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Fausto Famà

Publications and source records attributed to Fausto Famà.

9 recordsLinked to original sources

Breast vasculitis presenting as a tumor-like lesion. A case report.

Breast vasculitis presenting as a tumor-like lesion is rare. The differential diagnosis in these cases can be extremely difficult but is very important for treatment and follow-up. We report the case of a 80-year-old woman who was admitted to our service with a lesion resembling an inflammatory carcinoma of the breast. We discuss the pathological and clinical characteristics, the presentation, assessment and treatment of this case and its resolution. Few reports in the literature have addressed the possible occurrence of systemic vasculitis mimicking cancerous lesions. The most common location of such lesions was shown to be the breast in one review. Although rare, such manifestations can be effectively recognized and treated.

Aged, 80 and over↗

[Radioimmunoguided surgery (R.I.G.S.) in colorectal cancer. Preliminary results].

The authors describe their experience in utilizing 'ArcitumoMab' and radioimmunoguided surgery in a group of patients with localized and advanced colorectal cancer. Twenty-one patients were studied who were found to be positive to 'ArcitumoMab'. Immunoscintigraphy was obtained in 95% of cases. Radioimmunoguided surgery was performed in all cases. One case, which was negative at immunoscintigraphy, was found to be positive intraoperatively when radioimmunoguided surgery was performed. Radioimmunoguided surgery, in the authors' view, is a useful technique but needs to be validated in larger samples, particularly in cases of relapse.

Aged↗

[Surgical treatment of breast cancer after neoadjuvant therapy].

Primary chemotherapy represents a new therapeutic strategy that allows the implementation of conservative surgical treatment in locally advanced breast cancer or in cancers measuring > 3 cm. Of 127 patients with breast cancers measuring > 2.5 cm, 86 were treated with primary chemotherapy. This consisted in the administration of the ADM + TAX protocol in 28 cases and CNF in 58 cases. Three complete responses, 8 cases of stable disease and 75 partial responses were observed. Eleven radical mastectomies and 74 conservative treatments were performed. The chemotherapy protocol enabled us to convert 87% of the patients treated to conservative treatment, thus affording a treatment that offers a better quality of life despite the existence of a voluminous cancer and is of considerable psychological help in patients suffering from cancer of the breast.

Adult↗

[Nipple discharge: personal experience with 2,818 cases].

After mastodynia, nipple discharge is the second most frequent condition that brings women to the attention of breast clinics. Seven types of nipple discharge exist: milky, multicolored, purulent, clear-watery, serous, pink or serosanguineous, brown or reddish-brown. From January 1982 to January 2003 we observed 2818 patients with nipple discharge (range: 16-83 years). Amongst these, 805 patients with nipple discharge were submitted to cytological examination of the secretions. One hundred and seventy-six had bilateral discharge, and 629 unilateral discharge. All patients with positive C3, C4 or C5 cytology and with unilateral discharge (227) were referred for surgical treatment. In 92 of these 227 cases (41%) the secretion was serous, in 59 cases (26%) bloody, in 45 cases (20%) purulent and in 31 cases (13%) multicolored. We performed duct galactophorectomy in 89 cases (39%), resection with reconstruction of the nipple-areola complex in 48 cases (21%), microdochectomy in 42 cases (18.5%), segmentectomy or quadrantectomy in 41 cases (18%), and mastectomy in 6 cases (3%); we also removed a papilloma from the ductal orifice in 1 case (0.44%). Histological specimens showed papilloma in 98 cases (43%), breast cancer in 39 cases (17%), galactophoritis in 36 cases (16%), fibrocystic disease in 46 cases (20%), including 31 (14%) with florid adenosis, and papillomatosis in 8 cases (4%). An increased probability of cancer is therefore associated with serous, bloody, reddish brown and watery secretions. This is particularly true when the secretion is unilateral and originates from a single duct, when there are cytological alterations, whether mammographic or galactographic, and when the patient is aged over 50 years.

Adolescent↗

[Sentinel lymph-node biopsy in breast cancer: five years' experience].

