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C Iacono

Publications and source records attributed to C Iacono.

At least 55 records · Page 3Linked to original sources
PubMed1991

Cystic tumors of the pancreas: evaluation by ultrasonography and computed tomography.

The personal series of 30 cystic tumors of the pancreas [12 serous cystic tumors (SCT) and 18 mucinous cystic tumors (MCT)] is presented. All neoplasms were evaluated with ultrasonography (US) 28 of 30 with computed tomography (CT); the tumoral histotype could be correctly defined in 73% of cases (seven of 12 SCT and 15 of 18 MCT). Percutaneous fine-needle aspiration (FNA) with diagnostic aims (preparation of cytological smears and/or biochemical assays) was performed in only 10 of 30 cases, yielding a 100% sensitivity; on the whole, the combined use of imaging modalities and FNA allowed correct characterization of the cystic tumors in 27 of 30 cases (90%). The usefulness of a precise diagnostic workup of these neoplasms is emphasized, due to their prognostic and therapeutic outcome.

Biopsy, Needle↗
PubMed1990

The contribution of ultrasonography and computed tomography in the diagnosis of nonfunctioning islet cell tumors of the pancreas.

The personal series of 12 nonfunctioning islet cell tumors (NFIT) of the pancreas is reported. The ultrasound and computed tomography features of NFIT are analyzed, and a few signs are identified that may be useful in the differential diagnosis vs ductal carcinoma. The necessity to complete the diagnostic work up by means of fine needle aspiration biopsy and cytologic smears is also emphasized.

Adenoma, Islet Cell↗
PubMed1990

Small-cell neuroendocrine carcinoma of the ampullary region. A clinicopathologic, immunohistochemical, and ultrastructural study of three cases.

We report the clinicopathologic, immunohistochemical, and ultrastructural features of three small-cell neuroendocrine carcinomas of the ampullary region of the duodenum. All patients were men; their ages were 51, 62, and 66 years. The therapy consisted of pancreatoduodenectomy. All patients died of the disease; median survival was 10 months from the diagnosis. The histological appearance was identical to pulmonary and extrapulmonary small-cell carcinoma. The neuroendocrine differentiation was demonstrated ultrastructurally by the presence of dense-core granules, and by the positive immunoreaction for neuron-specific enolase and Leu-7 in each case. One case expressed a focal positivity for chromogranin A (PHE-5) and argyrophilic granules. The same case showed the presence of neurofilaments on frozen material. Neurofilament proteins could not be demonstrated in any case in paraffin sections. Neoplastic cells exhibited cytoplasmic immunostaining for cytokeratins (CAM 5.2) in all cases. In one case, a large number of neoplastic cells (60-70%) exhibited nuclear Ki-67 positivity. We postulate that the disease's histogenesis was from epithelial stem cell expressing both epithelial and neuroendocrine characteristics. The clinical behavior of small-cell neuroendocrine carcinomas of the ampullary region appears to be extremely aggressive, with early metastases and fatal outcome.

Adenocarcinoma↗
PubMed1990

Mediastinal chondrosarcoma. Case report.

A 34-year-old man and a 71-year-old woman underwent radical removal of mediastinally sited chondrosarcoma, presumably originating in the periosteum of the vertebral body. The man (with mesenchymal chondrosarcoma) died of remote metastasis 6 years postoperatively. The woman (poorly differentiated chondrosarcoma, grade 2-3) is still alive 2 years after the operation.

Adult↗
PubMed1990

[Diagnostic imaging of pancreatic metastasis].

The authors present their personal series of pancreatic metastases (8 cases) which were evaluated with different imaging modalities--i.e., sonography, computed tomography, and angiography. Possibilities and limitations of non-invasive modalities are pointed out, and the usefulness of angiography is emphasized for the identification of small hypervascular lesions. The fairly rare diagnosis of these tumoral lesions is due to 3 causes: low incidence of pancreatic metastases; their frequently small size which justifies eventual false negatives; the frequent lack of symptoms calling for imaging modalities. Moreover, pancreatic metastases are usually diagnosed in an advanced stage. Thus, the therapeutic approach must be planned in every single case, in relation to the perspectives of survival and to the residual quality of life.

Adult↗
PubMed1989

Surgical strategy in primary retroperitoneal tumours.

