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ABSTRACT: Basosquamous carcinoma (BSC) is a rare epithelial tumor with a still confusing terminology. Since 2005 a more comprehensive and broader classification has existed. To retrospectively review our cases of BSC according to the new WHO definition and to re-evaluate their clinical and demographic characteristics and the margin involvement after traditional surgical excision. The data were compared with the same results obtained by basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). Histologically confirmed carcinomas observed in our Department during a sixteen-year period (1994-2011) were studied. Surgical excision was evaluated following the international guidelines. Histopathologic subtypes of BSC were classified in accordance with accepted criteria. Seventy-six patients had a BSC, 305 a SCC, 3,643 a BCC. There were significant differences among the median age of BSCs, the total BCCs and Non-Aggressive BCCs (74.7, 68.8 and 68.3 years respectively; p<0.05). BSC was more significantly located on head-neck region than Non-Aggressive BCC (p<0.04), and less on trunk than Mixed Histology BCC (p<0.01) and Non-Aggressive BCC (p<0.005). BSC has higher prevalence of positive margins after excision than total (p<0.03) and Non-Aggressive BCC (p<0.001). Basosquamous carcinoma fits to a tumor type with a different behavior pattern from non-aggressive basal cell carcinoma and more similar to squamous cell carcinoma or aggressive variants of basal cell carcinoma. Its infiltrative growth and the stromal reaction patterns give enough evidence to support the notion of considering basosquamous carcinoma as a relatively aggressive tumor.
European journal of dermatology : EJD. 12/2012;
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Francesco Rocco,
Gabriele Cozzi,
Matteo Giulio Spinelli,
Bernardo Maria Rocco,
Giancarlo Albo,
Elisabetta Finkelberg,
Isabella Oliva,
Paolo Fontanella,
Daniela Varisco, Laura Moneghini,
Michele Talso,
Carlotta Palumbo
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ABSTRACT: Aggressive angiomyxoma (AAM) is a rare mesenchymal benign myxoid tumor, characterized by locally infiltrative nature and high recurrence rate. AAM occurs almost exclusively in adult females, arising from the soft tissue of the pelvic region: to our knowledge, only 43 cases occurring in men have been reported. We report a case of massive recurrence of scrotal AAM in a 46-year-old obese man, who already underwent surgery for the same disease in 2004 and 2005. The mass had a circumference of 106 cm and weighted 30 kg. It was impossible to appreciate the testes and to find the penis. The patient underwent scrotal resection, bilateral orchidopexia and transposition of the penis, by means of a preputial flap. Residual scrotal skin was modeled in order to create a neoscrotum, where the testes were placed and secured with interrupted sutures. Histologic examination showed diffuse angiomyxoma-like lipomatosis. After three months, the patient presented with local relapse which also involved the external urethral orifice.
Rare tumors 07/2011; 3(3):e31.
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European journal of dermatology: EJD 02/2011; 21(2):259-60. · 2.53 Impact Factor
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ABSTRACT: Colorectal polyps of mesenchymal origin represent a small percentage of gastrointestinal (GI) lesions. Nevertheless, they are encountered with increasing frequency since the widespread adoption of colonoscopy screening.
We report a case of a small colonic polyp that presented as intramucosal diffuse spindle cell proliferation with a benign cytological appearance, strong and diffuse immunoreactivity for S-100 protein, and pure Schwann cell phenotype. Careful morphological, immunohistochemical and clinical evaluation emphasize the differences from other stromal colonic lesions and distinguish it from schwannoma, a circumscribed benign nerve sheath tumor that rarely arises in the GI tract.
As recently proposed, this lesion was finally described as mucosal Schwann cell hamartoma.
BMC Gastroenterology 01/2011; 11:68. · 2.42 Impact Factor
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ABSTRACT: This study investigated the quality of root-end filling in cases of periapical lesions persisting after endodontic surgery. Ten patients requiring extraction of an endodontically treated tooth were included. The root-ends of extracted teeth were examined by scanning electron microscopy. Defects at the interface between the root-end filling and cavity margin were classified as ideal, imperfect (some marginal disruption) or inadequate (continuous marginal disruption involving >30% of the interface). Four cases were scored as imperfect, and six were scored as inadequate. A defective apical seal could favour continuous leakage of surviving bacteria and their by-products from the infected root canal system to periapical tissues, thereby sustaining inflammation.
Journal of Oral Science 01/2011; 53(3):393-6.
