[Primary malignant lymphoma of the breast. Apropos of 2 cases].
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Biomedical subjects
Publications and source records attributed to F G Cerrai.
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Between 1978 and 1984, 34 patients carrier of rectal neoplasms, were observed and treated in Divisione di Chirurgia Generale of Casale Monferrato Hospital. Twenty of such patients had been operated with curative procedures and 14 with palliative procedures. At the moment of this investigation 14 patients were still alive. The survival rate at 5 years, referred to '78, '79, '80, '81, respectively was 37.2%. For the last three years, the fifth year delay time shall be waited. The survival rates per year, have been reported her, for the whole period of the investigation. The AA, have evaluated the gross incidence rate for male and female patients (3.1 and 2.1 respectively). Survival and incidence data have been composed to those reported in the literature. Whilst survival rates agree with those from other authors, the incidence rates result considerably lower than those from other West Countries. It could be abscribed to an underestimation of the actual number of rectal neoplasm bearing patients, which could escape the investigation because diagnosticed and treated elsewhere. It should be noted nevertheless that the Casale Hospital supplies a scarcely industrialized urban area, and a wide rural environment, so that resident population might be included within one of the groups partially protected by environmental and alimentary conritions against the disease. In conclusion the AA. consider of a primary importance the development of centres suitable for base medicine aimed at assuring a real and effective prevention activity.
The authors report here on the results of a statistical and epidemiological review of cases of carcinoma of the large bowel observed in the General Surgery Division of the Casale Monferrato Hospital. After supplying introductory data on the diffusion of the disease, risk factors and statistical aspects, the authors report data on 137 cases of large bowel carcinomatous neoplasms observed and treated over the period 1978-1984, complete with tables summarising the neoplastic localizations aid the types of operation performed. After calculating the operative mortality and both the absolute and relative survival rates, the authors analyze the results of the survey, comparing the findings obtained with those reported in the literature by various authors.
The Authors report an investigation on 42 patients with large bowel occlusions for neoplastic lesions. Obstruction complications were localized in 69% in sigmoid colon and recto-sigmoid junction. This pathology involved old patients with one or more associated affections. The Authors explain reflections on surgical treatment, on necessity of therapeutic approach in high-risk patients, and of large bowel surgery with oncologic radical treatment.
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An investigation on prostatic dancer is reported by AA., along a five years period (80-84) in Casale Monferrato territory (USSL 76, Piedmont) incidence rate (29,8) aid mortality data (27,7) are also reported in comparison to those reported in "Registro Tumori del Piemonte (Turin)", "Registro Tumori Lombardia (Varese)" and ISTAT (national territory). A. marking differencies among reported data, give some explanation about disagreement. AA.'s further assert that the given under-estimation of the incidence rate is due to the different diagnosis in different USSL. The over-estimation of death rate is partially given first by people come back in primitive country of origin, and second by data acquired in original countries, about death.
Our two-step technique for endoscopic treatment of gastric leiomyomas is illustrated. From January 1979 to June 1991, nine symptomatic patients with sessile leiomyomas of the stomach were treated at the Endoscopy Division of Istituto Nazionale Tumori, Milan. The diagnosis was achieved by means of endoscopic observation of the lesion and, when possible, by ultrasound endoscopy. This new technique consists of first removing superficial portion of the tumor by electrosurgical snare. Second, a cleavage plane is found within the proper muscle layer; the tumor is enucleated as much as possible by tightening the snare around it and creating a pseudo-stalk. No major complication occurred nor were any recurrences observed at 21.8 months in the 7/9 patients treated by endoscopy alone. Endoscopic therapy was performed on an outpatient basis and only large lesions required short hospitalization.
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We reviewed our results of using stents for palliation of cancer of the lower third of the esophagus and gastric cardia. During a 14-year period, 76 patients with either lower third esophageal cancer (n = 43) or cancer of the gastric cardia (n = 33) received stents for palliation of malignant dysphagia. Successful endoscopic placement was initially achieved in all patients, with 71 patients available for follow-up. Of these, 40 (56%) were subsequently able to eat solid or semi-solid food, 25 (35%) could swallow only liquids, and 6 (8%) were unimproved. The combined early and late complication rate totalled 22%. Early complications included perforation (n = 3) and stent migration (n = 4); late complications consisted of dislodgment (n = 6), obstruction by tumor (n = 2), and severe esophagitis (n = 1). There were no procedure-related deaths, but survival at 1 year was estimated to be only 1.5%, with a median survival of 2.5 months after stent insertion. The endoscopic placement of prosthetic stents for cancer of the distal esophagus and gastric cardia entails a higher complication rate, less successful palliation, and shorter survival time compared to similar treatment for more proximal esophageal cancer.
Endoscopic polypectomy is the treatment of choice in symptomatic polyps of the stomach. From 1974 to 1989, at the Endoscopy Division of National Cancer Institute of Milan, 37 patients underwent endoscopic polypectomy, to remove 55 gastric adenomas. Areas of malignancy were revealed in 3 patients. Two of them, not operable for advanced age and poor general conditions, are controlled endoscopically. Endoscopic polypectomy can be performed on an outpatient basis or with a short period of hospitalization. It represents the only form of therapy in not operable patients. Furthermore this method allows to prevent the malignant transformation of the adenomas, which, as reported in the literature, ranges between 3.4% to 66.5%. Our experience confirms the validity of this technique which is safe and effective.
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