyroidism].

BACKGROUND: Surgical treatment in the patient effected by secondary hyperparathyroidism consists in subtotal parathyroidectomy or total parathyroidectomy plus autotransplantation of parathyroid tissue. METHODS: The results obtained with surgical treatment of 6 patients observed in the years 1995-1996 are analyzed. Two glands were hyperplastic in four patients, 3 in the others. Every patient was submitted to a subtotal parathyroidectomy. RESULTS: Postoperative course was marked by transient hypoparathyroidism in one case. After 18 months of follow-up, no recurrences were observed. CONCLUSIONS: It is pointed out that in case of secondary hyperparathyroidism subtotal parathyroidectomy represents the surgical treatment of choice, according with literature data. Otherwise total parathyroidectomy plus autotransplantation, characterized by a more complex surgical technique, lead to the same results.

Aged↗

[Neoadjuvant chemo-radiotherapy in the treatment of rectal cancer: preliminary results].

Many studies in the literature have confirmed the role of combined therapy in the treatment of rectal neoplasms. Aim of the Authors' study was to evaluate the efficacy of preoperative neoadjuvant radiochemotherapy in these patients. The study group consisted of 15 patients, affected by rectal adenocarcinoma T < 4 M0 with age < 75 years, observed from January to August 1998, who underwent to RT of pelvis with three fields--total dose 32 Gy- in ten days associated with 5 FU(500 mg/m2) during the first five. After restaging the patients were operated on. Anterior resections (AR) were followed by mechanical colorectal anastomosis in 10 patients, coloendoanal anastomosis in 4, while in 1 case an abdominoperineal resection (APR) was performed. The protocol was well tolerated in every patient and perioperative complications were similar to those in the control group. A considerable reduction of the mass was obtained in a great percentage of patients studied, confirmed by pathologic examination like "down staging" of cancer. In no case a complete response to the therapy was observed (pT0N0). Survival in the patients operated on for rectal adenocarcinoma in about 50% and local relapse is the most important site of recurrent disease. The aim of neoadjuvant protocol is the control of lymphatic spread and reduction rectal neoplasm allowing coloanal anastomosis in the treatment of the 1/3 inferior rectal cancer. Literature data confirm a significant decrease of local relapse, probably with a better survival. The Authors study confirms that combined preoperative therapy is well tolerated in most of the cases and it represents the protocol of choice in the patient affected by rectal cancer.

Adenocarcinoma↗

Drainage in thyroid surgery: a prospective randomised clinical study.

Drainage in thyroid surgery is still an area of controversy. We analysed the results of a prospective randomised trial conducted in our institution in order to assess the utility of drainage after thyroid surgery. Sixty patients were entered into the study, thirty of whom were drained after surgery and thirty who received no drainage. The two groups were well matched with regard to most characteristics. There was no difference between the two groups in terms of early or late postoperative complications. We therefore conclude that, in our experience, drainage after uncomplicated thyroid surgery is of no benefit.

Adult↗

[The right inferior laryngeal nerve with a non-recurrent course].

Two cases of a right non-recurrent laryngeal nerve were encountered during the performance of 992 thyroid operations. In its abnormal non-recurrent course the nerve passes transversely from under the carotid sheat hand takes a position which is at right-angles to the normal recurrent laryngeal nerve.

Aorta, Thoracic↗

[Cervico-mediastinal carcinoma of the parathyroid: report of a case].

Parathyroid carcinoma is a rare malignancy. We report the case of a 66 years old man referred to our department for a large substernal goiter suspected as a thyroid cancer associated with severe hyperparathyroidism. After normalization of serum levels of calcemia, total thyroidectomy and subtotal parathyroidectomy was performed. Histopathology revealed a parathyroid cancer of 450 g.

Adenocarcinoma, Clear Cell↗

[Histophenotypical variants of squamous cell carcinoma of the skin].

Cutaneous squamous cell carcinoma (SCC) is, in its most frequent presentation, a moderately aggressive neoplastic disease. It can, however, present in a moltitude of clinico-pathological variants, some of which are characterized by a more malignant attitude. It is important to determine which tumors, among the various histophenotypes, are high risk in order to establish the appropriate treatment and follow-up. Histologic subtype has been considered as a possible variable in determining the prognosis of cutaneous SCC. We report our experience with 3 cases of peculiar variants of cutaneous SCC.

