Molecular targets and oxidative stress biomarkers in hepatocellular carcinoma: an overview

Hepatocellular carcinoma (HCC) is a complex and heterogeneous tumor with multiple genetic aberrations. Several molecular pathways involved in the regulation of proliferation and cell death are implicated in the hepatocarcinogenesis. The major etiological factors for HCC are both hepatitis B virus (HBV) and hepatitis C virus infection (HCV)

Microcarcinoma tiroideo: nostra esperienza

I tumori differenziati della tiroide hanno ottima prognosi; sempre più frequente è la diagnosi di neoplasie differenziate sottocentimetriche (microcarcinomi). L?evoluzione clinica di questi ultimi può essere sostanzialmente diversa, dal solo reperto autoptico all? interessamento linfonodale locoregionale, alla metastatizzazione a distanza. Numerosi fattori prognostici , sia clinici che genetici, sono stati considerati al fine di predire la maggiore o minore aggressività di queste neoplasie. Nella nostra casistica dal 2001 al 2004 abbiamo sottoposto ad intervento chirurgico 74 pazienti con diagnosi di microcarcinoma (MCT). Si è quindi proceduto alla valutazione dei principali fattori di rischio e delle procedure chirurgiche adottate. La multifocalità e le dimensioni sembrano essere gli elementi maggiormente indicativi di maggiore aggressività. Il nostro atteggiamento terapeutico è quello di eseguire sempre la tiroidectomia totale anche nelle patologie benigne e la tiroidectomia totale con linfectomia del comparto centrale in caso di diagnosi pre-operatoria di MCT. English version Differentiated thyroid cancer had an excellent prognosis; the diagnosis of sub-centimetric differentiated cancer (microcarcinoma) is more and more frequently. Clinical evolution of microcarcinoma could be various: microcarcinoma can represent an autoptic finding or can evolve with locoregional lymph node involvement or metastasis. Various clinical and genetic factors have been considered to predict the aggressiveness of this neoplasm. From 2001 to 2004, 74 patients with diagnosis of thyroid microcarcinoma underwent surgical treatment. By a retrospective survey we evaluated risk factors and the choice of surgical treatment. The aggressiveness appear to be related mainly to multifocality and size. Our therapeutic strategy is to perform total thyroidectomy for benign pathologies, total thyroidectomy with lymphadenectomy in cases with preoperative diagnosis of microcarcinoma

Breast surgery and sentinel node biopsy. Our experience

Massive campaigns of screening of breast pathologies improved early diagnosis of breast cancers. Most of these cancers are small- sized (T1) and seldom show intraoperative nodal involvement. Sentinel node biopsy is the elective choice in the abovementioned cases because, if negative, it avoids axillary dissection. International literature reports rates of false negative sentinel node biopsy ranging among 4,5 and 12%; results in our experience account for almost 6%. As a consequence, there is the definite risk of potentially positive axillas that will not be dissected with subsequent risk of axillary recurrence within 24 months. The reason of that could be related to the fact that in Referral Centers this technique is performed in strictly selectioned patients, so as to gain a diagnostic accuracy of 98%. The rate of axillary recurrences does not justify the routinary axillary dissection, since this is just a staging, not a therapeutic procedure. In case of doubt, it can be recommended a close and careful follow-up of the axilla

Il cancro della mammella maschile. La nostra esperienza di 5 anni e confronto con la letteratura internazionale

Il cancro della mammella nell’uomo è una malattia rara, ne consegue una scarsa conoscenza circa l’eziologia, la clinica ed il trattamento. Questa neoplasia non mostra differenze di sopravvivenza rispetto all’analoga femminile, tuttavia, a causa delle ridotte dimensioni della ghiandola mammaria maschile, è caratterizzata da una più rapida diffusione locale, con conseguente diagnosi tardiva e bassi tassi di sopravvivenza. Gli Autori presentano la propria esperienza di 5 anni e attraverso la revisione della letteratura internazionale cercano di precisare lo stato attuale delle conoscenze circa prognosi, terapia e sopravvivenz

Surgical treatment with Ligasure® Precise of schwannoma of brachial plexus: case report

We present a case of bulky schwannoma arising from the brachial plexus treated by a new surgical device. A 38-year-old man presented with a slow-growing left-sided supraclavicular mass and complained paresthesia of the third and forth fingers of the hand and forearm weakness. Physical examination revealed Tinel’s sign. A CT-scan revealed a solid mass situated in the left profound supraclavicular fossa. The tumour was resected with the utilization of bipolar vessel sealing system (Ligasure® Precise). This device is very useful in suturless removal of masses localized in deep supraclavicular fossa. During the operation, care was taken to preserve the nerve functio

Laserterapia interstiziale nell’epatocarcinoma su cirrosi: nostra esperienza

Interstitial lasertherapy (ILT) is one of the percutaneous thermal procedures allowing the ablation of primary or secondary hepatic lesions. This technique can be performed without general anaesthesia, since the patient is completely painless, in spite of the high temperatures reached, because there are no sensitive fibers around the lesion. This study includes patients with small hepatocarcinomas (< 2 cm) non peripherically sited, far from the gallbladder and the hepatic hilum. Twenty patients suffering from 24 cirrhotic hepatocarcinomas (two patients showed two nodules) have been enrolled for the present study. Mean diameter of lesions was 1,8 cm (1,3- 2 cm). One or more 21 G (length 20 cm) Chiba's needles were inserted under sonographic view into the lesions. The laser energy was switched on at 4 Watts for 4-6 minutes, until an amount of energy of 900-1800 Joule was reached. All the patients were discharged 48 hours after the procedure. Triphasic CT-scan with contrast were performed 7 to 14 days after ILT, in order to check its efficacy. CT-scan showed complete necrosis in all the nodules ranging from 1,5 to 3 cm. All the patients received only one ILT session, whose longest duration was 20 minutes. No major complications occurred. ILT of small hepatocarcinomas is a safe, efficient procedure, also feasible without anaesthesia. Differently from percutaneous radiofrequency, in fact, it shows the advantage of less pain, that can avoid the need for general anaesthesia