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L Troncone

Publications and source records attributed to L Troncone.

At least 19 recordsLinked to original sources
PubMed1991

Autonomously functioning thyroid adenoma in a seven year old boy.

Hyperfunctioning thyroid adenoma is an extremely rare disorder in childhood. A case of a seven year old boy is reported. Clinical and laboratory findings were similar to those seen in adults. Recovery of thyroid function was prompt after ablative surgery and no substitutive therapy was required.

Adenoma↗
PubMed1990

Role of immunoscintigraphy in clinical assessment of gastrointestinal tumors.

From June 1986 until April 1989 31 patients with gastrointestinal tumors were studied at follow-up for recurrences by immunoscintigraphy (IS) using F(ab)2 fragments of monoclonal antibodies anti CEA and anti CA 19-9. IS was employed to confirm the presence of metastases already found (group A) and to verify metastases suspected following physical and instrumental examinations and/or increases in CEA and/or CA 19-9 (group B). Thirty-four IS findings have been evaluated to date: 19 in group A, with 18 true positive and 1 false negative results; 15 in group B. In these patients there were 12 cases of pathologic high fixation: 6 were confirmed using standard examinations after a median follow-up of 1 month (range 1-12); 6 cases had no metastatic evolution at the suspected site after a follow-up of 5-28 months. In 3 cases IS was negative, these patients are disease free at 13, 14 and 24 months. In group B, 5 of 8 abdominal intense fixations were early diagnoses of local or peritoneal recurrences. The overall accuracy was 79.4% and it was not affected by circulating CEA levels; sensitivity was 96%. IS can be considered useful as a primary diagnostic examination in the follow-up of patients with suspected abdominal metastases.

Adult↗
PubMed1990

Thyroid carcinoma mimicking a toxic adenoma.

A young woman with a thyroid papillary carcinoma behaving as an autonomously hyperfunctioning nodule is described. Only 17 similar patients have been seen in the past 25 years. It is emphasized that hyperthyroidism does not exclude malignant disease in hot nodules. This possibility suggests that all thyroid nodules, either cold or hot, require careful management. Therefore, in "at risk" cases, surgery could be the most useful treatment.

Adenoma↗
PubMed1990

The diagnostic and therapeutic utility of radioiodinated metaiodobenzylguanidine (MIBG). 5 years of experience.

The authors' experience of more than 5 years in the diagnostic and therapeutic use of radioiodinated MIBG in neural crest tumors is reported. 123I/131I-MIBG scintigraphy was performed in 158 patients: 75 suspected (24 proven) pheochromocytomas (pheos), 43 neuroblastomas (NB), 20 medullary thyroid carcinomas (MTC), 6 ganglioneuromas, 5 carcinoids and 1 insulinoma. Eight cases of tumors not originating from the neural crest were also investigated. The diagnostic sensitivity of the method was above 90% both in pheos and NB (primary tumors and bone metastases). The examination was less effective in localizing MTC (sensitivity = 64.4% in primary or residual/recurrent tumors). The scintigraphic outcome was negative in ganglioneuromas, carcinoids and insulinoma. Specificity was very high (greater than 95%), and no false positive results were found in tumors not deriving from the neural crest. 131I-MIBG treatment was administered to four patients with malignant pheo, nine with NB and four with MTC. Therapy resulted in a complete response in one pheo, two NB and one MTC treated after surgery or at diagnosis (one NB); it gave partial response and prolonged remission in five advanced cases (one pheo, two NB and two MTC); it resulted in temporary stabilization of the disease in one pheo and two NBs; it was ineffective in four cases.

3-Iodobenzylguanidine↗
PubMed1989

131I-metaiodobenzylguanidine in the treatment of neuroblastoma at diagnosis.

Radioactive metaiodobenzylguanidine (131I-MIBG) is taken up specifically by neuroblastoma cells and appears to represent a new treatment modality in patients with advanced neuroblastoma. Taking into account the fact that all patients so far treated were heavily pretreated and resistant to chemotherapy, the results obtained appear encouraging. In order to explore further the potential role of this new drug in untreated patients, we treated with 131I-MIBG a child with stage III neuroblastoma at diagnosis. We observed the complete disappearance of a large abdominal tumor mass after a relatively low dosage of 131I-MIBG, with minimal hematologic toxicity. No further treatment was given and, at present, the patient is alive with no evidence of disease 18 months from diagnosis. This child represents, to our knowledge, the only case of neuroblastoma thus far treated at diagnosis and the excellent response obtained suggests the need for further investigations of this therapy in untreated patients.

