Mesenterite retrattile: presentazione di un caso

Gli Autori riportano un caso di mesenterite retrattile, processo infiammatorio cronico del meso evolvente verso la fibrosi. La mesenterite è una patologia istologicamente benigna che tuttora si associa, in una certa percentuale di casi, a neoplasie prevalentemente dell’apparato urogenitale. Le manifestazioni cliniche sono caratterizzate dalla comparsa di masse addominali e di crisi subocclusive intestinali che possono esitare in occlusioni franche. La diagnostica per immagini è aspecifica e spesso la diagnosi è possibile solo con la biopsia del meso. Il trattamento nei casi non complicati da occlusione è basato sull’uso di farmaci steroide

Colangiocarcinoma associato a malattia di Caroli monolobare sinistra

Caroli’s disease is a cystic expansion of hepatic biliary duct ,frequently shown with not specific pain symptomatology to the right abdominal quadrant, icterus and recurrent cholangitis, these ones hardly controllable with antibiotics therapy only. Cholangio-RM is the most appropriate investigational methodical to diagnose the disease and to show the continuity of cystic expansion with biliary three. Authors report a cases of Caroli’s associated to cholangiocarcinoma. When the disease is banished to one hepatic lobe only, the surgery resection is the most indicated election’s therapy to solve an eventual intrahepatic biliary lithiasis, potentials cholangitis, and the possible neoplastic risk. In the event of spreaded disease, the treatment includes endoscopic treatment, pharmacologic therapy and, at last, hepatic transplant

Chemio-radioterapia neoadiuvante nel carcinoma del retto. Studio clinico a lungo termine in un singolo centro

The standard therapy for patients with clinically resectable rectal cancer is generally surgery. Tumor regression can be obtained by preoperative radio-chemotherapy that allows radical tumor resection with an increase in sphincter-saving procedures. The aim of this study was to evaluate the safety and efficacy of preoperative combined radiotherapy (RT) and chemotherapy (CT) in patients with T2 and T3 rectal cancer. Between September 1999 and December 2008, 58 patients with palpable rectal adenocarcinoma received preoperative radiotherapy by the 3-field technique to a total of 50.5 Gy (5 x 1.8 Gy/die for a total of 28 sessions) and chemotherapy with 5-fluorouracil by continuous intravenous infusion. Surgery, 19 resections according to Miles (32%) and 39 anterior resections (67%) with total mesorectal excision, was performed 6 weeks later. Alive and free disease 33 (57%), Alive with metastases 3 (5%) deceased 15 (26%) Loose 7 (12%). The histopathological examination showed total tumor regression in 12 patients (20%). Local response to preoperative RT/CT was highly satisfactory, allowing anal sphincter preservation with a low local recurrence rate. Optimization of the combined therapy could yield even more optimal results.