Contributo Critico e Casistico Alla Conoscenza Dei Tumori Del Sistema Nervoso Simpatico

Considerazioni Sui Tumori Glomici Con Particolare Riguardo Alla Localizzazione Gastrica

The glomic tumours of the stomach are exceedingly unfrequent, occur in the middle age, have a slow or very slow evolution and are small in size. Histologically, they must be distinguished from the more frequent haemangiopericytomas. Clinically, they are characterized by gastralgiae of ulcerous and haemorrhagic type. A personal case, which adds to the 7 ones referred to in the literature, is exposed. It concerns a woman aged 45, who has been suffering for 4 months from anorexia, vomit and postprandial pain. She was operated upon 2 years ago, and at present she is well.

CONSIDERAZIONI MORFOLOGICHE ED ISTOGENETICHE SUI TUMORI GLOMICI IN BASE AD OTTO OSSERVAZIONI PERSONALI

8 cases of glomic tumors (4 of epithelioid type, 4 of angiomatous type according to Masson) are described.

The glomic tumor may arise in any vascular region, owing to the ubiquity of the epithelioid cells which are the originating elements.

The following classification is proposed for the tumors which originate in the vessel-ruling tissues:

1) pheocromocytoma (from the adrenal chromaffin tissue);

2) paraganglioma (from carotid gland and aortic body and from jugular and coccygeal glomera);

3) glomic tumor (from the glomerular arterio-venous anastomoses);

4) pericytoma (from the pericytes).

The two last forms are histologically rather similar. The intermediate forms are also frequent.

A Clinical and Morphological Study of 256 cases of Tumors of the Peripheral Nervous System

Two hundred and fifty three tumors of the peripheral nervous system (112 in males and 141 in females) were studied both from clinical and histological point of view; in addition, there were 3 patients with typical v. Recklinghausen disease, in which no histological examination was performed. The study included 217 benign tumors (208 spinal and 9 sympathetic), and 36 malignant tumors (29 malignant neurilemmomas and 7 sympathoblastomas). There were 179 superficial tumors (164 benign and 15 malignant), and 74 deeply localized tumors (53 benign and 21 malignant). The unifocal tumors were 238 (206 benign and 102 malignant), while multiple tumors were present in 15 cases. At the first hospitalization, the average age was 41.0 years for the spinal tumors and 25.3 years for the sympathetic tumors. Generally, patients affected with benign spinal tumors were slightly younger than those with malignant neurilemmomas. On the contrary, the average age of patients with benign sympathetic tumors was much higher than that of patients with sympathoblastomas. The time elapsed from the beginning of the symptoms at the first hospitalization was studied in 170 cases: in 93 cases it was of 1–2 years, in 77 ranged from 3 to over 5 years, while in 12 cases symptoms were already present at birth. Among the neurilemmomas, there was one undoubted case of malignant transformation from a preexisting benign tumor, while in 4 other cases this transformation was probable. Pain was observed in 47 cases, 34 of benign tumors and 13 of malignant tumors. In the benign tumors, the therapy consisted of surgery alone, while in the malignant tumors association of surgery with radiotherapy and chemotherapy was often used. There were 7 recurrences, i.e. 2 neurilemmomas and 5 neurofibromas, among 155 cases of benign tumors in which the follow-up was satisfactory. Six of these cases were reoperated without further recurrence.

I SIMPATOBLASTOMI

The histo-anatomical and clinicoradiological characteristics of sympatoblastomas are shortly reviewed and some particular possibilities of evolution are pointed out.

Two own cases illustrating peculiar clinical aspects and evolution of the diseasse are presented.