Biomedical subjects

P Miccoli

Publications and source records attributed to P Miccoli.

At least 145 records · Page 8Linked to original sources

PubMed1992

Carotid body tumours. A review of eight cases.

Between 1968 and 1988, eight patients with carotid body tumour have been operated on at Istituto di Clinica Chirurgica at the University of Pisa. We undertook the follow-up of all these patients. Two of them presented with bilateral and familial lesions. There was no mortality or morbidity, except in one patient, who had the vagus resected because it was invaded by tumour. For investigation of familial occurrence we have found ultrasound very useful for screening.

Aged↗

PubMed1992

Multicentric breast tumour: an anatomical-clinical study of 100 cases.

Multicentric tumours (MT) represent a potential limit to the treatment by conservative surgery of cancer of the breast. In order to determine which anatomical-clinical features of breast cancer would indicate the highest risk of MT, we studied 100 patients with MT and 452 patients with unicentric tumours (UT), all of whom had been subjected to radical mastectomy during the period 1980 to 1988. Statistical analysis showed a significant difference between the two groups of parameters for bilateral breast cancer (with regard both to metachronous and synchronous lesions), for primary tumours of over 2 cm in size, for both lobular and invasive ductal histotypes and for involvement of the nipple-areola complex. Therefore, if the indications in favour of conservative surgery are applied accurately in combination with radiation therapy, the clinical and biological significance of multicentricity is minimized.

Adult↗

PubMed1991

[Role of diaphanoscopy in breast diseases].

The diagnostic value of diaphanoscopy in a series of 200 cases of breast diseases, all confirmed by cytohistologic examination, is illustrated. Diaphanoscopy showed a high sensitivity towards haemorrhagic cysts, early age fibroadenomas, adenosic dysplasia, haematomas as well as carcinomas.

Adult↗

PubMed1991

[Focal nodular hyperplasia of the liver associated with cardial achalasia, situs viscerum inversus and gastric mucosal ectopia in the duodenum].

The authors describe the clinical case of a young woman with a focal nodular hyperplasia (FNH) of the liver associated with achalasia of the cardia, situs inversus totalis and ectopy of gastric mucosa in duodenum, and discuss the etiopathogenic aspects of the hepatic lesion. The frequent association of the FNH with various malformations, as the literature and this case-report relate, seems to confirm the hypothesis of a dysgenetic hamartomatous origin. Therefore any liver single mass in a patient with a malformative syndrome must rouse the suspicion of a FNH.

Adult↗

PubMed1990

[Neck masses in childhood. Surgical experience in 154 cases].

Neck masses of children often constitute a complex problem of diagnosis and treatment. Despite the currently available diagnostic techniques, excisional biopsy still remains the procedure of first choice in a high percentage of cases to obtain a definitive diagnosis. In the present research, we analyze the problems of differential diagnosis and surgical treatment of neck masses in children, on the basis of 154 cases recruited in 20 years (at the Dept. of Surgery of the University of Pisa). Specific and unspecific lymphadenitis were observed in 26 (16.9%: and 18 cases 18 cases (11.7%), respectively. Hodgkins' lymphoma was present in 12 patients (7.8%). Thyroid disorders were diagnosed in 48 cases; 31 (20.1%) of these were benign, and 17 (11.1%) were malignant. Thirty-nine children showed congenital anomalies: 26 (16.9%) suffered from cysts of the thyroglossal duct, 10 (6.5%) from branchial abnormalities, and 3 (1.9%) from cystic lymphangioma. Two dermoid cysts (1.3%) and 2 parotid gland mixed tumours (1.3%) were also observed. The deep knowledge of embryology and anatomy of the neck, a careful clinic examination, an echography, as well as a fine needle-aspiration, seem thus essential to achieve the correct diagnosis and treatment.

Adolescent↗

PubMed1989

Relationship between progesterone receptor, axillary node status and productive fibrosis in ductal infiltrating carcinoma of the breast.

