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Biomedical subjects

M Plocco

Publications and source records attributed to M Plocco.

At least 19 recordsLinked to original sources
PubMed2000

[Arterial aneurysms associated with cystic hepato-renal disease].

BACKGROUND: Ehlers Danlos syndrome (type IV) and kidney and liver cyst disease can present a common factor: anomalous biosynthesis of structural collagen and elastic tissue. We present an exceptional case. CASE REPORT: A 62-year-old man complained of pain in the upper left quadrant of the abdomen. Ultrasonography, magnetic resonance imaging and arteriography evidenced an aneurysm of the splenic artery, an aneurysm of the hypogastric artery, multiple cysts in the kidney and liver, and mitral valvulopathy. Treatment was splenectomy with resection of the splenic aneurysm and resection of the iliac aneurysm and iliac-iliac bypass. DISCUSSION: The association of kidney and liver cyst disease with venous gastrointestinal and cardiovascular complications is well known. The simultaneous presence of cysts and peripheral and visceral aneurysms with anomalies of the arterial wall resembling Ehlers Danlos syndrome (type IV) would suggest that these two diseases might result from a common connective tissue anomaly. The underlying mechanism(s) remain unknown.

Aneurysm↗
PubMed2000

Cystic peritoneal mesothelioma: report of a case.

Peritoneal mesothelioma is a rare disease, especially when it arises in a cystic form with tardive and often nonspecific symptoms. While diffuse neoplasms have an unfavorable prognosis, cystic forms are usually benign. An accurate diagnosis can only be made only with electron microscopy and immunohistochemical studies. A 92-year-old woman with an ultrastructurally ascertained cystic peritoneal mesothelioma was admitted to the hospital's emergency ward, and was considered to be unusual because of the size of the mass and the patient's age. A review of the literature is made, and the clinical and diagnostic aspects of this disease are also discussed.

Aged↗
PubMed2000

Baroreflex failure syndrome after bilateral excision of carotid body tumors: an underestimated problem.

Carotid body tumors (CBTs) are relatively rare paragangliomas that develop from neural crest cells at the bifurcation of the common carotid artery. They are generally slow growing and benign. Excision is currently considered the treatment of choice, although vascular and especially neural injuries are still relatively frequent in patients with large or bilaterally resected tumors. The baroreflex failure syndrome (BFS) has recently been identified as a severe, rarely recognized, and certainly underestimated complication after the bilateral excision of CBTs. The present report describes a case of a bilateral CBT followed by BFS and reviews the experiences reported in the literature. In light of the low incidence of malignancy of these tumors, their biologic behavior, their very high rate of cranial nerve palsy, and the occurrence of BFS in bilaterally resected paragangliomas, the current practice of bilaterally removing these tumors is questioned.

Baroreflex↗
PubMed2000

[Malignant nodular hidradenoma. A clinical case].

Malignant clear cell hidradenoma is an uncommon tumor of eccrine sweat gland origin. In contrast to the benign form, malignant clear cell hidradenoma tends to invade the surrounding tissue and has a high incidence of distant metastases. For these reasons a wide surgical excision associated to a locoregional lymph node dissection should be performed alter the initial diagnosis. The case of a 17 year old female with this rare lesion is reported; the literature is reviewed and surgical treatment discussed.

Adenoma, Sweat Gland↗
PubMed1999

[Isolated mesenteric fibromatosis. A clinical case].

The authors report a case of isolated mesenteric fibromatosis un associated with familial adenomatous polyposis or Gardner's syndrome or prior abdominal surgery. These neoplasms are usually asymptomatic until when the compression of the small or large bowel or the ureter causes symptoms; although they are benign lesions without metastases, local recurrences are very frequent. Surgical removal is the primary treatment; until now no satisfactory results have been obtained with other therapeutic modalities.

Adult↗
PubMed1999

Obstructive biliary symptomatology as the first sign of HIV-infection.

