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Daniela Massi

Publications and source records attributed to Daniela Massi.

At least 37 records · Page 2Linked to original sources
PubMed2005

Ungual basal cell carcinoma on the fifth toe mimicking chronic dermatitis: case study.

BACKGROUND: The finger, toe, and nail unit are rare sites of basal cell carcinoma (BCC). Only a few patients with BCC of the foot have been described in the world literature, and ungual BCC is even less frequent. OBJECTIVE: To discuss through a case report the clinical features and diagnosis of BCC of the foot. METHODS: We report an unusual case of BCC of the nail unit of the fifth toe of an elderly woman that mimicked chronic dermatitis. CONCLUSION: Our case clearly highlights the need for biopsy and histopathologic examination whenever we see inflammatory lesions with a loss of substance that are refractory to systemic or topical treatments.

Aged↗
PubMed2004

Tumor lymphangiogenesis in head and neck squamous cell carcinoma: a morphometric study with clinical correlations.

BACKGROUND: Tumor metastasis to regional lymph nodes via the lymphatic system represents the first step of dissemination in head and neck squamous cell carcinoma (HNSCC) and serves as a major prognostic indicator for disease progression and as a guide for therapeutic strategies. In the current study, the authors investigated whether tumor lymphangiogenesis may be related to the risk of lymph node metastasis and to clinical outcome in patients with HNSCC. METHODS: Immunostaining for the lymphatic marker D2-40 was used, and lymphangiogenesis was quantified within the tumor and in the peritumoral area in 52 HNSCC specimens using computer-assisted morphometric analysis. RESULTS: Lymphatic vessels were found to be significantly more numerous and larger in the peritumoral area compared with within the tumor, and the number and relative area of intratumoral and peritumoral lymphatics was significantly higher in HNSCC cases with lymph node metastasis. Multivariate analysis demonstrated that high peritumoral lymphangiogenesis (above the median value) was associated with an increased risk of developing lymph node metastasis. No correlation was found between tumor lymphangiogenesis and the disease-free or overall survival in the current series. CONCLUSIONS: The results indicate that peritumoral lymphangiogenesis may be an indicator of the risk of lymph node metastasis in patients with HNSCC.

Aged↗
PubMed2004

Vasculogenic mimicry has no prognostic significance in pT3 and pT4 cutaneous melanoma.

The concept of vasculogenic mimicry has been introduced to define periodic acid-Schiff (PAS)-positive channels and loops lined by tumor cells, instead of endothelium, able to contribute to microcirculation in uveal melanomas. Previous studies have shown that the PAS-positive patterns are associated with a poor prognosis in uveal melanoma. The aim of the current study was to investigate whether vasculogenic mimicry has a prognostic impact in pT3 and pT4 cutaneous melanoma. Fifteen patients with pT3 and pT4 cutaneous melanoma who did not experience progression after 10 years of follow-up and 30 matched controls who underwent progression were selected. Tumor sections were stained with PAS reaction, omitting the nuclear counterstaining. For immunohistochemistry, sections were stained with CD31, CD105 (endoglin), and laminin. Differences in the distribution of the PAS-positive patterns and a series of clinicopathological variables were evaluated by the Pearson chi(2) and Mann-Whitney U tests. We observed PAS-positive linear sheets, arcs, elliptical loops, and networks encircling roundish to oval aggregates of melanoma cells. The overall distribution of the PAS-positive patterns did not match with the blood microvessels' architecture as detected by immunohistochemical analysis. No statistically significant differences in the distribution of PAS-positive patterns were found between cases and controls. The presence of a parallel pattern correlated significantly with thickness (P = 0.04), whereas an inverse correlation was found with vessel area (P = 0.05). In conclusion, our results suggest that there is a mismatch between vasculogenic mimicry and tumor angiogenesis and do not support any prognostic role of vasculogenic mimicry in thick cutaneous melanoma.

Adult↗
PubMed2004

Atypical CD30+ cutaneous lymphoid proliferation in a patient with tuberculosis infection.

We describe the case of a 65-year-old woman affected by a diffuse lymphadenopathy consistent with tuberculous infection who developed a papular eruption on the head and neck region. Histopathologic examination of one papule showed an atypical CD30+ lymphoid infiltrate, which initially was cause of concern for the pathologists but was eventually regarded as reactive in nature. The case reported herein enlarges the spectrum of inflammatory infiltrates in which atypical CD30+ cells may be found. Since the reactive atypical CD30+ cells are morphologically similar to those cells observed in CD30+ lymphoproliferative disorders, including lymphomatoid papulosis, complete clinical history and laboratory findings are necessary to make the final and correct diagnosis. Although the pathogenetic relevance of the presence of CD30+ cells within the cutaneous infiltrate of patients with systemic tuberculosis remains to be determined, our findings support the hypothesis that the cytokine profile associated with tuberculosis may not be strictly TH1-like, and that a TH1-like to TH2-like switch may also occur.