The presence of progesterone receptor (PR), productive fibrosis (PF), axillary nodal status and tumor size are important prognostic variables in breast cancer. In this study we have analyzed the relationship between these four parameters in 78 ductal infiltrating carcinomas of the breast. No relationship was found between PF and the presence of lymph node metastatic disease: however, in the tumors with positive nodes, a limited metastatic diffusion (1-3 lymph nodes) was significantly associated with PF (p less than 0.05). Our study failed to demonstrate any relation between estrogen receptor (ER) and both presence and extension of nodal involvement; in contrast, the tumors with limited metastatic diffusion (1-3 lymph nodes) had a significantly higher prevalence of PR positivity (p less than 0.05). Furthermore, PF was strongly associated with PR (p less than 0.001) and less well with ER (p less than 0.05). The simultaneous presence of PR and marked PF was strongly correlated with limited metastatic involvement of the axilla (p less than 0.007). Tumor size was correlated with the number of positive nodes (p less than 0.001), but not with PR or PF. The results demonstrate that PR status, PF and tumor size are related to limited metastatic diffusion of the axilla: furthermore PF and PR have been shown to be strongly related and we have demonstrated that, at least in ductal infiltrating carcinoma, the simultaneous presence of them identifies a subset of tumors with low metastatic capacity independently of tumor size.

Adult↗

PubMed1989

Clinical and biologic behavior of bone metastases from differentiated thyroid carcinoma.

Thirty (3.8%) of 780 patients with differentiated thyroid cancer seen between 1970 and 1987 had bone metastases. The primary tumor was follicular in 26 patients and papillary in four. Mean age at diagnosis was 61 years. The manifestation of bone metastases was the presenting symptom in 18 patients (60%). Treatment included total thyroidectomy, levothyroxine sodium therapy, and radioactive iodine treatments. Twenty-seven patients had bone metastases from the initial observation, with 44 sites involved. Of the sites, 27 (61%) were shown both on iodine 131 whole-body scan (WBS) and on x-ray film, 11 (25%) only on WBS, and six (14%) only on x-ray film. Multiple involvement was observed in 11 patients. The radiologic appearance was invariably osteolytic. Serum thyroglobulin was elevated in all patients. After radioactive iodine, no WBS+/X-ray+ metastases showed a complete response, although a sclerotic border was noted in several cases, whereas six WBS+/X-ray- lesions were no longer detectable by WBS. Treatment with radioactive iodine and bone surgery resulted in a complete cure in three patients and in a reduction of tumor mass in three. Twenty-one (70%) of the patients died of thyroid cancer after a mean survival of 86 months. Of the nine patients still alive, two are free of disease, three have a good quality of life, and four have severe disability.

Bone Neoplasms↗

PubMed1988

Relationship between progesterone receptor and productive fibrosis as an index of tumor differentiation in breast cancer.

We studied the relationship between steroid receptors (SR) and various stromal parameters in 100 breast cancers. Each specimen was submitted to SR determination by the dextran-coated charcoal assay and to histologic examination. No relationship was found between the presence of SR and necrosis or fibroblastic cell content. There was an inverse correlation between SR positivity and the extent of lymphocyte infiltration (p less than 0.05). ER + PR + status was strongly correlated with marked productive fibrosis (PF) (p less than 0.005). When SR were separately assayed, only the presence of PR was correlated with PF (p less than 0.005); similar results were obtained for PR levels (p less than 0.01). PF was also associated with a higher nuclear grade (p less than 0.001). In conclusion, in this study a strong correlation between PR positivity or concentration and extent of PF was demonstrated in breast cancer. Since PR synthesis is an expression of an intact regulatory pathway, our data suggest that stromal production in breast cancer is related to the degree of differentiation of malignant epithelial cells.

Adult↗

PubMed1988

Thyroid carcinoma in thyrotoxic patients treated by surgery.

