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Biomedical subjects

E Campagnutta

Publications and source records attributed to E Campagnutta.

At least 19 recordsLinked to original sources

[Isolated splenic metastasis in a case of adenocarcinoma of the uterine cervix. A clinical case].

The incidence of splenic metastasis, revealed during autopsy, from solid tumours varies from 1.6% to 30% with a mean of 7%. The clinical observation of splenic metastasis in patients with carcinoma of the exocervix is only occasionally reported. In the majority of cases metastasis appears 4 or 5 years after the onset of disease. The case reported here is the only example we have found in the literature relating to an adenocarcinoma of the uterine cervix which led to an isolated splenic metastasis. A 47-years-old patient underwent radical hysterectomy according to Meigs due to a stage 1B N0 G2 endocervical adenocarcinoma. The patient was subsequently reoperated due to pelvic recurrence and received radiotherapy. Almost five years after the first operation CT showed a suspected isolate splenic recidivation following pain in the left side. Hepatosplenic scintigraphy confirmed the presence of a large central cold area, with blurred edges, suggesting metastasis. The patient again underwent laparotomy: the volume of the spleen was found to be increased with the splenic hilum covered with neoplastic tissue. Splenectomy was performed. Abdomino-pelvic and retroperitoneal inspection showed no further signs of metastasis. Histological tests confirmed the massive metastasis of the adenocarcinoma in splenic parenchymal tissue which was relatively differentiated with a clear cell appearance. Seven months later the patient was again operated following intestinal occlusion due to numerous entero-enteric adhesions. During the course of surgery a micronodule was removed from the cholecystic serosa, apparently composed of fibrin; histological analysis proved that this micronodule was the site of glandular micrometastasis. The patient then began three cycles of chemotherapy with Adriamycin (60 mg/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma

[Local anesthesia in cervix biopsy].

The Authors evaluated the perception of pain in a group of 35 patients undergoing cervical biopsy and the efficacy of using 40 mg of lydocaine (xylocaina spray) in 24 patients compared to a control group. Pain perception was evaluated using Scott-Huskissons's visual analogous scale. It was observed that this diagnostic method was painful and that premedication using topical anesthesia was an efficacious method of significantly reducing painful symptoms.

Anesthesia, Local

[CA-125 serum levels in the diagnostic and clinical approach to ovarian cancer].

The CA 124 serum level is a useful marker in monitoring epithelial ovarian carcinoma. More elevated serum levels when compared to the conventional cut-off (ie 35 U/ml), after the first surgical and/or chemotherapeutic approach, give evidence for the presence of an endocelomic and/or retroperitoneal tumour or are indicative of relapses. Also, they are well correlated with the endoperitoneal cytology pattern. Good correlation exists between the serological amount of CA 125 and tumoral mass before surgical removal whereas its efficacy in the differential diagnosis between primary ovarian tumours and metastatic disease ad well as its diagnostic specificity towards pelvic bulks, before removing them, is limited. Higher specificity seems to be obtained on increasing the cut-off threshold over 70 U/ml.

Adult

[Bilateral hydrothorax with hydromediastinum after cannulation of the left internal jugular vein].

A rare case of combined bilateral hydrothorax and hydromediastinum was encountered during Total Parenteral Nutrition (TPN) via incannulation of the left internal jugular vein in a patient with advanced cancer of the portio. The possible anatomical and technical causes of this very serious complication were investigated in order to assess the importance of specific manual technique and to supply appropriate instrumental back-up that could prevent the recurrence of this sometimes fatal complication of TPN.

Catheterization, Central Venous

Intermittent pelvic arterial infusion with peptichemio, doxorubicin, and cisplatin for locally advanced and recurrent carcinoma of the uterine cervix.

The preliminary results of intraarterial chemotherapy with peptichemio, doxorubicin, and cisplatin as part of a multimodality treatment in locally advanced and recurrent cervical carcinomas are reported. Treatment consisted of a bilateral sequential infusion of peptichemio 20 mg, doxorubicin 10 mg and cisplatin 20 mg in a 6-hour period via an external infusion pump. After a rest period of 4 days, treatment restarted until maximum response or toxicity. Twenty-five patients, 12 with primary advanced (four Stage IIb, eight Stage III) and 13 with recurrent tumors were treated. All previously untreated patients obtained objective response. In particular, two patients with Stage IIb and III disease, respectively, achieved a complete response. Nine of 13 patients with recurrent disease (69%) were responsive, too, and therefore an overall objective response rate of 84% was achieved. Responses were noted after a median of five cycles of chemotherapy, whereas hematologic toxicity observed in all but one patient, was encountered after a median of four cycles. Toxicity of grade 1 and 2 was noted in 19 patients (76%), whereas of grade 3 and 4 in only 5 (20%). One treatment-related death, due to sepsis during myelosuppression, was reported. Catheter-related toxicity was noted in four patients causing femoral thrombosis in two. In one case a bypass operation was required. After intraarterial chemotherapy, all 21 responsive patients were eligible for radical surgery and 18 (86%) underwent both surgery and postoperative radiation therapy. Surgery was excluded in three patients. In these three cases radiation therapy alone was employed. In this series, the schedule of intraarterial chemotherapy employed was very effective. Patient accrual is ongoing in order to confirm the response rate so far obtained and to evaluate, with a longer follow-up, the impact of this multidisciplinary approach on local control and survival.

Adult

Surgical treatment of intestinal occlusions in advanced ovarian carcinoma.

The Authors report encouraging results concerning the surgical treatment of intestinal occlusions in 31 patients affected by advanced ovarian carcinoma. They stress the need for an increasingly accurate association of chemotherapy and aggressive surgery and underline the vital role that total parenteral therapy has to play in improving these results which are, nevertheless, satisfactory.

Adult