Pancreatic cancer with liver metastases in a pregnant patient: case report and review of the literature

In this case report, the authors discuss clinical presentation, surgical procedure and early results of chemotherapy of pancreatic carcinoma with liver metastases diagnosed a few days after delivery. Pancreatic adenocarcinoma occurs infrequently in pregnant and childbearing women: only ten cases have been reported in the literature. The early diagnosis of pancreatic cancer is difficult because symptoms appear when cancer is about to reach an advanced stage. In pregnancy, it is even more difficult because symptoms like dyspepsia, vomiting and epigastric pain may result confusing. The authors outline the difficulties in diagnosis and treatment of this kind of disease during pregnancy.

Interstitial radiosurgery with the photon radiosurgery system in the minimally-invasive treatment of selected deep-seated brain tumors

The purpose of this study was to evaluate the results of interstitial radiosurgery (IR) with Photon Radiosurgery System (PRS) in 18 patients (P) with deep-seated brain primary or secondary tumors. Follow-up varied from 2 to 53 months (mean, 13.6 mo). Seven P with glioblastomas died due to tumor progression. Five P with metastases died for systemic disease while local control was achieved in all. Six P with low-grade astrocytomas were well and imaging showed tumor control. We conclude that PRS IR is effective in the treatment of metastases while it provides lower benefit in malignant gliomas. It could play a major role in low-grade astrocytomas.

[Video-laparoscopic splenectomy: experience in 3 cases]

BACKGROUND

In selected cases the spleen can be removed:

METHODS

2 women and 1 men with immune thrombocytopenic purpura, with hypersplenism without splenomegaly, underwent splenectomy by laparoscopic means.

RESULTS

In 2 cases the splenectomy has been performed entirely by laparoscopic means. In 1 case the operation has been converted as we have not been able to control a venous bleeding from injured hilar spleen vessels.

DISCUSSION

No particular technical problems arose in the 2 cases entirely conducted by laparoscopic means. Care must be taken manipulating the hilar vessels as the veins are fragile and their bleeding is difficult to be controlled in laparoscopy. The laparoscopic splenectomy seems to offer less postoperative pain, shorter hospitalization and improved cosmesis according to our previous experience with open splenectomy.

CONCLUSIONS

The good result of the operations encourages the laparoscopic approach to splenectomy, in selected cases.

Somatostatin reduces 3H-thymidine incorporation and c-myc, but not thyroglobulin ribonucleic acid levels in human thyroid follicular cells in vitro

The action of somatostatin (SRIH) on 3H-thymidine (thy) incorporation and on c-myc and thyroglobulin RNA levels in a suspension of follicles from normal and goitrous human thyroid was examined. SRIH, at 10(-7) M concentration, inhibited basal thy incorporation (maximally by 4 h lasting for up 24 h), which effect was greater in goiter than in normal thyroid and was also detected in growing adherent epithelial cells. Moreover, in a follicle suspension SRIH prevented TSH-stimulated thy incorporation, both in normal and in goitrous thyroid. Basal expression of c-myc RNA was not affected by SRIH in either tissue, whereas the TSH-stimulated c-myc RNA level was significantly reduced in goiter. No effect of SRIH was observed on basal or TSH-stimulated thyroglobulin RNA levels. SRIH did not alter basal cAMP concentrations in normal or goitrous follicles, but it significantly reduced TSH-stimulated cAMP accumulation both in normal thyroid and in goiter. Overall, our data indicate a direct inhibitory action of SRIH on growth, but not on differentiation, of human thyroid, probably by a mechanism not entirely cAMP dependent.

Immunoscintigraphic localization in a benign thyroid neoplasm of a monoclonal antibody directed against melanoma

In a prospective study for evaluation of the use of a monoclonal antibody directed against melanoma in the staging of patients affected by malignant melanoma, we report monoclonal antibody uptake in a follicular thyroid adenoma. Computed tomography, ultrasonography, and pertechnetate scintigraphy did not provide a certain diagnosis. Only pathologic examination of the surgical specimen was conclusive.

[Effects of somatostatin on human thyroid folliculi in vitro]

Somatostatin (SRIF) inhibits calcitonin and T3-T4 secretion in thyroid. We have investigated the in vitro effect of SRIF on the basal and TSH induced [3H]thy incorporation, thyroglobulin (tgb) RNA and cAMP level in follicular cells, isolated from normal and adenomatous human thyroids. [3H]thy uptake has been evaluated as TCA-precipitable material in 2, 4, 8, 24 h incubated follicles and 24 h incubated adherent cells. Tgb RNA has been quantified with cytoplasmic dot blot hybridization and cAMP level with RIA method. SRIF reduces basal and TSH-induced [3H]thy in both suspension follicles and epithelial adherent cells. However it does not modify tgb RNA nor cAMP levels in incubated follicles. These data suggest a direct antiproliferative effect of SRIF on human thyroid.