We report the incidence of thyroid cancer in a series of 1832 consecutive patients seen for thyrotoxicosis of any etiology during 1970 and 1985 in our department. Surgical treatment for thyrotoxicosis was selected as the treatment of choice in 179 patients (9.8%), 86 with toxic diffuse goiter (TDG), 21 with toxic nodular goiter (TNG) and 40 with toxic adenoma (TA). The presence of thyroid cancer was found in 11 patients for a total incidence of 6.1%. Six patients had TDG (percent incidence in this group 6.9%), 4 patients had TNG (7.5%) and 1 had TA (2.5%). While the presence of thyroid cancer was totally unsuspected in TNG and TA, in TDG 4 out of 6 patients found to have a cancer, had been suspected before surgery. When a thyroid nodule was present in a toxic diffuse goiter the possibility to face with a malignant lesion reached 22.2% of the cases (4 out of 18 cases), while only 2 out of 68 patients (2.9%) with TDG and no nodule had thyroid cancer. These results confirm recent other series reporting the frequent association of hyperthyroidism and thyroid cancer and suggest that in thyrotoxic patients any nodule must be screened carefully to rule out malignancy.

Adenoma↗

PubMed1988

Thyroid cancer in children and adolescents.

We report on 49 patients younger than 18 years at diagnosis, of 776 patients with thyroid cancer, seen in our institution in the last 17 years. Female/male ratio was 2.2:1. Histologic type was papillary in 44, follicular in 4, and medullary in 1. Initial treatment was near-total thyroidectomy with or without neck dissection. Surgical complications (vocal cord palsy, permanent hypoparathyroidism, or both) were found in 25 patients and were usually associated with more advanced primary tumors. At surgery, node metastases were present in 73% of the patients and lung metastases, detected by chest x ray films, in 6%. Patients were treated with thyroid suppressive therapy and, except the one with medullary cancer, with radioiodine (131I) therapy. After a mean follow-up of 7.7 +/- 4.4 years (range, 1 to 17 years), one patient with lung metastases died of respiratory failure. Of 36 patients who have been followed up more than 4 years, 22 (61.1%) are now cured, and 14 have metastases (to lymph nodes, 2; to nodes and lung, 10; and to lung, 2). Since 1977 serum thyroglobulin (Tg) was used routinely as a tumor marker for differentiated thyroid cancer. After operation, Tg was elevated in all patients both not receiving (mean +/- SE, 902 +/- 380 ng/ml) and receiving (44 +/- 15 ng/ml) suppressive therapy; after 131I treatment, serum Tg dropped to 104 +/- 50 and 7.3 +/- 1.7 ng/ml, without and with suppressive therapy, respectively. Of 11 patients with lung metastases treated with 131I, respiratory function, as assessed by means of spirometry, was normal in three, mildly reduced in six, and severely impaired in two (including the one who died). In conclusion, our study indicates that thyroid cancer in young patients is rather advanced at initial examination and usually associated with node and, less frequently, lung metastases. Total thyroidectomy, radioiodine treatment, and thyroid suppressive therapy represent an effective combination of treatments for this disease and allow a good quality of life. The most serious adverse effect is represented by the high incidence of surgical complications and by pulmonary restrictive disease in relation to lung metastases.

Adolescent↗

PubMed1988

Correlation between 5-year survival of T1-T2N0 breast cancer and some pathological parameters.

In order to more clearly define the factors influencing prognosis, 113 cases of T1-T2N0 breast cancers, all operated on by means of radical mastectomy, were reviewed. The following pathologic parameters were analyzed in relation to 5 years survival: histological type, nuclear grading, vascular embolization, size and border of the tumour, and sinus histiocytosis, diffuse cortical hyperplasia and germinal center hyperplasia of axillary nodes. We observed a close correlation between the presence of sinus histiocytosis and prognosis, as many authors have reported. Diffuse cortical hyperplasia stands out from our data as the most unfavourable prognostic factor.

Adult↗

PubMed1986

Fine needle aspiration in the diagnosis of breast masses: our experience.

The authors compare their experience, obtained after 626 examples of fine needle aspiration cytology of the breast, with the results of other departments. The very high specificity of the test is confirmed (absence of false positive). Also false negatives are quite low (6%). Finally, the repeatibility of such a procedure and the low cost suggest inclusion of fine needle aspiration cytology in every diagnostic protocol for mammary cancer.

Adult↗

PubMed1986