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ABSTRACT: Syphilis is a chronic infection that is classified into three stages. In its tertiary stage, syphilis spreads to the brain, heart and other organs; the lesions may involve the skin, mucous membranes and bones. Neuropathic arthropathy associated with tertiary syphilis has rarely been described in Europe and its association with HIV-HCV co-infection has not been reported so far.This article reports the case of a man with tertiary syphilis presenting with rapidly evolving neuropathic arthropathy of the hip and extensive bone destruction.
On initial presentation, the patient complained of progressively worsening left-sided coxalgia without localized or generalized inflammation. The patient reported to have no history of previous infections, trauma or cancer. Plain x-ray films of the left coxofemoral joint showed marked degeneration with necrosis of the proximal epiphysis of femur and morphological alterations of the acetabulum without protrusion. Primary coxarthrosis was diagnosed and hip arthroplasty was offered, but the patient declined treatment. Three months later, the patient presented a marked deterioration of his general condition. He disclosed that he was seropositive for HCV and HIV, as confirmed by serology. Syphilis serology testing was also positive. A Girdlestone's procedure was performed and samples were collected for routine cultures for bacteria and acid fast bacilli, all resulting negative.Although histological findings were inconclusive, confirmed positive serology for syphilis associated with progressive arthropathy was strongly suggestive of tertiary syphilis, probably exacerbated by HIV-HCV co-infection. The patient partially recovered the ability to walk.
Due to the resurgence of syphilis, this disease should be considered as a possible cause of neuropathic arthropathy when other infectious causes have been ruled out, particularly in patients with HIV and/or HCV co-infection.
BMC Infectious Diseases 01/2011; 11:159. · 3.12 Impact Factor
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Acta Dermato-Venereologica 11/2010; 91(1):76-7.
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European journal of dermatology: EJD 12/2009; 20(2):226-7. · 2.53 Impact Factor
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ABSTRACT: Two cases of low-grade myofibroblastic sarcoma (LGMS) are presented: one of lateral tongue, the other of lower buccal vestibule. LGMS represents a distinct atypical myofibroblastic tumor that occurs in several sites, primarily within the head and neck regions. A painless, enlarging mass is the most common clinical presentation, but a definitive diagnosis requires both histopathological and immunohistochemical analyses. Histologically, LGMS commonly presents as a cellular lesion composed of spindle-shaped tumor cells arranged primarily in fascicles with a diffusely infiltrative pattern. Immunohistochemically, LGMS shows positive staining for at least one myogenic marker, such as desmin, and muscle actin.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 09/2009; 108(2):248-54. · 1.50 Impact Factor
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ABSTRACT: The incidence of tongue cancer is increasing worldwide, and its aggressiveness remains high regardless of treatment. Genetic changes and the expression of abnormal proteins have been frequently reported in the case of head and neck cancers, but the little information that has been published concerning tongue tumours is often contradictory. This review will concentrate on the immunohistochemical expression of biomolecular markers and their relationships with clinical behaviour and prognosis. Most of these proteins are associated with nodal stage, tumour progression and metastases, but there is still controversy concerning their impact on disease-free and overall survival, and treatment response. More extensive clinical studies are needed to identify the patterns of molecular alterations and the most reliable predictors in order to develop tailored anti-tumour strategies based on the targeting of hypoxia markers, vascular and lymphangiogenic factors, epidermal growth factor receptors, intracytoplasmatic signalling and apoptosis.
Journal of Oncology 02/2009; 2009:412908.
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Archives of dermatology 06/2008; 144(5):689-90. · 4.76 Impact Factor
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ABSTRACT: Artificial separation of oral mucosa into epithelium and connective tissue represents the first step in investigating both the basement membrane zone and its two components (epithelium and connective tissue) separately. It is a useful tool in analysing the possible role of hepatitis C virus in the pathogenesis of oral lichen planus (OLP). The aim of the present study was to test different methods to separate the epithelium from the connective tissue of oral mucosa affected by OLP as a preliminary step for further immunohistochemical or molecular investigations.
Fourteen tissue biopsies of the oral mucosa of clinically and histopathologically confirmed OLP lesions underwent epithelial connective separation (ECS) using six different reagents.
Among the separation methods tested, CaCl2 1 M at 37 degrees C for 30 min, NaCl 1 M at 4 degrees C for 26 h and elastase at 4 degrees C for 22 h allowed good ECS without structural alteration or tissue loss. The present study provides useful information regarding techniques to separate the epithelium from the connective tissue as a preliminary step to investigate oral mucosa affected by OLP from an immunohistochemical or molecular viewpoint.
