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L Califano

Publications and source records attributed to L Califano.

At least 37 records · Page 2Linked to original sources
PubMed1999

Surgical management of the neck in squamous cell carcinoma of the tongue.

If the nodes are involved, survival of patients with squamous cell carcinoma of the tongue is considerably reduced. Surgery remains the treatment of choice and, to define its role, we have reviewed 82 consecutive cases. Sixty-two cases (76%) were T1-2, and 46 patients (56%) had involved nodes. The cervical region II was the most often involved (n=26). Occult nodal metastases were present in 12 cases. The extent of nodal spread and prognosis varies according to whether the body or the base of the tongue is involved. Lesions of the base with involved node should be treated by a selective posterolateral neck dissection, whilst in the case of a lesion of the body of the tongue, the dissection should be selective anterolateral. In lesions of the base, when there are no nodes involved, a prophylactic selective posterolateral neck dissection is recommended, whilst in the case of the lesions of the body, selective supraomohyoid neck dissection in T2-4 lesions is recommended.

Adult↗
PubMed1999

Neuroendocrine (Merkel cell) carcinoma of the oral mucosa: report of a case with immunohistochemical study and review of the literature.

Merkel cell carcinoma (Mcc) is an uncommon and aggressive tumour with neuroendocrine features that occur predominantly in the head and neck region. The rarity of this tumour, especially when it arises in the oral mucosa, makes both early identification and standardisation of treatment difficult, particularly as regards complementary treatment. The availability of monoclonal antibodies with restricted specificity for some antigens thought to be related to neuroendocrine carcinomas, such as Merkel cell carcinoma, and ultrastructural studies offer some new leads to investigation. This has allowed, a greater number of these tumours to be discovered, thereby increasing the chances of effective management. A case of Mcc of the floor of the mouth is reported, together with the results of cytokeratin, neuron specific enolase and chromogranin immunohistochemistry.

Antibodies, Monoclonal↗
PubMed1999

[Vertical nystagmus induced by the head-shaking test: 10 cases].

In cases of central and/or peripheral vestibular system asymmetry, Head-Shaking test-induced Nystagmus (H.S.-Ny) can appear after a cycle of 20 horizontal head oscillations. Four types of H.S.-Ny have been described, all of which are horizontal: 1) deficit Ny; 2) recovery Ny; 3) biphasic Ny; 4) triphasic Ny. None of these forms are specific for any given vestibular asymmetry site, whether central or peripheral. The authors report another low vertical type of H.S.-Ny found in 13 of the 1500 cases where the test was performed. Ten of these cases are discussed here. Vertical H.S.-Ny was found in 7 cases of N.M.R.-confirmed central pathologies, in 1 case of complications from epidemic parotitis and in 2 cases for which N.M.R. did not confirm the presence of an organic pathology. Vertical H.S.-Ny was often associated with other vestibular signs (Gaze-Ny, Rebound Ny, variable direction Ny, down-beat positional Ny, labyrinthine hyper reflexia). The authors consider this form of nystagmus a simple, easily determined signal of great importance in diagnosing the presence of a central, tronco-encephalic and cerebellar pathologies.

Adult↗
PubMed1998

Skin lesions in diabetes mellitus: prevalence and clinical correlations.

With the aim to assess the prevalence and the main clinical correlations of skin lesions in diabetes mellitus, 457 diabetic subjects consecutively attending an outpatient clinic underwent a dermatological examination. Neurovascular foot lesions were excluded. Thirty-five of 64 IDDM patients (54%) had skin alterations mainly consisting of vitiligo (9% of all patients), psoriasis (9%) and eczema (8%). The most frequent skin lesions observed in 240/393 NIDDM subjects (61%) were represented by infections (20% of all patients) and diabetic dermopathy (12.5%), while other lesions were not common. NIDDM patients with skin infections had a worse metabolic control, and those with diabetic dermopathy had a greater prevalence of neuropathy and large vessel disease than patients without skin lesions. These data show that the prevalence of skin diseases in a large, unselected diabetic population is higher than expected and indicate that, in most cases, a careful dermatological examination and a better metabolic control are needed in order to improve quality of life in these patients.

Adolescent↗
PubMed1998

Perineural invasion of the lower alveolar nerve by oral cancer: a follow-up study of 12 cases.