Sixty-nine patients with primary retroperitoneal tumours (17 benign, 52 malignant including 4 malignant tumours of uncertain origin) were reviewed to determine the best form of surgical strategy. Total resection was performed in 88 per cent of benign cases and in 65 per cent of malignant cases. In 62 per cent of the total resections for malignant tumours, en bloc excision included adjacent organs or anatomical structures. Operative mortality rate (in terms of the total number of operations performed) was 5 per cent. Postoperative complications occurred in 14 per cent and recurrences in 35 per cent. The overall 5-year survival rate was 67 per cent in patients with totally resected tumours and zero in patients whose tumours were treated by partial resection or biopsy. An aggressive surgical approach aimed at total excision of the tumour is the best form of therapy currently available. In the totally resected retroperitoneal tumour, the use of adjuvant radiotherapy and/or chemotherapy depends on the grade of the malignancy and clearance as assessed histologically. Careful follow-up based on the use of computerized axial tomography and ultrasound allows early identification of recurrence at a stage when the recurrence is amenable to total resection.

Adolescent↗
PubMed1989

Thoracic complications of pancreatitis.

Pancreatitis may be associated with thoracic complications, notably chronic massive pleural effusion (CMPE) and, rarely, pseudocysts with mediastinal extension (PME) and enzymatic mediastinitis (EM). Our personal experience with 14 cases of thoracic complications (nine CMPE, two PME associated with pleural effusion, and three EM of 670 patients who underwent surgery; of these, 191 had acute and 479 had chronic pancreatitis) during 16 years (1970-1986) is reported. In the patients with CMPE, the initial symptoms were progressive dyspnea eventually associated with cough and chest pain. In the PME cases, there was dysphagia associated with left subscapular pain and left chest pain. The initial signs in the patients with EM were sudden dyspnea, cyanosis, retrosternal pain, tachycardia, and acute heart failure. A fistula between the pancreatic ductal system and the pleural cavity in seven of the nine patients with CMPE was demonstrated by intraoperative pancreatography and/or cystography. On the contrary, preoperative endoscopic pancreatography demonstrated the sinus tract in only three of the seven. In both cases of PME, computed tomography (CT) provided a correct diagnosis that was confirmed at surgery. In the patients with EM, the diagnosis was suggested by the clinical appearance and was confirmed by the chest roentgenogram and by CT. All patients had operations after varying periods of unsuccessful 2-4-week-long conservative treatment. One patient with infected ascites died postoperatively. There were no thoracic recurrences of pancreatic disease among the other patients at a 10-month-10-year follow-up observation after surgery.

Acute Disease↗
PubMed1988

[Spontaneous rupture of the esophagus (presentation of a case)].

The authors describe the case of a 67-year-old patient with spontaneous rupture of the middle third of the oesophagus, occurring apparently without any involvement of intraluminal hypertension. The surgical treatment consisted in the execution of an aspiration drainage of the left pleural cavity, followed by a right thoracotomy with exploration of the mediastinum. A gastrostomy according to Witzel was also performed. Total parenteral nutrition was instituted in the post-operative period. Healing of the oesophageal lesion was confirmed radiologically 2 months after admission to our department.

Aged↗
PubMed1988

Bronchopulmonary carcinoids: report of nine surgically treated cases.

Nine cases of bronchial carcinoids treated by surgery are reported. Six of them were females and three males. Their ages ranged from 37 to 68 years (median 52.8 years). Lobectomy was carried out in four instances (bilobectomy in one) and pneumonectomy in three. Based on preoperative histology two conservative operations were performed: one patient underwent segmental resection of the right upper lobe for a peripheral carcinoid and the other sleeve resection of the bronchus. The operations were complicated only in one case in which a broncho-pleural fistula appeared postoperatively and was successfully treated by thorachoplasty. There was no postoperative death. The only patient with an atypical carcinoid died one year after pneumonectomy. The other eight patients, with typical carcinoids are alive and without recurrent disease at 6 months to 8 years from surgery. Lymph node and parenchymal infiltration, observed in 3 patients, were not fatal. It is concluded that carcinoids should now be considered malignancies; typical carcinoids carry a more favorable prognosis than atypical ones and can be managed by conservative operations without affecting the survival rate. The spreading of the tumor to lymph nodes and surrounding tissues was not associated with an increased mortality in the reported cases.

Adult↗
PubMed1987

[Esophagogastroplasty in the treatment of squamous carcinoma of the esophagus (our experience)].

The authors report on their experience with 42 cases of squamous carcinoma of the oesophagus subjected to oesophagectomy and oesophagogastroplasty. The patients' mean age was 55.2 years (range: 41-70) with a 13:1 male/female ratio. A positive history of cigarette smoking and of alcohol consumption was found in 87% and 80% of patients respectively. The sites of the neoplasms were as follows: 24 in the mid 3rd of the oesophagus, 9 in the lower 3rd, 6 in the upper 3rd of the thoracic oesophagus and 3 in the cervical oesophagus. In 39 patients the operation was performed in two stages according to Lewis and in 2 cases it was performed in 3 stages according to McKeown, while one patient was treated with a pull-through operation according to Akiyima. Six patients died during the first 30 days postoperatively as a result of circulatory complications or ARDS. Fistulization of the anastomosis as observed in 5 cases, though this was clinically manifest only in two. Mean survival was 5.9 months, 18.6 months and 10.5 months according to the period considered.

