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PubMed2000

[Insular thyroid carcinoma].

A new case of insular carcinoma of the thyroid gland is presented. It was described by Carcangiu et al(1) in 1984 as a poorly differentiated carcinoma, less of one hundred cases were published after its description. We report a case of a patient who was referred for compressive symptoms caused by a mediastinal mass. It was found a tumor of left thyroid lobe strongly adherent to adjacent structures, which was informed as a poorly differentiated insular carcinoma. She underwent total thyroidectomy and posterior treatment with an ablative dose of 1311. She is currently free of disease after one year of follow-up. The diagnosis, treatment, differential diagnosis with another thyroid carcinomas and the rarety of this type of tumors are analyzed. The importance of a correct diagnosis is fundamental in order to carry out an aggressive treatment and a more exhaustive follow-up in these patients, taken account its behavior and its poor prognosis when compared with well-differentiated carcinomas.

Aged↗

PubMed1995

[Acute cholecystitis caused by cystic polyp].

We present the case of a 72 years-old woman with acute cholecystitis, secondary to the obstruction of the cystic duct by a 5 mm adenomatous polyp. Diagnosis of gallbladder polyps is mainly based on ultrasonographic exploration. The recovery was uneventful.

Acute Disease↗

PubMedDate not supplied

[The mucosal electrosensitivity of the anal canal following restorative proctocolectomy for ulcerative colitis].

The aim of this study was to investigate the mucosal electrosensitivity of the anus in 23 patients following restorative proctocolectomy for ulcerative colitis. In 16 cases mechanical anastomosis was performed 2 cm above the pectineal line conserving the transitional anal mucosa and in 7 cases distal rectal mucosectomy and manual anastomosis was performed to the pectineal line. In these patients and in those of the control group of 21 patients without previous anorectal disease, the threshold of sensitivity of the lower, middle and upper anus segment was determined. A clinical questionnaire was made in the patients with ileoanal reservoir to evaluate the existence of alterations in continence, and in the capacity to discriminate between gases and stools. The sensitivity thresholds obtained were significantly higher than those in the control group. A significantly greater sensitivity threshold (p = 0.01) was found in the upper anus segment in patients with mucosectomy (median 18.5 mA) with respect to the patients with mechanical anastomosis (median 11 mA). A significantly greater threshold was also observed (p = 0.03) globally in the patients with some alteration in continence (median 15 mA; 57.1% mucosectomy and 18.8% mechanical anastomosis) with respect to completely continent patients (median 11 mA). The results demonstrate the importance of conserving the transitional anal mucosa during surgery with the aim of improving the functional results during the follow of the functioning ileoanal reservoir.

Adult↗