3-Iodobenzylguanidine↗
PubMed1989

Diagnostic and therapeutic potential of new radiopharmaceutical agents in medullary thyroid carcinoma.

Recently developed radiopharmaceuticals have been proposed for imaging medullary thyroid carcinoma (MTC) with some having therapeutic potential. This study compares the imaging results obtained with radioiodinated meta-iodo-benzylguanidine (MIBG), 99mTc (V) DMSA, and 131I F(ab')2 anti-carcinoembryonic antigen (anti-CEA) in a group of MTC patients. In 23 patients 131I MIBG imaging showed a high specificity (no false-positive results) but a less satisfactory sensitivity (50%). In 12 patients 99mTc (V) DMSA revealed a better sensitivity (77%) but a lower specificity (three false-positive results). Positive results were obtained in two of three patients studied with 131I F(ab')2 anti-CEA. These data suggest that the highly sensitive 99mTc (V) DMSA should be considered as a first choice procedure followed by the highly specific radioiodinated MIBG to confirm the initial results. Since radioiodinated MIBG imaging may have therapeutic usefulness, 131I MIBG was evaluated in an integrated treatment protocol in four cases of proven MTC. The preliminary results obtained were encouraging.

3-Iodobenzylguanidine↗
PubMed1988

The possible use of radioiodinated metaiodobenzylguanidine (MIBG) in medullary thyroid carcinoma.

The value of radioiodinated metaiodobenzylguanidine (MIBG) in imaging thyroid medullary carcinoma (MTC) was investigated (18 studies) in 12 patients with proven MTC. Calcitonin (CT), carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) were also determined. The patients were divided into two groups. Group I comprised 7 patients who had relapsed; two of them were also studied before total thyroidectomy. In the 2 cases studied before total thyroidectomy 123/131I-MIBG imaged the primary tumor (partially) and the residual tumor involved lobe. The residual/recurrent tumor present in 4 and some of the remote metastases in 3 out of 5 were detected. Group II includes 5 patients studied postoperatively with no evidence of disease. A residual tumor in one of the 2 patients without evidence of disease on the basis of conventional diagnostic modalities but with elevated tumor markers was visualized; the outcome was correctly negative in 3. One patient underwent treatment with 131I-MIBG. A total dose of 27.1 GBq (733 mCi) was given. Relief of pain and partial regression of the lesions was achieved.

3-Iodobenzylguanidine↗
PubMed1988

[A comparison of scintigraphy with radioiodinated MIBG and CT in localizing pheochromocytomas].

In order to define the diagnostic roles of MIBG imaging and CT in the detection of pheochromocytomas (pheos), the results obtained in 45 patients suspected of bearing pheo and studied with both modalities were analyzed and compared. Scintigraphy was correctly negative in 22/23 cases, correctly positive in 11/12 adrenal and 5/5 extra-adrenal pheos, and in 4/5 malignant pheos (metastases present in 2 cases were also identified). CT was correctly negative in 20/23 cases (a mass other than a pheo was detected in 3 patients); correctly positive in 12/12 adrenal and 4/5 extra-adrenal pheos and in 5/5 malignant pheos. Sensitivity, specificity and accuracy of scintigraphy and CT were 91% and 95.4%, 95.6% and 87%, 93.3% and 91.1% respectively (differences were not statistically significant). The overall data emphasize the complementary role of 123/131I-MIBG imaging and CT in the location of pheochromocytomas. A flow-chart essentially grounded on the combined use of both these diagnostic modalities is proposed which includes 123/131I-MIBG scintigraphy as a first choice examination.

3-Iodobenzylguanidine↗
PubMed1987

Treatment of neuroblastoma with 131I-metaiodobenzylguanidine.