Adult↗
PubMed1986

[Nd-YAG laser disobstruction of esophageal endoprostheses occluded by neoplastic development in the palliative treatment of esophageal cancer].

Since August 1984 18 patients suffering from inoperable esophageal cancer have been treated by Nd. Yag Laser therapy under endoscopic control in the Verona University Institute of Clinical Surgery. Three patients, all males ranging in age from 68 to 80 years, had endo-esophageal prostheses which were occluded as a result of the neoplasms. Occlusion of the prostheses had been ascertained by both x-rays and endoscopy. The symptoms consisted of severe dysphagia of solid foods in 2 cases and of solids and liquids in 1 case. The original sites of the tumors were the lower 3rd in two cases and the mid 3rd in 1 case. Histologically, the tumors were identified as 2 squamous-cell carcinomas and 1 adenocarcinoma. Laser treatment was given on average once every 7 days. Patients were admitted to the day hospital, thus avoiding negative repercussions in terms of quality of life or length of hospital stay. In 2 cases there was an improvement in symptoms with the possibility of semi-solid nutrition after a single treatment with 6000-5032 Joules. In the third case, to obtain the same result, 2 treatments were necessary at an interval of 7 days with a total of 9396 J. One patient died of cardiorespiratory failure 24 days after the first treatment. A second patient was treated a further 3 times with a total of 12356 J and is now on a liquid and solid diet 5 months after the first treatment. The third patient was treated 4 times with a total of 15769 J; this patient was on a liquid and solid diet, but died of cardiorespiratory failure 3 months after the first treatment. In the light of our experience, Nd. Yag Laser disocclusion of endo-esophageal prostheses occluded by neoplasms presented no complications and was an appropriate indication in these cases with satisfactory long-term results.

Adenocarcinoma↗
PubMed1986

[Indications and results of surgery in native valve infectious endocarditis. Apropos of 104 surgically-treated cases].

From 1972 to 1984, 104 cases of aortic valve infectious endocarditis were treated surgically. The average age of the patients was 40 years and the majority were men (69/104). Forty patients had no previous cardiac disease; 44 patients had documented valvular heart disease, which was unlikely in the remaining 20 patients. There were 16 mitral valve, 55 aortic valve, 1 tricuspid, 30 mitro-aortic, 1 mitro-tricuspid and 1 mitro-aorto-tricuspid valve infections. Aerococcus viridans was isolated in only 4 out of 71 positive cultures: the prevalence of the infecting organisms was otherwise normal (30 staphylococcus, 30 streptococcus, 7 rare organisms). Forty one patients were operated because of haemodynamic deterioration, 13 for resistant infection and 13 for an association of both indications; 37 patients were operated for embolism or threatening vegetations. Eight patients were in functional Class I, 26 in Class II, 52 in Class III and 17 in Class IV. The patients were divided into 4 groups according to the degree of surgical emergency (26 extremely urgent, 26 semi urgent, 32 controlled endocarditis and 20 chronic endocarditis). The actuarial survival rate was 70% at 5 years. Poor prognostic factors were the presence of previous valve disease, the isolation of a staphylococcus and an aortic valve localisation. The degree of emergency and the precise surgical indication did not seem to be important. Most patients at long term were in functional Classes I or II. There was no preferential indication for bioprosthetic or mechanical valve replacement in endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Tricuspid endocarditis with right-left shunt in the atrium].

A case of tricuspid regurgitation due to endocarditis causing a right-to-left shunt through a patent foramen ovale is reported. Tricuspid valve endocarditis occurred after septic abortion and caused valvular regurgitation with dyspnea and cyanosis. The diagnosis was made by echocardiography and the finding of peripheral arterial desaturation, and it was confirmed at surgery. The physiopathology of these right-to-left shunts is the same as that already described during traumatic tricuspid regurgitation: reopening of the foramen ovale by the right atrial dilatation and ventricularisation of right atrial pressures. The presence of a shunt is an indication for surgery.

Abortion, Spontaneous↗
PubMed1986

[Retroperitoneal neurilemmoma (considerations on 4 cases)].

The authors show 4 cases of retroperitoneal neurilemmoma, surgically treated by simple excision of the tumour. From the general observations, as well as from the analysis of the literature, they can remark the rareness of the location in such anatomical region. The clinical symptoms are common to those of the region retroperitoneal tumours, and are due to the compressive effect developed by the tumour on the contiguous structures. As regards the diagnostic procedures, they emphasize the primary value of axial computed tomography in the evaluation of the retroperitoneal pathology. The diagnosis cannot be but histologic, and is based upon the presence of the typical histologic pictures according to Antoni A and B types.

Adult↗