A 41-year-old white homosexual man presented with epigastric pain and jaundice. Physical examination showed enlargement of bilateral axillar and left inguinal lymph node, while ERCP and a CT scan suggested interruption of bile flow in the intrapancreatic tract of the common bile duct. An endoprosthesis was positioned in the common bile duct during the ERCP. Blood tests (both ELISA and Western blot techniques) showed positivity for anti-HIV antibodies and a CD4 count of 780/mmc (normal: 900-1,200/mmc). A few days later, a dramatic increase of the size of a lymph node in this right axilla occurred, rapidly reaching 5 cm of diameter. A biopsy was performed at this level, and histological examination revealed a high grade B-cell Burkitt type lymphoma. Bone marrow biopsy was negative, as well as lumbar puncture. Aggressive chemotherapy with adriamycin, cyclophosphamide, bleomycine, eldesine and prednisone, together with intratechal administration of methotrexate, was attempted. However, after a marginal and transient regression, the NHL rapidly progressed and the patient eventually died seven months after the diagnosis of NHL. A post mortem examination confirmed the diagnosis of Burkitt lymphoma of the peripancreatic and axillar lymph nodes, with diffusion to the leptomeninges, subaracnoideal spaces and encephalus. No signs of lymphoma were detected in other nodal or extra nodal areas.

Adult↗
PubMed1995

[Hürthle cell tumors: personal experience].

Hürthle cell tumors of the thyroid gland are uncommon lesions (3% of all well differentiated tumors). Histological diagnosis is often difficult: according to recent criteria only those tumors with almost 75% of oxyphil cells are well recognized as Hürthle cell neoplasms. Extracapsular and blood-vessels invasion, capsular penetration, DNA patterns and tumoral necrosis are indicative for malignancy. The Authors report their experience in the management of 46 patients who underwent thyroid surgery for Hürthle cell neoplasms. Histological findings, surgical approach and post-operative follow up are discussed.

Adenoma, Oxyphilic↗
PubMed1995

[Primary lymphoma of the rectum: diagnosis and treatment].

The authors report a rare case of primary rectal lymphoma non Hodgkin in a young non HIV infected man. Preoperative diagnostic problems, the standards for classification and staging and the proper treatment are briefly discussed. The importance of an accurate histological and immunohistochemical study on preoperative multiple biopsies for a correct diagnosis, staging and treatment, are emphasised in this report.

Adult↗
PubMed1995

[Adrenal cysts: therapeutic indications].

Adrenal cysts are relatively rare and usually discovered only if large and associated with clinical manifestations. Asymptomatic cysts are diagnosed with increasing frequency because of their incidental finding on ultrasonography or computed tomography, but surgical treatment is indicated when the cysts are large, symptomatic or rapidly expanding. A case of adrenal cyst is reported. The clinical, pathologic and therapeutic implications of this disease are briefly discussed.

Adrenal Gland Diseases↗
PubMed1994

[Palliative treatments in inoperable pancreatic tumors. Technics compared].

The authors experience of palliative treatment of advanced pancreatic cancer is reported. 32 patients underwent palliative surgical procedures of biliary decompression (20 choledochoduodenostomy and 12 cholecystoenteric bypass). In 26 patients a gastroenteric anastomosis was also performed. 8 patients underwent non surgical procedure because of their very poor conditions or short term survival. The authors point out the advantages offered by surgical treatment. Nevertheless a careful selection of patients submitted to this procedure is recommended.

Aged↗
PubMed1994

[Neurogenic tumors of the brachial plexus].

The Authors report two cases of solitary neurogenic tumors of the brachial plexus not associated with Von Recklinghausen's disease. Peripheral nerve tumors are relatively rare and only 25% occur above the clavicles. The mass, usually asymptomatic, may cause sensory radicular symptoms or rarely motor deficits in the involved arm. Wide radical excision of a benign neurogenic tumor is the treatment of choice; for malignant tumors, associated with a particularly poor prognosis, a more aggressive surgical approach may be necessary. Adjuvant radiation therapy and chemotherapy do not seem to have any effect on survival rates.