Aged↗
PubMed2004

Eruptive multiple blue nevi of the penis: a clinical dermoscopic pathologic case study.

Multiple blue nevi have rarely been reported, and the majority of the lesions are located on the trunk and lower extremities. The blue nevus is a rare lesion on genital mucosa and may cause confusion in differential diagnosis with other pigmented lesions such as genital melanocytic macules, lentigo simplex, and malignant melanoma. Here, we describe an unusual patient who presented with a sudden onset in adulthood of multiple blue nevi on the glans penis. The epiluminescence examination revealed a substantially homogenous bluish pigmentation, which led us to favor a diagnosis of blue nevus, whereas not entirely excluding the possibility of a regressing melanoma or a metastatic melanoma. Because of the well-known diagnostic value of the blue hue in the diagnosis of malignancy by dermoscopy, a careful examination of these lesions should be made in order to minimize any risk of misclassification with melanoma.

Adult↗
PubMed2004

Dermoscopic features of combined melanocytic nevi.

In order to investigate the possible role of dermoscopy in the non-invasive classification of combined nevi, we analyzed dermoscopic features of a series of combined nevi consecutively excised. Two dermatologists expert in dermoscopy retrospectively evaluated all images based on the presence of dermoscopic findings to analyze which epiluminescence microscopy features were more frequently associated with each type of combined nevus. Dermoscopy may provide useful information in the non-invasive diagnosis of combined nevi, allowing a conservative management, but this may be limited to combined nevi including a blue nevus component. Conversely, combined nevi including a Spitz nevus component may be difficult to classify even by dermoscopy, thus requiring careful monitoring or surgical excision.

Adolescent↗
PubMed2004

Insight into the pathogenesis of sporadic basal cell carcinoma.

Sporadic basal cell carcinoma (BCC) is the commonest human cancer. Although its aggressiveness is low and metastatic potential negligible, the increasing incidence of the tumor in the Western world drives attention to its pathogenesis. In 1996, germ-line mutations in the patched receptor of the Sonic hedgehog (Shh) signaling pathway were described in the Gorlin-Goltz syndrome in association with multiple nevoid BCCs. Later, the aberrant activation of the Shh was identified in sporadic BCCs as well. Recently, the role of other tumor suppressors and DNA repair gene mutations and their relationship with UV radiation-induced DNA damage have been elucidated.

Basal Cell Carcinoma↗
PubMed2004

Pigmented Bowen's disease mimicking cutaneous melanoma: clinical and dermoscopic aspects.

BACKGROUND: Pigmented Bowen's disease (BD) (squamous cell carcinoma in situ) has been rarely described among white patients. OBJECTIVE AND METHODS: We report the case of a 48-year-old white male presenting a lesion of pigmented BD on his left thigh, clinically mimicking a superficial spreading melanoma. RESULTS: Naked-eye physical examination revealed a single 1.8 x 1.5 cm, hyperpigmented plaque with a rough surface, which appeared irregularly shaped and sharply demarcated. The assessment of this uncommon tumor by means of dermoscopy, never reported in literature before, was performed. According to standardized terminology, none among the well-established dermoscopic criteria useful to discriminate between melanocytic and nonmelanocytic origin was detected within the lesion. A reticular pigmentation simulated remnants of atypical pigment network, being of uncertain diagnostic value in the preoperative classification of the lesion. Other recognized patterns were irregular, brown globular structures and wide regression-like areas. None of the features diagnostic for pigmented basal cell carcinoma was found as well. CONCLUSION: The correct classification of nonmelanocytic origin of the lesion was therefore achieved only at histologic examination, after the complete surgical excision. In spite of its rarity, pigmented BD should be included among those lesions, which may simulate cutaneous melanoma. According to criteria validated by literature, dermoscopy failed to improve a preoperative classification of this peculiar skin tumor.

Bowen's Disease↗
PubMed2004

Dermoscopic features of mucosal melanosis.

BACKGROUND: Melanosis (lentiginosis, labial melanotic macula) is a benign pigmented lesion of mucosa characterized by pigmentation of basal keratinocytes with melanocytic normal or slightly increased in number. Melanosis, particularly when occurring on genitalia, can clinically mimic mucosal melanoma thus creating concern in both the patient and the physician. OBJECTIVE: In this study dermoscopic features from a series of clinically equivocal (n=11) or clinically typical (n=10) mucosal melanosis were analyzed. METHODS: All the women consecutively seen at the Vulva Clinic of the Department of Obstetrics and Gynecology, University of Florence, Italy, from May 1, 2002 to June 30, 2002, were examined. RESULTS: Three major dermoscopic patterns were identified: (1) a "structureless" pattern, predominantly found in clinically equivocal vulvar melanosis, with a blue hue, associated with the presence of melanophages in the upper dermis, present in the majority of these lesions; (2) a "parallel pattern," often found in clinically typical melanotyc macules of the lips and penis; and (3) a "reticular-like" pattern associated with clinically equivocal melanosis occurring at peculiar sites such as the areola (all the three cases occurred at that site) or, rarely, on the lip. CONCLUSIONS: Dermoscopy can play a role in the noninvasive classification of mucosal melanosis. The risk of misclassification with melanoma is probably dependent on dermoscopy pattern shown by the lesion. Prospective studies including early melanomas are needed to establish diagnostic performance of dermoscopy in pigmented lesions of the mucosa.