Seven patients with neuroblastoma (six children and one adult) were treated with therapeutic doses of high specific activity 131I-metaiodobenzylguanidine (131I-MIBG). Six patients were in stage IV and unresponsive to conventional treatment. One patient, in stage III, was treated at diagnosis, an approach never previously reported. Single doses of 131I-MIBG varying from 70 to 184 mCi split into two parts were administered by slow i.v. infusion (4 to 8 hours) at 2- to 4-day intervals. The following results were obtained in the six evaluable patients: two patients showed transient stabilization of the disease; three had an objective response, with shrinking of the primary tumor and/or regression of the metastatic lesions. Of these three patients, two suffered relapses at 2 and 7 months, respectively, from the first course of MIBG. The third patient, in whom the residual disease almost completely disappeared following MIBG therapy, is still alive in complete remission after autologous bone marrow transplantation with a follow-up of 14 months. The single patient treated at diagnosis showed a dramatic response to a relatively low dosage of MIBG, with histologically proved disappearance of the tumor mass. Our data indicate that MIBG may be useful in the treatment of neuroblastoma unresponsive to conventional chemotherapy. The complete response observed in the patient treated at diagnosis suggests that the full potentiality of MIBG therapy should be explored in untreated patients.

3-Iodobenzylguanidine↗
PubMed1986

[A new medico-nuclear outlook for the diagnosis and treatment of pheochromocytomas: 131I-meta-iodobenzylguanidine (131I-MIBG). Comments on results obtained].

The diagnostic and therapeutic potential of 131I-MIBG, the new imaging agent with structural similarity to norepinephrine, was evaluated in 23 patients with a suspect pheochromocytoma. Seven out of 8 benign pheochromocytomas (2 ectopic) were correctly localized with 131I-MIBG scintigraphy (1 false negative). In 2 catecholamine-secreting malignant pheochromocytomas both the primary tumor and the metastases (1 case) were demonstrated. One uncommon case of dopamine-secreting malignant pheochromocytoma, as expected, was not shown. In the remaining 12 cases, found to be "normal" after completing the work-up, distribution of the radiopharmaceutical was evaluated using a semiquantitative grading system. 131I-MIBG scintigraphy proved to be a non invasive and accurate (95%) diagnostic modality, specific for neuroadrenergic tumors. The treatment with 131I-MIBG was also carried out in 2 malignant pheochromocytomas with encouraging results.

3-Iodobenzylguanidine↗
PubMed1986

[Possibility of using 131I-meta-iodobenzylguanidine in the diagnosis of neuroendocrine tumors differing from pheochromocytomas].

The results obtained using 131I-MIBG to diagnose different neuroendocrine tumors in 17 patients are discussed. In 8 of the neuroblastomas studied the examination gave a wide spectrum of scintigraphic results according to the various stages of evolution of the tumors, thus supplying additional useful information for metabolic treatment. Contradictory data were obtained in 5 cases of medullary cancer of the thyroid. The overall results were unexpectedly negative for 2 carcinoid tumors and, as expected, negative for 2 ganglioneuromas. These data confirm that 131I-MIBG is a non invasive, reliable and easy-to-perform technique which is no longer limited to the diagnosis of pheochromocytomas, but can also be used for the diagnosis of other tumors derived from neural crest cells.

3-Iodobenzylguanidine↗
PubMed1978

Growth hormone response to propranolol and L--dopa in obese subjects.

Oral administration of propranolol and L-dopa produced a marked increase in plasma growth hormone values in 12 obese subjects who had failed to respond to L-dopa alone. GH values after propranolol and L-dopa in obese subjects were not significantly different from those of normal subjects after L-dopa at 60, 90, and 120 min. Association of propranolol and L-dopa appears to be a simple means of investigating GH response in obese subjects.

Adolescent↗
PubMed1977

Radioisotopic study of the adrenal glands using 131I-19-iodocholesterol.

Scintigraphy of the adrenal gland with 131I-19-iodocholesterol has recently been added to radiological techniques in adrenal imaging and has been used successfully to demonstrate anatomical and functional disorders of the adrenals in a variety of clinical situations. A review of the authors' experience stresses the diagnostic value of this method. Radiological findings and results of scintillation imaging are complementary: their comparison improves and clarifes indications for scintigraphy. Hyperadrenal cortical diseases always gave satisfactory scintigrams, the most interesting results being obtained in adrenal cortical hyperplasia and unilateral hyperfunctioning adenomas. In these cases the evaluation of the response to stimulation or suppression tests was very useful. On the other hand scintigraphy was less valuable in demonstrating malignant and non malignant tumours.

Adenoma↗