Intracranial tumors and West syndrome

Two infants, 6 and 7 months of age, are reported with both West syndrome and cerebral tumors. In both patients, initial neurologic examinations were normal and tumor diagnoses were determined through routine imaging studies. Initial response to adrenocorticotrophic hormone treatment did not differ from that observed in patients with cryptogenic West syndrome. Early treatment of West syndrome and resection of tumor, when possible, may offer successful treatment of patients with both benign brain tumors and West syndrome.     

Juxtaepiphyseal aneurysmal bone cyst

Nine cases of aneurysmal bone cyst arising in juxtaepiphyseal locations with gross invasion of the adjacent growth plate are reported. In five of these patients an abnormality of growth, due to premature fusion of the affected growth plate, ultimately developed. Treatment of these lesions should attempt to avoid this complication, which appears to be more common than has been appeaciated in the past. These nine cases represent 23% of 39 cases of aneurysmal bone cyst occurring in a long bone adjacent to an open epiphyseal plate. This series was extrapolated from a total of 198 cases of aneurysmal bone cyst in the files of the Istituto Ortopedico Rizzoli, Bologna, Italy.     

Histologically verified lung metastases in benign giant cell tumours—14 cases from a single institution

From 1975 to 1997, 649 cases of benign giant cell tumours of the bone were treated at the Istituto Rizzoli. Fourteen patients (2.1%) experienced lung metastases after a mean of 35.2 months. The time interval between the diagnosis and the appearance of the lung metastases ranged from 3 months to 11.9 years. Metastasectomy was performed in all patients. Histologically, the metastases were identical to the primary bone lesions. Two patients with unresectable multiple metastases received additional chemotherapy. After a follow-up of 70 months (range: 8.2 to 185 months), all patients are alive. Ten patients showed no evidence of disease, one of these after a second resection of metastases, and four patients presented stable disease with multiple lung metastases. Local recurrence of the bone lesion occurred in seven patients before or simultaneously to the metastases. In contrast to previous reports, we could not detect a predominance of the distal radius, but all of the patients had a stage III tumour according to the Enneking criteria of benign lesions. We conclude that even metastatic benign giant cell tumours have an excellent prognosis after adequate resection. No prognostic factors despite high-grade lesions were detectable.     

Vorläufige Ergebnisse der Pfortaderhochdruckbehandlung bei Lebercirrhose durch Unterbindung der Arteria hepatica

Ohne ZusammenfassungMit 16 Textabbildungen.     

Leiomyoma of the esophagus]

In this paper the Authors report a review of the clinical records from 1972 to 1985 of the Institut of IV Clinica Chirurgica of Rome of esophageal leiomyoma. We report on 7 cases: three males and four females. Their ages ranged from 37 to 78 years (mean 54 years). The most frequent symptoms were dysphagia (71.4%), loss weight (57.1%) and slight epigastralgia (42.8%). Barium meal, esophagoscopy, esophageal manometry, TAC are the most sensitive procedures for a correct preoperative diagnosis. The therapy of choice is surgical treatment. However surgery is conservative: extramucosal enucleation of the leiomyoma is the procedures of choice. The postoperative course was free of complications, the long-term results were excellent.