Adult↗
PubMed2003

Frequent loss of expression of the cyclin-dependent kinase inhibitor p27(Kip1) in estrogen-related Endometrial adenocarcinomas.

PURPOSE: p27(Kip1) is a member of the Cip1/Kip1 family of cyclin-dependent kinase inhibitors and is a potential tumor suppressor gene. Low levels of p27 are associated with poor prognosis in a variety of gynecological tumors, including breast, ovarian, and cervical carcinomas. The role of p27 in endometrial cancer remains controversial. EXPERIMENTAL DESIGN: In the present study, p27 protein expression was investigated by immunohistochemistry in a series of 217 endometrial adenocarcinomas and, where present, in synchronous normal endometrium, simple and complex hyperplasia (with or without atypia), and cystic atrophy. The relationship between p27 expression and clinical outcome was also evaluated. RESULTS: Immunohistochemical analysis revealed a significant loss of p27 expression from normal (33%) through hyperplastic endometrium (50%) to endometrial adenocarcinomas (71%; P </= 0.001). In addition to nuclear staining, cytoplasmic localization of p27 was noted in 193 (91%) of 217 specimens examined. When the clinical outcome of the patients was evaluated in relation to p27 status, we found no significant correlation between the presence of p27 staining and clinicopathological parameters or survival. CONCLUSIONS: These data indicate that p27 expression could progressively decrease from normal endometrium through hyperplastic endometrium to invasive endometrial carcinomas, suggesting that loss of this tumor suppressor may represent a novel and distinct molecular alteration involved in estrogen-related endometrial adenocarcinomas (type I). Despite the suggested role of the p27 protein in determining the prognosis of several human tumors, it was not found to be a predictor of clinical outcome in this large group of patients with endometrial cancer.

Adenocarcinoma↗
PubMed2003

Cytotoxic/natural killer cell cutaneous lymphomas. Report of EORTC Cutaneous Lymphoma Task Force Workshop.

BACKGROUND: Cutaneous lymphomas expressing a cytotoxic or natural killer (NK) cell phenotype represent a group of lymphoproliferative disorders for which there is currently much confusion and little consensus regarding the best nomenclature and classification. METHODS: This study analyzes 48 cases of primary cutaneous lymphoma expressing cytotoxic proteins and/or the NK cell marker, CD56. These cases were collected for a workshop of the European Organization for Research and Treatment of Cancer Cutaneous Lymphoma Task Force, to better clarify the clinical, morphologic, and phenotypic features of these uncommon tumors. RESULTS: Several categories with different clinical and pathologic features were delineated: 1) aggressive, CD8+, epidermotropic, cytotoxic T-cell lymphoma; 2) mycosis fungoides, cytotoxic immunophenotype variant; 3) subcutaneous panniculitis-like T-cell lymphoma; 4) NK/T-cell lymphoma, nasal type; 5) CD4+, NK cell lymphoma; 6) blastoid NK cell lymphoma; (7) intravascular NK-like lymphoma; and 8) cytotoxic, peripheral T-cell lymphoma. CONCLUSIONS: Our data show that primary cutaneous cytotoxic/NK cell lymphomas include distinct groups of diseases, clinically, histologically, and biologically. Because the finding of a cytotoxic phenotype often has prognostic significance, the routine use of cytotoxic markers in the diagnosis and classification of cutaneous lymphomas should be expanded.

CD4-Positive T-Lymphocytes↗
PubMed2003

Paraganglioma of the nasal cavity: a case report.

We describe the case of a 72-year-old woman presenting with a 1-year history of recurrent epistaxis and unilateral progressive nasal obstruction with associated rhinolalia resulting from the presence of a tumor mass occupying two-thirds of the right nasal cavity. Histopathologically, neoplastic cells or "chief cells" were arranged in well-defined nests, which had the classic alveolar or so-called "zellballen" pattern. Immunohistochemical studies highlighted the presence of S-100 protein-positive sustentacular cells located at the periphery of the clusters of chief cells. The chief cells showed a diffuse and intense positivity for neuron-specific enolase and synaptophysin. A diagnosis of paraganglioma was made. The lesion was excised completely and the patient did not develop recurrences or distant metastases after 8 months of follow-up. Paragangliomas arising in the nasal cavity and paranasal sinuses are extremely rare tumors. We report on the clinical, histopathological and immunohistochemical findings of our case and review the cases previously described in the literature.

