Adenocarcinoma arising in a Warthin’s tumor

SummaryCarcinoma ex pleomorphic adenoma is a well-recognized entity, while, in rare cases carcinomas may arise from the epithelial component of Warthin’s tumor. We present a case of adenocarcinoma arising in a Warthin’s tumor located in the left parotid gland in a 49-years-old patient. Chest X-ray, laboratory investigation and thyroid scintigraphy were normal. A ultrasonography and computerized axial tomography showed multiple nodules. A fine needle aspiration biopsy showed typical features of Warthin’s tumor. The histology showed the presence of a metastatic adenocarcinoma, that was thyroglobulin and calcitonin negative. The patient underwent a total left parotidectomy, was carefully followed-up, and at a 7 years check-up visit no other primary malignant lesion has manifested

Microimaging FT-IR of Head and Neck Tumours. The case of salivary glands

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A Solid Mass in the Head of the Pancreas with Intense 18FDG Uptake: Intraductal Tubulopapillary Neoplasm

Context 18FDG-PET/CT has emerged as a useful diagnostic modality for the staging of different malignancies. Its role in the characterization of both cystic and solid pancreatic tumors is debated, especially in the differential diagnosis between malignant and benign/borderline tumors. Case report A 66-year-old man complained of abdominal discomfort with no other symptoms. An abdominal US showed a solid mass in the head of the pancreas. He underwent contrast medium CT scan and MRI that showed a pseudonodular mass of 35x40 mm in the pancreatic head without dilatation of the common bile duct/main pancreatic duct. There was no infiltration of the surrounding pancreatic parenchyma, duodenum and peripancreatic vessels. Serum CA 19.9 was 795 U/mL. A 18FDG PET/CT scan showed an intense uptake by the mass. He underwent pylorus-preserving pancreaticoduodenectomy. Macroscopic examination of the specimen revealed a 4 cm tumor with endocystic growth without infiltration of surrounding structures, including common bile duct and main pancreatic duct. Histologically the tumor was composed of cubic to cylindrical well-differentiated cells, with low/intermediate grade atypia. Tumor cells formed tubulopapillae and contained little cytoplasmic mucin. Immunohistochemical profile showed positivity only for cytokeratin 7 and cytokeratin 19. Ki67 index was 25-30%. 37 lymph nodes were removed without metastases. A diagnosis of intraductal tubulopapillary neoplasm (ITPN) with low-grade/intermediate dysplasia was made. Conclusion ITPN is a rare primary pancreatic neoplasm accounting for less than 1% of all pancreatic exocrine neoplasms. ITPN can show a different biological behavior, from low-grade to high-grade dysplasia and invasive carcinoma. Presence of high proliferative index, high-grade atypia, and, obviously, infiltration of surrounding structures/lymph node metastases, indicate malignancy. Differential diagnosis include mainly solid-pseudopapillary tumor and acinar cell carcinoma. In this case intense 18FDG uptake and high CA 19.9 level prompted for resection, although only low-grade/intermediate dysplasia was present

S100A8 calcium-binding expression in radicular and dentigerous cysts and in keratocystic odontogenic tumors

Introduction: Recently the term Keratocystic Odontogenic Tumor (KCOT) has been recommended for Odontogenic Keratocysts (OKC) to address the neoplastic nature of the lesion compared to radicular and dentigerous cysts. S100 are calcium-binding proteins involved in cell differentiation and inflammation, with a potential role in neoplastic transformation. Aim: The aim of this study was to evaluate whether S100A8 protein expression is different in KCOT compared to radicular cysts (RC) and dentigerous cysts (DC). Methods: A total of 84 consecutive odontogenic cysts, 34 RC, 25 DC, and 25 KCOT, were analyzed in this study. Results: Epithelial cells in KCOT cases were not immunoreactive for S100A8 except focally in cases associated with inflammation, while RC cases showed a variable positivity of all the epithelial layers from the basal to the superficial in 19/34 cases and DC cases showed a weak positivity of the intermediate and superficial layers in 7/25 cases. Conclusion: The lack of S100A8 protein expression seems to be observed more frequently in KCOT compared to RC and DC. This difference might be related to their neoplastic nature and a potential aggressive biological behavior for odontogenic cystic lesions

In vitro biological effects of raw and thermally treated asbestos-containing materials

Asbestos cement, the main asbestos-containing material (ACM) manufactured in Italy in the past, is a health hazard whose elimination is a priority concern. Asbestos fibers can be transformed into potentially non-hazardous silicates by high-temperature treatment via complete solid-state transformation. In this study human A549 cells were directly exposed to raw cement asbestos (RCA), chrysotile and cement asbestos subjected to an industrial process at 1200 °C (HT-CA) and raw commercial grey cement (GC) for 24 and 48h, or treated with conditioned culture medium up to 96 h. In our previous studies we demonstrated that the final product of heat treatment of cement asbestos was considerably more inert and had lower cytotoxic potential than the original asbestos material. However, to better evaluate the risks of interactions with the materials, further in vitro investigations were performed concerning fiber-cell superficial interactions, immuno-hystochemical expression of cytochines p53, p53 homologue p73, TNF-related apoptosis- inducing ligand (TRAIL), and conditioned medium effects on cell viability. Data showed more severe cytotoxic damage by raw cement-asbestos compared to the heat treated materials and different expressions of cytochines that exert critical role in regulating the cell response to asbestos-induced DNA damage. These data should be taken in consideration for a safe recycling of thermal transformed asbestos materials