Journal of Cutaneous Pathology 04/2006; 33(3):220-6. · 1.56 Impact Factor
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ABSTRACT: Allogenic peripheral stem cell transplantation (HSCT), a procedure that is widely used in the treatment of a large number of malignant and nonmalignant hematological diseases, is still associated with a wide range of complications, one of the most important of which is graft-versus-host disease (GVHD). The patients undergoing allogeneic HSCT are at high risk of developing secondary neoplasms, particularly leukemias and lymphomas. Solid tumors are less frequent, but their incidence seems to be higher in the patients who develop GVHD; the most frequent solid tumors are squamous cell carcinomas. We here describe the clinical course and histopathologic aspects of a squamous cell carcinoma arising on GVHD-induced oral lesions in a 53-year-old woman with non-Hodgkin's lymphoma undergoing allogeneic HSCT. Immediately after the transplantation, the patient developed GVHD involving the gastroenteric tract, skin, joints, and oral cavity, which was treated with cyclosporin, prednisone, azathioprine, colchicine, and photophereses. In addition to the sporadic reports of similar pictures published in the literature (16 cases of squamous cell carcinoma owing to oral GVHD in patients undergoing allogeneic HSCT), our case underlines the susceptibility of HSCT patients with oral GVHD to carcinoma of the oral cavity. All patients treated with allogeneic HSCT (particularly those who have developed GVHD) should therefore undergo a careful examination of the oral mucosa and be closely followed up over the long term with the aim of identifying the onset of secondary tumors as early as possible.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 08/2005; 100(1):63-9. · 1.50 Impact Factor
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ABSTRACT: We analyzed mutations in the 5' non-coding region of the BCL-6 gene in 46 cases of primary cutaneous B-cell lymphomas (PCBCL), using a polymerase chain reaction single strand conformation polymorphism (PCR-SSCP) method. The results indicate that PCBCL display a low frequency of mutations and support a marginal zone B-cell origin for most of these neoplasms.
Haematologica 06/2004; 89(5):624-6. · 6.42 Impact Factor
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ABSTRACT: Two white men 57 and 39 years old, and a 47-year-old white woman were seen with slowly developing papulo-nodular lesions of the areola-nipple complex. None of the patients presented with regional lymphadenopathy, history of trauma, or relevant sun-exposure. After excison of the mass, the histologic diagnosis of basal cell carcinoma was made. At two years of follow-up, no recurrence was evident. The low incidence of basal cell carcinoma in this particular site allows us to consider the areola-nipple complex location as unusual. Moreover, literature reports do not suggest that these BCCs have an increased potential for malignancy. The treatment options depend on the extension of the tumor and on the possible involvement of the areola-nipple complex and mammary tissue.
The Journal of Dermatology 12/2003; 30(11):822-6. · 1.49 Impact Factor
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ABSTRACT: We report a case of malakoplakia involving the pancreas in a 74-year-old man with associated regional lymphoadenopathy. Histological examination of both pancreas and lymph nodes revealed a diffuse histiocytic infiltrate containing numerous Michaelis-Gutmann bodies. Electron microscopy supported the diagnosis of malakoplakia and showed bacterial-like structures. Differential diagnosis includes myofibroblastic inflammatory tumor and histiocytic neoplasms. Lymph-node involvement during malakoplakia is extremely rare and it has never been documented microscopically. Lymphohematogenous spread of bacteria may be the cause of the nodal involvement, which, however, does not appear to influence the clinical course of the disease.
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 02/2003; 442(1):82-5. · 2.49 Impact Factor
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ABSTRACT: Die Tumoren des Haarkeims sind eine Gruppe von Hauttumoren, in denen man teilweise oder vollständig den Entstehungsprozeß
des Haarfollikels beobachten kann. Das Trichoblastom stellt das benigne, epitheliale Extrem des Spektrums dar. Wir berichten
von einem Fall einer 32jährigen Frau mit adenozystischem Trichoblastom als auschließlich adenoid-zystisch aufgebauter Läsion,
einer in der Literatur sehr selten beschriebenen Variante. Außerdem wird ein geschichtlicher Überblick über die Tumore des
Haarfollikels und die damit verbundenen Probleme ihrer Klassifikation gegeben.
In hair germ tumors, hair follicle development is partially or completely recapitulated. The trichoblastoma represents a purely
epithelial tumour within this group of tumours. We identified a trichoblastoma showing exclusively adenocystic features in
a 32 years old woman. This variant has been very rarely described in the literature. We review the history of hair germ tumors
and discuss the problems of their classification.
Der Hautarzt 05/1997; 48(6):417-419. · 0.58 Impact Factor
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European journal of dermatology: EJD 20(5):656-7. · 2.53 Impact Factor
