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Napoli, Italy

Ravo V.,PO Ascalesi ASLNA | Calvanese M.G.,The Second University of Naples | Manzo R.,PO Ascalesi ASLNA | Cuomo M.G.,The Second University of Naples | And 3 more authors.

Aims and background. Solitary plasmacytomas are rare tumors accounting for less than 10% of plasma cell neoplasms. On initial presentation they must be differentiated from multiple myeloma. This can be difficult because a high percentage of these tumors may be associated with subsequent development of multiple myeloma. We present a case of plasmacytoma of the larynx treated with surgery and radiotherapy. Case report. A 56-year-old man presented a solitary plasmacytoma of the larynx. The diagnosis was made by biopsy and the presence of a mass on the right side of the larynx was confirmed by computed tomography and whole-body positron-emission tomography. Soon after the biopsy the patient underwent a CO 2 laser cordectomy. After the definitive histological confirmation, the patient was referred to our department for three-dimensional conformal radiotherapy (3DCRT) to the involved site with curative intent. The prescribed dose was 50 Gy. Results. Five months after the 3DRTE treatment there was no CT or PET evidence of tumor, and examination by the otorhinolaryngologist confirmed the success of laser cordectomy and 3DRTE treatment. There were no long-term side effects of the treatment. Conclusion. Radiation therapy following CO 2 laser cordectomy can achieve excellent locoregional control of solitary plasmacytoma of the larynx. © Il Pensiero Scientifico Editore. Source

Laghi F.,Second University | Catalano O.,INT Pascale | Maresca M.,Second University | Sandomenico F.,INT Pascale | Siani A.,INT Pascale
Ultraschall in der Medizin

Purpose: To evaluate whether the use of contrast-enhanced ultrasound (CEUS) could improve the characterization of indeterminate subcentimetric focal liver lesions (FLLs) seen with multidetector computed tomography (MDCT) in cancer patients. Materials and Methods: For 12 months all patients with extrahepatic tumors showing small (< 10 mm), indeterminate focal liver lesions on whole-body or abdominal computed tomography (CT) underwent immediate, targeted ultrasound (US) to rule out a cystic lesion. Whenever unenhanced US demonstrated a non-cystic lesion or failed to recognize any focal abnormality within the suspected area, CEUS was carried out. During the arterial phase, CEUS was focused on the area reflecting the CT finding, while the entire organ was explored during the portal-sinusoidal phase. Results: Among the 132 patients with MDCT evidence of indeterminate, subcentimetric focal liver lesions (206 lesions), US proved the cystic nature of 138 lesions in 87 patients. In 45 cases US failed to recognize any abnormality or cystic image and these subjects underwent CEUS. The CEUS results were confirmed by further assessment or follow-up for 43 / 45 patients (3 cysts, 8 hemangiomas, 47 metastases, 2 areas of focal steatosis, 2 eosinophilic necroses, 1 granuloma, 1 abscess, 1 fistula). CEUS failed to detect 3 lesions (1 metastasis and 2 benign lesions). In 8 cases CEUS recognized additional liver metastases. Conclusion: CEUS can be helpful in demonstrating or excluding metastases in cancer patients with MDCT evidence of subcentimetric, indeterminate focal liver lesions. © Georg Thieme Verlag KG Stuttgart - New York. Source

Marone U.,Melanoma Soft Tissues Head and Neck Skin Cancers | Catalano O.,INT Pascale | Caraco C.,Melanoma Soft Tissues Head and Neck Skin Cancers | Anniciello A.M.,INT Pascale | And 7 more authors.
Ultraschall in der Medizin

Purpose: The objective of our study was to define the diagnostic accuracy of high-resolution ultrasound (US) in detecting nodal involvement before sentinel lymph node biopsy (SLNB) in patients with cutaneous melanoma, to define the sonographic criteria used to assess nodal metastases, and to establish if high-resolution US can directly select patients to radical lymphadenectomy, sparing selective lymphadenectomy. Materials and Methods: 623 patients underwent high-resolution US of the regional lymph nodes, 24 hours prior being submitted to the sentinel lymph node biopsy procedure. The US findings were compared with histological findings. Results: In 14.7% out of 122 excised lymph nodes, high-resolution US showed sonographic features consistent with malignant involvement before the surgical step.US scan sensitivity and specificity were 15 and 100%, respectively, since positive and negative predictive values were 100 and 87% respectively. Conclusion: US is an effective modality in the presurgical detection of subclinical deposits within sentinel lymph nodes. However, preoperative staging work-up with high-resolution US cannot substitute the SLNB, mainly because of low sensitivity due to missing many micrometastases. © Georg Thieme Verlag KG Stuttgart ·l New York. Source

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