Andrea Toso

CLINICAL AND MOLECULAR FEATURES OF MUCOSA-ASSOCIATED LYMPHOID TISSUE (MALT) LYMPHOMAS OF SALIVARY GLANDS

To analyze clinical features and to discuss the modality of investigation and treatment of a series of mucosa‐associated lymphoid tissue (MALT) lymphomas. To investigate the prevalence of aberrant promoter methylation, responsible for gene inactivation, in a selected panel of genes potentially involved in the pathogenesis of B‐cell malignancies as O6‐methylguanine‐DNA methyltransferase (MGMT), p73, death‐associated protein kinase (DAP‐k).

Factores pronósticos de hipoparatiroidismo definitivo tras tiroidectomía total

Introduccion y objetivo La hipocalcemia tras tiroidectomia total constituye la mayor complicacion, en la mayoria de los casos, transitoria, en relacion con un dano funcional de las paratiroides u otros factores reversibles. Se trata de un estudio sobre 67 pacientes sometidos a tiroidectomia total para identificar posibles factores clinicos, anatomopatologicos y quirurgicos predictivos de hipocalcemia definitiva tras tiroidectomia total. Metodos Recogida de valores plasmaticos de calcio en el periodo postoperatorio y factores como edad, sexo, funcionalidad tiroidea, diagnostico anatomopatologico definitivo, extirpacion accidental de las paratiroides y su autotrasplante, reintervencion para identificar factores de riesgo para el desarrollo de hipoparatiroidismo definitivo. Las comparaciones han sido efectuadas entre los pacientes con hipocalcemia y concentraciones normales de calcemia postoperatoria. Resultados La hipocalcemia aguda transitoria ha sido identificada en 25/67 pacientes (43,3 %). El hipoparatiroidismo definitivo ha sido identificado en 8 (11 %) pacientes. Conclusiones En nuestro estudio ha supuesto que una calcemia despues de 24 h de la intervencion quirurgica inferior a 7,5 mg/dl sea un factor altamente pronostico de hipoparatiroidismo definitivo; esta determinacion es un parametro fiable, economico, rapido y muy predictivo del desarrollo de hipoparatiroidismo definitivo. No se han encontrado asociaciones estadisticamente significativas con otros factores, como funcionalidad tiroidea, histologia, extirpacion accidental o autotrasplante de las paratiroides, asi que podemos afirmar que una atenta manipulacion de las paratiroides conservando cuidadosamente la vascularizacion glandular representa un factor de fundamental importancia para garantizar una normal funcionalidad paratiroidea postoperatoria.

Percutaneous Sclerotherapy With OK-432 of a Cervicomediastinal Lymphangioma.

The present study reports a case of percutaneous sclerotherapy of a giant cystic cervicomediastinal lymphangioma using OK-432. To the best of our knowledge, percutaneous sclerotherapy of a mediastinal lymphangioma using OK 432 has not previously been reported in the English literature.

Delayed carotid pseudoaneurysm: a life-threatening complication after endoscopic sinus surgery.

Abstract Internal carotid artery pseudoaneurysm is a rare but potentially lethal complication of sinus surgery. We present 2 cases of delayed carotid pseudoaneurysm development after internal carotid laceration during functional sinus surgery for chronic sinusitis to emphasize the need to follow up the patients with profuse bleeding perioperatively and to identify when to suspect iatrogenic vascular malformations.

Extramedullary Plasmacytoma of the Larynx Treated by a Surgical Endoscopic Approach and Radiotherapy

Extramedullary plasmacytoma (EMP) is a rare variant of plasma cell myeloma that affects soft tissues. The head and neck region are the most affected sites, although others have also been described. Herein we report an uncommon case of EMP of the larynx in a 65-year-old male who presented with a history of progressive dysphonia and hoarseness. Laryngeal fiberscopy evidenced a reddish pedicled voluminous mass in the left false cords and ventricle. Microscopic suspension laryngoscopy was performed under general anaesthesia and a 4 W Acublade CO2 Laser was used for transoral resection of the lesion. This was followed by adjuvant radiotherapy, with the widely recommended doses on the supraglottic region, to achieve better local control. Diagnosis of EMP is based on immunohistochemistry and the exclusion of systemic plasma cell proliferative disorders. Diagnosis of solitary EMP can be made only if studies for disseminated disease and X-ray and/or magnetic resonance imaging of the spine, pelvis, femurs, and humerus and bone marrow biopsy are negative. As there are no internationally established guidelines, treatment of EMP is mainly based on consensus of expert opinion.

Persisting subcutaneous emphysema of eyelids mimicking orbital tumor.

Abstract Eyelids emphysema is a rare condition due to air trapping in subcutaneous tissue of the orbit. It has been clinically and radiologically documented, but histologic evaluation has not been noted. We report a case of a middle-aged woman with periorbital swelling due to self-induced Valsalva maneuver, persisting after decompressive therapy. A fine-needle biopsy was performed and showed a mixed population of osteoclastic-like giant cells and mononuclear epithelioid cells, which were suspected of pathological proliferative disease. Specimens from blepharoplasty indicated pseudocystic empty spaces surrounded by epithelioid cells and giant cell granulomas. Immunohistochemical stains favored diagnosis of benign granulomatous disease, such as subcutis cystic pneumatosis. Histologic examination represented an important tool for differential diagnosis with soft tissue neoplasms of the orbit in subcutis emphysema with unusual clinical presentation and abnormal course.