Aged↗
PubMed2003

Sebaceous carcinoma arising from nevus sebaceus: a case report.

BACKGROUND: Sebaceous carcinoma (SC) is a rare, aggressive, malignant tumor that is derived from adnexal epithelium of sebaceous glands that are distributed mostly in the skin of the head, neck, and hair-bearing regions of the body. OBJECTIVE: To discuss the clinical and histologic features and the prognosis of the extraocular SC. METHOD: We report a case of SCs of the scalp arising from a previous lesion clinically compatible with a nevus sebaceous. The lesion was surgically excised completely. RESULTS: The postoperative course was free of complications, and the patient was clinically free of disease at her recent follow-up 2 years after treatment. CONCLUSIONS: The absence of metastasis or cutaneous recurrence in our patient, notwithstanding the size of the lesion and its late removal, almost 25 years after the first signs of its growth, confirms a much improved prognostic behavior for extraocular SCs.

Aged↗
PubMed2003

Immediate local and regional recurrence after the excision of a polypoid melanoma: tumor dormancy or tumor activation?

Recurrent melanoma occurs in approximately one third of the patients who are treated for cutaneous melanoma. Although the majority of recurrences occur within the first few years of primary therapy, a significant number remain at risk beyond 10 years. Tumor dormancy provides the conceptual framework to explain a prolonged quiescent state in which tumor cells are present, but tumor progression is not clinically apparent. Surgery, or other perturbing factors, might modulate the transition of dormant cancer cells to rapidly growing ones. These may be due to a perturbation of the mechanisms of tumor regulation such as local immunity or angiogenesis. Here, the case of a woman is discussed in whom the surgical removal of a polypoid melanoma was followed, in less than a month, by local recurrence and locoregional lymph nodal metastases, which were previously clinically absent.

Aged↗
PubMed2003

Blue hue in the dermoscopy setting: homogeneous blue pigmentation, gray-blue area, and/or whitish blue veil?

In dermoscopy, the correct recognition of the single parameters is fundamental to achieve great diagnostic accuracy, but the scarce morphologic expression of a parameter may lead to diagnostic errors. We report the case of a 27-year-old white man presenting a pigmented lesion of the back, which was present since puberty. Clinical examination revealed on the back the presence of a flat, gray-blue lesion and at the periphery a small dark-brown papule. An assessment of the lesion by means of dermoscopy was performed. The purpose of this report was to analyze the Blue Hue in dermoscopy with its histopathologic correlates, starting with the discussion of a clinical case.

Adult↗
PubMed2003

Expression and prognostic significance of matrix metalloproteinases and their tissue inhibitors in primary neuroendocrine carcinoma of the skin.

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) have been implicated in the development and progression of many tumors, but data for primary neuroendocrine carcinoma (PNC) of the skin are lacking. The aim of the study was to assess the expression of MMPs and TIMPs in PNC and to evaluate their prognostic significance. Expression of MMP-1, MMP-2, MMP-3, MMP-9, MMP-11, MMP-13, and MMP-14 and TIMP-1, TIMP-2, and TIMP-3 was evaluated by immunohistochemistry on 23 samples of PNC of the skin. The results were matched with clinical features and patient survival. In the 23 specimens of PNC, high (>20% of positive neoplastic cells) MMP-1 expression was found in 13 (56.5%) cases. MMP-2 was evidenced in 12 (52.1%) cases, 8 (34.7%) of which showed high expression in neoplastic cells. MMP-3 was detected in 11 cases (47.8%), with high expression in 9 (39.1%) of them. High MMP-9 expression was observed in 3 (13%) cases, whereas high MMP-14 expression was detected in 11 (47.8%) specimens. Expression of TIMP-1 by neoplastic cells was found in 8 (34.7%) cases, with high expression in 3 cases, whereas high TIMP-3 expression was detected in 21 (91.3%) cases. No immunoreactivity for MMP-11, MMP-13, or TIMP-2 was found. Statistical analysis failed to identify a significant correlation between MMP/TIMP expression and clinical parameters. By univariate analysis, stage >I (P = 0.01), high expression of MMP-1 (P = 0.04) and MMP-3 (P = 0.01) resulted significant negative prognostic factors, whereas by multivariate analysis, stage was the only factor that affected survival (P = 0.02). Our results suggest that MMP-1 and MMP-3 may influence the invasive and metastatic potential of PNCs. It is conceivable that future attempts to specifically block MMP-1 and MMP-3 activity may provide a novel means to inhibit invasiveness and distant spread in selected patients with PNC.

Aged↗