Adult↗
PubMed1992

[Drainage in surgery on the thyroid].

The authors report their experience of 534 thyroid operations and underline the importance of neck drainage in this type of surgery. Drainage positioning is very important for the prevention and immediate indication of hemorrhaging complications. Some correct indications, like large goiters, hyperthyroidism, reoperation and the lack of vascular ligature, are considered and discussed.

Adolescent↗
PubMedDate not supplied

Type B1 thymoma in multiple endocrine neoplasia type 1 (MEN-1) syndrome.

AIMS AND BACKGROUND: Multiple endocrine neoplasia (MEN) syndromes include a group of disorders characterized by the neoplastic transformation of two or more endocrine tissues. In type 1 syndrome (MEN-1), pituitary, parathyroid and pancreatic islet tumors are most frequently represented. Thymic neoplasms are also rarely associated, and thymectomy during subtotal or total parathyroidectomy should always be considered. STUDY DESIGN: The authors describe a rare case of a 22-year-old male who presented a type B1 thymoma without myasthenia gravis associated to hyperparathyroidism, corticoadrenal adenoma and three neuroendocrine pancreatic lesions (somatostatinoma, glucagonoma and insulinoma).

Adult↗
PubMedDate not supplied

[Assessment of conventional approaches in adrenalectomy].

The choice of operative approach represents one of the main problems of adrenal gland surgery, nowadays the minimally invasive techniques (laparoscopic adrenalectomy) in selected cases may be an important alternative to conventional approaches. Retrospective analysis was performed on 140 patients with adrenal gland tumors from 1980-1997; there were 95 women and 45 men: The tumors were resected through flank extraperitoneal approach (35 patients), transabdominal (91), thoraco-abdominal (14). Operating time, perioperative blood loss, postoperative course were evaluated. The authors conclude that in functioning and non-functioning adenomas, in pheochromocytoma, smaller than 6 cm., with precise pre-operative unilateral localization, flank extraperitoneal approach may be sufficient, in patients with Cushing disease resistant to pituitary surgery or irradiation, in patients with familiar history or bilateral pheochromocytoma, in patients with suspected malignant disease, a thorough surgical exploration of the abdominal cavity is recommended.

Adolescent↗
PubMedDate not supplied

[Clinical and therapeutic features of MEN II].

Multiple Endocrine Neoplasia type 2 is a genetically transmitted poliendocrinopathy, in which pheochromocytoma (PCC), medullary thyroid carcinoma (MTC) and parathyroid disease may occur and coexist with different rates. Although the clinical behaviour of each component is well known and usually predictable, controversies still exist on the most appropriate therapeutical strategy when patients exhibit synchronous lesions; many elements may influence this choice: the evidence of bilateral (PCC) or multicentric (MTC) lesions, the evaluation of their malignancy, the adoption of therapies other than surgery (alpha receptor blockers in PCC). In this paper the Authors report their experience in diagnosing and treating MEN 2; it is based on 5 patients operated from 1972 to 1993 and on the screening of their relatives for thyroid and/or adrenal lesions. The individual manifestations of the disease, with regard to time and extent of organ involvement, are considerably variable; however, an aggressive approach of MTC, even in presence of a synchronous PCC, as well as a unilateral adrenalectomy (with a close follow up of the patient) when surgical exploration does not show an involvement of the remaining gland, is suggested.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Role of surgery in the treatment of primary gastric lymphoma].

Recently the role of surgery in the LGP treatment is reviewed. 30 cases of LGP are reported; GT was in 9 cases performed, GST in 21 cases. All the patients were included in a therapeutical protocol as chemo and/or radio-therapy as adjuvant treatment. Two patients treated with GT died; the medial survival ranged was 30.5 months for the patients in stadium Ie, 52 months for the patients in stadium IIe and 15 months for the patients in stadium IV. The central role of surgery for treatment of this lesion is underlined; finally the role of adjuvant therapy is emphasized in the improvement of long-term survival.

Adult↗