Adult↗

[Role of lymphadenectomy in the treatment of Merkel-cell tumors in i and ii stages].

Merkel cell carcinoma (MCC) is a rare, malignant skin cancer, exhibiting neuroendocrine differentiation, with a significant incidence of locoregional lymph nodal involvement (40%-73%). The accepted staging system classifies MCC as: stage I, localized skin disease; stage II, regional lymph node disease; stage III, metastatic disease. The clinical differentiation of stage I and II patients is difficult and understaging is frequent. Surgery, as first approach, represents the leading treatment for this neoplasm and, depending on stage consists in: local wide excision for stage I patients and local excision and lymphadenectomy for stage II. In our experience, lymphadenectomy, included in the initial treatment of all stage II patients, seemed to influence positively the prognosis. In comparing stage related recurrence and survival rates the results we obtained were better in stage II patients, where lymphadenectomy was included in the initial treatment than in stage I subjects, who received local excision alone as first treatment and lymphadenectomy as secondary treatment for nodal recurrence (overall recurrence rate 86% vs 20%, survival rate 71% vs 80% in stage I vs stage II patients). The performance of lymphadenectomy for stage I MCC could be reconsidered both for a more reliable staging of the disease and for a positive impact on recurrence and survival rates.

Carcinoma, Merkel Cell↗

[Video-laparoscopic cholecystectomy: first years of experience].

Laparoscopic cholecystectomy is became the elective operation in the treatment of symptomatic lithiasis of gallbladder, and it represent the surgical choice in 96% of cases. The authors on the base of their first years experience analyzes the results of literature with particular reference to the complications, like lesion of principal biliary tract and of other organs or vessels, underlining how the right selection of patients can be reduce morbidity. In this direction the subdivision of contraindication, in relative and absolute, already described in literature, represent an obliged chose to respect the mini-invasive principle which laparoscopic technique mean.

Cholecystectomy, Laparoscopic↗

[Role of intraoperative cholangiography in videolaparoscopic cholecystectomy].

Laparoscopic cholecystectomy represents elective the treatment of symptomatic lithiasis of gallbladder, due to advantages of shorter hospitalization and lower cost. The evolution of technological instruments permits today an easy and rapid execution of intraoperative cholangiography (IC). Therefore the elective or selective application of IC is debated, because of the effective determination of iatrogenic lesions and the real possibility of diagnosis for unknown lithiasis of biliary tract. Some authors agree that anatomic lesions cannot be prevented by IC, because 50% of its occur during the surgical dissection to prepare structures of Calot's triangle to make cholangiography. On the other hand the early diagnosis of iatrogenic lesions is fundamental for the results. The previous biliary symptomatology (jaundice), the elevation of biochemical parameters of biliary function (bilirubinemia, transaminase and alkaline phosphatase) and the dilatation of biliary ducts represents the indication to IC. The examination is also recommended in case of difficulties of dissection due to inflammatory process, to clarify the anatomy with more safety. Finally, the technique is well defined. The choice of patients is made on the basis of surgeon's opinions but we think that a good selection of patient is the only chance to perform IC with the best results.

Cholangiography↗

[Differentiated cancer of the thyroid: our experience].

The authors explain their experience about 136 patients affected by differentiated thyroid carcinoma. They compare different surgical procedure (total thyroidectomy vs conservative surgery). Although the surgical significance above the survival is discuss again, the authors, analysing the prognostic factors and the long term results, identify the total thyroidectomy maybe associated to lymphectomy and radioiodine therapy like the best treatment for this pathology.

Adolescent↗

[Morgagni-Larrey hernia: surgical treatment with Marlex. A case report].

The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occlusive symptomatology. This type of diaphragmatic hernia is uncommon and characterized by an aspecific symptomatology which realize different problems in children and adult patients, in whom diagnosis can be made incidentally, executing analysis for other pathologies. Using Marlex mesh to repair hernia represents an improvement of surgery, because it enables to repair a great hernia with a better result, and no recurrence.

Biocompatible Materials↗