The method is simple, therapeutic results are satisfactory, and patients tolerate the procedure well. We recommend it in any case in which total fistulectomy cannot be done because of the risk of incontinence.
This paper reports macro- and microscopic changes in hyperfunctioning thyroid nodules (HTN), initially diagnosed as solitary, in patients treated with percutaneous ethanol injection (PEI). In 78 patients, benign solitary HTN were diagnosed by clinical and hormonal examination. High resolution ultrasonography confirmed the solitary nodule. The results of fine needle aspiration biopsy (FNAB), performed twice, ruled out malignancy of the nodule. The patients were referred for PEI treatment. At 1-year follow-up, newly formed thyroid nodules, whose volumes increased, were detected in five patients (6.4%) with HTN, initially diagnosed as solitary. Therefore, these patients were operated on. Subtotal thyroidectomy was performed. At the intraoperative macroscopic evaluation, a hard fibrous solid mass was found in place of three nodules (n1, n2, n3) following PEI treatment. The middle area of the cut surface of PEI-treated nodules (n4 and n5) in the other two patients was firm and haemorrhagic, surrounded by a fibrous mass. Histolopathologic examination of n1, n2 and n3 revealed fibrosis and hyalinosis. Examination of n4 and n5 showed haemorrhagic necrosis in the middle of the nodules surrounded by fibrous tissue.
SummarySpinal arachnoid cysts (AC) are intraspinal extramedullary loculated cerebral spinal fluid collections. They are relatively uncommon lesions. Spinal AC often cause symptoms such as pain, weakness and radiculopathy. In this pictorial essay we demonstrate the main radiological features of spinal AC, as well as symptoms and complications associated with them. We also describe the main differential diagnoses.
Presented is a retrospective analysis of 27 patients with plasma cell neoplasms of the spine treated by surgery. Multiple myeloma was confirmed in 22 (81%) and solitary plasmacytoma in 5 patients (19%), assessed at the time of surgery. Nineteen patients (70%) with the preliminary diagnosis of malignancy of unknown etiology were admitted for surgery. In 23 patients (85%) the essential symptom was back pain, which preceded surgery by an average of 4 months. Thirteen patients (48%) were bedridden due to tumor spinal cord compression, on average for 7 days before undergoing surgery. Only 5 out of 13 bedridden patients (38%) regained the ability to walk after surgery and 8 patients (62%) remained bedridden despite successful surgical decompression of the spinal cord. The difference of survival of the patients between bedridden and able to walk prior to surgery was statistically significant (Cox's F-Test = 0.005).
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