LRYGB produces an overall improvement in lipid profile, with a clear benefit in all lipid fractions. Although LSG does not alter LDL cholesterol levels, its effect on HDL cholesterol is comparable to or greater than that obtained with malabsorptive techniques.

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A 52-year-old woman was admitted to our hospital presenting with subarachnoid hemorrhage, left ophthalmoplegia, and right hemiparesis. Previous symptoms and signs suggested the presence of panhypopituitarism. A giant intracranial aneurysm of the internal carotid artery, diagnosed by magnetic resonance imaging, showed the characteristic flow void phenomenon with black appearance. Analysis of endocrine function disclosed panhypopituitarism and hyperprolactinemia. After proximal balloon occlusion of the aneurysm, diabetes insipidus developed. Pituitary function reassessed 6 months after initial admission confirmed anterior and posterior hypopituitarism and hyperprolactinemia. Possible mechanisms are discussed. A review of the literature on pituitary dysfunction caused by carotid artery aneurysms discloses that the pituitary-gonadal axis is the most frequently involved (67.5% of cases), followed by the pituitary-adrenal axis (48.6%) and the pituitary-thyroid axis (40.5%). These frequencies are very similar to those described in other types of hypopituitarism.

Distant metastasis from follicular thyroid carcinoma developed in a 48-year-old woman 11 yr after the resection of the primary tumor. Distant metastasis consisted in invasion of the left infraspinatus muscle by malignant thyroid cells. After its surgical removal, in the following 6-8 months multiple metastasis to distant skeletal muscle and brain appeared, and despite chemotherapy and local radiotherapy, the patient finally died. Intercellular adhesion molecule-1 (ICAM-1), a single chain transmembrane glycoprotein, was detected on the surface of cells of the metastatic tissue. Although ICAM-1-positive staining has been recently described in primary tumors such as papillary adenocarcinoma, and metastatic tumors from skin, brain, thymus, liver, adrenal gland and prostate, to our knowledge its expression on distant metastasis from thyroid carcinoma has not been previously reported.