Addition of the tumour-stroma ratio to the 8th edition American Joint Committee on Cancer staging system improves survival prediction for patients with oral tongue squamous cell carcinoma

Aims One of the objectives of current research is to customise the treatment of cancer patients. The achievement of this objective requires stratification of patients based on the most significant prognostic factors. The aims of this study were to evaluate the prognostic value of the tumour-stroma ratio (TSR), defined as the proportion of tumour cells relative to surrounding stroma, in patients with oral tongue squamous cell carcinoma (OTSCC), and to develop a prognostic nomogram based on the most significant clinicopathological features. Methods and results Clinicopathological data of 211 patients treated at 'Ospedali Riuniti' General Hospital (Ancona, Italy) for OTSCC were collected. One hundred and thirty-nine patients were restaged according to the 8th edition American Joint Committee on Cancer (AJCC) staging system. Evaluation of the TSR was performed on haematoxylin and eosin-stained slides, and correlation with survival outcomes was evaluated. In addition, with the aim of integrating the independent value of the TSR with the 8th edition AJCC staging system, a prognostic nomogram for OTSCC has been developed. OTSCC with a low TSR (i.e. a high proportion of stroma and a low proportion of tumour cells) was shown to have negative prognostic value in terms of disease-specific survival, with a hazard ratio (HR) of 1.883 and a 95% confidence interval (CI) of 1.033-3.432 (P = 0.039), and overall survival (HR = 1.747, 95% CI 0.967-3.154;P = 0.044), independently of other histological and clinical parameters. For the cohort of 139 patients restaged according to the 8th edition AJCC staging system, variables correlating with a poor prognosis were: the TSR, perineural invasion, and sex. The nomogram built on these parameters showed good predictive capacity, outperforming the 8th edition AJCC staging system in stratifying disease-specific survival in OTSCC patients. Conclusions Including the TSR in the predictive model could improve risk stratification of OTSCC patients and aid in making treatment decisions.Peer reviewe

A pilot study to evaluate the expression of microRNA‐let‐7a in patients with intestinal‐type sinonasal adenocarcinoma

Despite its histological resemblance to colorectal adenocarcinoma, there is little information about the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinoma (ITAC). The present study investigated the possible role and clinical value of microRNA (miR)-let-7a, a head and neck squamous cell carcinoma-related miR, in a well-characterized and homogeneous cohort of patients with ethmoidal ITAC associated with occupational exposure, treated by primary surgery. miR-let-7a expression levels were analyzed in 23 pairs of ethmoidal ITAC and adjacent normal formalin-fixed paraffin-embedded tissues by reverse transcription-quantitative PCR. The expression was evaluated in tumor and healthy tissues according to: Tumor grade (G) of differentiation and extension, and pTNM stage, and presence/absence of recurrence. Comparisons within and between groups were performed using two-tailed Student's paired t-test and one-way ANOVA with Tukey's post hoc test. P<0.05 was considered to indicate a statistically significant difference. miR-let-7a expression in ethmoidal ITAC tissues was significantly lower than that in adjacent normal tissues (P<0.05; mean expression level +/- SD, 1.452707 +/- 1.4367189 vs. 4.094017 +/- 2.7465375). miR expression varied with pT stage. miR-let-7a was downregulated (P<0.05) in advanced stages (pT3-pT4) compared with earlier stages (pT1-pT2). Furthermore, downregulation of miR-let-7a in ITAC was associated with poorly-differentiated (G3) cancer (P<0.05). No other associations were observed between miR-let-7a expression and the other clinicopathological parameters, including disease-free survival. In conclusion, downregulation of miR-let-7a in ITAC was associated with advanced-stage (pT3 and pT4) and poorly-differentiated (G3) disease, suggesting that the mutation of this gene, combined with additional genetic events, could serve a role in ITAC pathogenesis

Is expression of p120ctn in oral squamous cell carcinomas a prognostic factor?

Objectives p120ctn is a component of the catenin family. To date, there have only been two studies examining expression levels of p120ctn in oral squamous cell carcinoma (OSCC). Materials and methods Paraffined specimens of 113 OSCCs and 12 of normal mucosa were examined by immunohistochemistry. Frozen samples of 20 OSCCs and 5 of normal mucosa were examined by Western blot (WB). Results were correlated with clinicopathological parameters. Five cell lines were examined by immunofluorescence, immunocytochemistry, and WB to show immunoreactivity and cellular localization of p120ctn. Results Altered p120ctn expression was observed in 109/113 cases of OSCC. Heterogenous cytoplasmic/nuclear expression was associated with loss of membranous distribution (88/113 cases). Complete loss of expression was noted in 21/113 cases. Increased cytoplasmic expression was evident in all positive cases, without significant correlation among p120ctn staining/pattern and grading/stage. Reduction/absence of p120ctn expression was related to poor prognosis ( P Conclusion p120ctn delocalization/loss of expression could be an independent prognostic marker in OSCC

Oral lichen planus in children: An Italian case series

Oral lichen planus usually occurs in adults; there are no clear data regarding the incidence and the clinical features of oral lichen planus in children. This paper reports clinical findings, treatments, and outcomes of 13 Italian patients with oral lichen planus in childhood diagnosed between 2001 and 2021. The most common finding was keratotic lesions with reticular or papular/plaque-like patterns, confined to the tongue in seven patients. Although oral lichen planus in childhood is rare and the malignant transformation index is unknown, specialists must be aware of its characteristics and oral mucosal lesions must be correctly diagnosed and managed