The role of laparoscopy and intraoperative ultrasound in the diagnosis and staging of lymphomas

aparoscopic surgery plays today an important role in the diagnosis and staging of abdominal lymphomas; in fact it provides adequate lymph node sampling for histological typing and immunophenotyping. The mini-invasive procedure is safe and effective. Intra-operative ultrasound permits to study the parenchimal organs in addition to intra-abdominal lymph node and/or masses.

What kind of surgery for cervical carcinoma?

The incidence and mortality of cervical cancer have changed over the past 50 years in developed countries, but this kind of tumor still remains a significant clinical problem because it is the second most common cause of morbidity and mortality from cancer among women. After histological confirmation of invasive cervical cancer, the extent of disease was determined using clinical criteria to assign a stage. This assessment is important because, while for the other gynecologic cancers clinical information obtained by surgery and histopathological examination is implemented and concurs to define the staging of the disease, the cervical cancer tumor stage is given after the primary diagnosis. In this review we discuss how the surgical approach to cervical cancer has been evolved, in order to modulate the radicality of the intervention itself and thus to preserve the pelvic innervation. This step has been achieved by deepening knowledge of functional pelvic anatomy and modulating the radicality of hysterectomy according to well defined surgical landmarks.

Surgical treatment of thymoma. Personal experience

Introduction. Thymomas (THs) are rare epithelial tumors of the thymus gland. In this study we report our personal experience in the management and surgical treatment of THs. Case reports. We report two clinical cases treated with combined therapy (surgery followed by adjuvant therapy). Results. Total transternal thymectomy was performed in both patients. The post-operative course was uneventful. The patients received adjuvant radiotherapy and chemotherapy. No relapse has been observed during follow-up. Discussion. THs are usually slowly growing tumors with similar incidence in both sexes. They occur through a wide age range, with a peak in the fifth and sixth decades. Distinctive features reminiscent of the normal thymus make the pathologic diagnosis of THs easy in most cases. Malignant behaviour is indicated by microscopic or macroscopic invasion of the tumor capsule or surrounding organs or by the presence of metastases. Although there is no standardized staging system for thymoma, the one proposed by Masaoka is commonly employed. Total thymectomy is the procedure of choice, even for encapsulated tumors, with carefully exploration of the mediastinum for evidence of ectopic thymic tissue or local invasion. Conclusions. Despite an indolent course and a cytologically bland appearance, all thymic tumors can manifest a malignant behavior. Surgery continues to be the mainstay of treatment, and the ability to achieve complete resection seems to be the most important prognostic factor. Multimodality treatment involving postoperative chemotherapy and radiotherapy appears to increase the rate of complete resection and improves survival in advanced THs.

Synchronous primary malignant tumors of the breast, caecum and sigma. Case report

We present the case of a patient with a double adenocarcinoma of the right colon and sigma associated with a bilateral infiltrating ductal breast carcinoma. Sigma and caecum bowel cancers were diagnosed at colonoscopy, with computerized tomography staging, while breast cancer was found with screening mammography. Following right hemicolectomy , sigmoidectomy and bilateral mastectomy the histology confirmed the presence of colonic adenocarcinoma and infiltrating and in situ lobular cancer. This case report reviews the treatment of synchronous neoplasia.

Serial killer: il database mondiale

Lo studio dei serial killer, quanto mai complesso e poliedrico, è reso difficoltoso, in parte, anche dall’attuale progresso, che ha portato questi soggetti devianti ad evolversi notevolmente sia in termini di astuzia (staging) che di mobilità. Tutto ciò dimostra che negli omicidi seriali, nonostante l'importante lavoro da parte di alcuni studiosi che sono riusciti a proporre contributi teorici di notevole importanza, è particolarmente frequente la c.d. “cecità di collegamento” fra omicidi perpetrati dalla medesima persona, ma in parti diverse nel mondo. È, quindi, indispensabile la costruzione di una banca dati mondiale che consenta a tutte le forze di polizia di avere sempre a disposizione informazioni raccolte sulla scena del crimine relativamente ad omicidi particolarmente aberranti e privi di un particolare movente. Sarà quindi compito del profiler, con strumenti di supporto creati ad hoc e tecnologicamente avanzati, reperire sulla scena del crimine queste informazioni attraverso una metodologia chiara e condivisa, che saranno, grazie alla banca dati, messe a disposizione di tutte le forze di polizia. The complex and multisided study of serial killers is partly made difficult by the current level of progress that has led these deviant people to evolve in relation to the aspects of shrewdness (concerning the staging) and mobility. Despite the important work of some scholars who proposed important theories, all this shows that, concerning serial murders, it is still particularly frequent not to pay attention to links among homicides committed by the same person but in different parts of the world. It is therefore crucial to develop a worldwide database that allows all police forces to access information collected on crime scenes of murders which are particularly absurd and committed without any apparent reason. It will then be up to the profiler, through ad hoc and technologically advanced tools, to collect this information on the crime scene that would be made available to all police forces thanks to the worldwide database.