Publications

We report a case of metastatic lobular breast carcinoma with extrahepatic gastrointestinal disease. On the basis of clinical findings, radiologic investigations, computerized axial tomography, gastrointestinal endoscopy, and gastric biopsy, the diagnosis of gastric and ileal Crohn's disease was made. The correct diagnosis of peritoneal carcinomatosis was made at laparoscopy. This case exemplifies the utility of laparoscopy in establishing the diagnosis and staging for abdominal disease of uncertain etiology.

Primary hyperparathyroidism often presents with minimal symptoms. Surgery has been advocated for those patients who are severely hypercalcemic, are young, have reduced bone density or reduced renal function, and have marked hypercalciuria. The natural history of primary hyperparathyroidism and the basis for these recommendations are discussed.