The authors report on their experience with sentinel lymph-node biopsy in breast cancer. Sentinel lymph-node biopsy was performed in 91 patients with T1-T2 N0 M0 breast cancer using radiocolloid (99mTC radiolabelled colloidal human albumin microaggregate) injected perilesionally in 56 cases and by Blu Patent V alone in 35 cases. The sentinel lymph nodes identified were located in the axilla in 88 cases, in the internal mammary nodes in 2 cases and in a subclavicular site in 1 case. The histological examination was negative in 62 cases and positive in 29; Axillary lymph-node dissection was carried out in node-positive cases. No recurrences were observed in any of the cases treated. Lymphatic mapping and sentinel lymphadenectomy in primary breast cancer is now a feasible and useful method of avoiding routine axillary lymphadenectomy. However, the role of micro- or macrometastases in sentinel lymph nodes and the significance of identification of tumour mRNA have yet to be defined.

Breast Neoplasms↗

[Evaluation of complications and long-term results after surgery for gynaecomastia].

In an attempt to evaluate ten years of surgical treatment of gynaecomastia, we analysed the incidence of complications and the quality of the results in a group of patients classified according to Simon. Over the decade 1992-2002, 107 patients with gynaecomastia aged from 17 to 79 years were treated. The prevalent surgical approach was subcutaneous mastectomy. In 71 patients the surgical approach was via a periareolar inferior incision, superior in 15, inferior with bilateral extensions in 10; using a complete circumareolar approach (according to Padron) in 8 patients and a subcutaneous transareolar mastectomy in 3. No immediate complications were observed. Ten patients presented a modest postoperative haematoma. Only in one diabetic patient with chronic bronchitis and grade III gynaecomastia did partial dehiscence of the surgical wound occur. Most patients achieved good results. We judged the results excellent in 94 patients, good in 11, and unsatisfactory in 2. On the basis of our experience and in agreement with the literature data, we can affirm that the best results were obtained by subcutaneous mastectomy with a periareolar incision.

Adolescent↗

[Management of polytrauma: our experience].

In the advanced nations trauma represents the third cause of death after cardiovascular diseases and tumours. Recently, great importance has been given to the need to treat traumas as quickly as possible in order to reduce mortality and morbidity. Prompt management of is the gold standard in the emergency setting and the phrase "golden hour" is now commonly used. The authors report on their experience with the management of multiple trauma, through the study of 617 clinical cases. Patients were evaluated with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS). Of 420 (68%) cases of major trauma only one patient had ISS > 60. Patients were admitted on average after 47 +/- 18 min. Only two deaths occurred in the emergency unit. The task of the emergency unit is to stabilise the patients, anticipate the complications, including mainly shock and multiple organ failure, optimizing time, interventions and resources to reduce morbidity and mortality.

Abbreviated Injury Scale↗

[Non-lactational mastitis: our experience].

The most frequent breast inflammatory diseases are lactational and non-lactational mastitis. The diagnosis of these lesions is always difficult, as they often mimic breast cancer. The Authors report on their experience about 830 clinical cases of non-lactational mastitis, 804 were superficial abscesses and 24 were phlegmons. In 379 cases an infectious cause was found: in 249 by Streptococcus/Pseudomonas and in 30 by Staphylococcus Aureus. All patients underwent surgical treatment. Diagnosis was obtained by clinical examination, routine investigations (ultrasound, mammography and cytology) and post-operatively by histological evaluation. The non-lactational mastitis are more frequent in the postmenopausal and the menopausal period, but MDAIDS (Mammary Ducts Associated Inflammatory Diseases Sequence) are particularly interesting. MDAIDS was observed in 178 cases, these are very peculiar lesions characterized by ducts ectasia, squamous metaplasia, lymphoid infiltration and strictly correlated with heavy smoking. Sometimes, only surgical treatment clarifies the nature of these lesions. Patients with inflammatory diseases of the breast present with mastalgia and secretions, symptoms which alert patients to consult quickly a specialist. Instrumental investigations often don't clarify the diagnosis and surgical treatment by incision and drainage or excision is definitive.

Abscess↗

[Gunshot wounds. Our experience].

Abdominal gunshot wounds may result in elevated morbidity and mortality. The optimal management is still controversial. The authors report on their experience with treatment of 49 patients. In all patients the PATI score was used to identify trauma and all were treated surgically. Laparoscopy was employed only in one patient. The mortality was 2% and the morbidity 6%. The authors conclude that the PATI score correlated well with morbidity and mortality. Resuscitation with immediate surgical treatment may reduce the morbidity and mortality rates.

Abdominal Injuries↗