Twelve previously untreated cases of oral cancer with perineural infiltration were studied retrospectively. Age, sex, site, clinical stage and outcome were evaluated. Management of the neoplasm in each case involved surgical removal and six patients required adjuvant radiotherapy. The most frequent site was the lip. At the time of diagnosis, five patients had sensory complaints and palpable lymphadenopathy was observed in three patients. The 5-year crude survival rate was 16.7%. In the cases with postoperative assessment of perineural infiltration, a median survival time of 30.8 months was observed; while in the case of preoperative assessment of nerve infiltration, extensive surgery was performed with a consequent median survival time of 44.5 months. The perineural infiltration of the lower alveolar nerve is more common (6.3%) than is generally thought. This frequency is due to the relationship with the lower lip and the mandibular region. In carcinoma of the lip, spread is generally limited to 10-15 mm along the lower alveolar nerve. In carcinoma of the mandibular region, spread is entirely dependent on the location of the tumour; the absence of clinical fixation to the bone and the small size of the carcinoma does not preclude the possibility of bone involvement. Neurological symptoms should be evaluated carefully, and a radiographic investigation of the nerve canal is mandatory.

Adult↗
PubMed1998

Surgical management of the neck in squamous cell carcinoma of the floor of the mouth.

Nodal involvement in squamous cell carcinoma considerably lowers survival rate. Despite its importance, neck management has still not been adequately explored. The Authors have retrospectively reviewed the records of 112 cases. Unilateral N+ were treated with a homolateral therapeutic and a controlateral prophylactic neck dissection; bilateral N+ were treated with a bilateral therapeutic neck dissection. On first observation the majority of cases (66.1%) were T1-2, N+ patients accounted for 45.5%. Among N- patients, 21.3% of occult nodal metastases were observed. The 5-year survival rate was 52.7%. With N+ lesions, a radical neck dissection should be performed; the dissection should be performed bilaterally. With N- lesions a prophylactic modified radical neck dissection is recommended in T2-4 lesions.

Adult↗
PubMed1997

Accuracy of fine needle aspiration biopsy in head and neck tumors.

PURPOSE: Fine-needle aspiration biopsy (FNAB) is frequently used in the diagnosis of lesions occurring in the head and neck region. This study evaluated the correlation between the findings on FNAB and the histological findings observed after surgery. MATERIALS AND METHODS: A review of 218 patients who underwent FNAB of a head or neck tumor was performed. Cytological reports were classified into the following diagnostic categories: negative or positive for malignant cells and unsatisfactory. False-positive, false-negative, true-positive (sensitivity), and true-negative (specificity) rates were calculated. RESULTS: Twelve specimens did not allow an adequate diagnosis (5.5%). Among benign tumors, 96.2% of the cases were correctly diagnosed, and 3.8% were nondiagnostic specimens. Among malignant tumors, 86.4% of cases were correctly identified. There were two (3.4%) false-negatives and six (10.2%) nondiagnostic specimens, with a total false-negative rate of 13.6%. CONCLUSIONS: Sampling errors present a minor problem with FNAB. Most nondiagnostic or incorrect specimens were caused by nonhomogenous lesions, with poor placement of the needle and an insufficient amount of aspirated material. FNAB is a useful modality for the diagnosis of head and neck masses.

Adenolymphoma↗
PubMed1997

Detection of latero-cervical metastases from oral cancer.

In squamous cell carcinoma of the oral cavity, the presence of nodal metastases greatly influences prognosis. The evaluation of regional lymph nodal involvement is crucial in the correct management of these neoplasms. The records of 45 patients with oral cancer were reviewed retrospectively to evaluate the accuracy and prognostic value of the techniques used to detect lymph node metastasis in the neck (clinical examination, echo-colour-Doppler, computed tomography and magnetic resonance imaging). Echo-colour-Doppler was the most accurate procedure with a predictive positive value of 95.6% and the lowest false-negative rate. Therefore, a diagnostic preoperative study must include echo-colour-Doppler preferably associated with computed tomography to achieve the greatest diagnostic accuracy.

Adult↗
PubMed1997

[Pathological fractures of the mandible caused by cancer of the oral cavity].

The pathological fracture of the mandible is a rare and undesirable consequence of cancerous bone invasion. This study investigates the retrospective incidence of this phenomenon in diagnosed cases of squamous cell carcinoma of the mandibular region, and reviews the methods of treatment used. A total of 194 patients with squamous cell carcinoma of the mandibular region were observed. Only six cases of pathological fractures were found. The treatment was conditioned by the need to eliminate the tumor, and was carried out in different methods according to the individual cases. This study underlines the importance of both knowing various techniques and collaborating with other specialists in treating the fracture.

Adult↗
PubMed1997

Cervical metastases from pulmonary epidermoid carcinoma.

A patient with a right latero-cervical swelling of three-months history was observed. Fine needle aspiration biopsy showed the presence of metastases of epidermoid carcinoma moderately differentiated. No signs or symptoms of head and neck neoplasm were presents. After instrumental evaluation the primary neoplasm was localised at the left lung and metastases were also localised in the right submandibular gland. Although metastases from pulmonary epidermoid carcinoma are normally bloodborne, in this case lymphatic metastases involving cervical areas were present, probably secondarily the submandibular involvement.

Biopsy, Needle↗
PubMed1996

Behaviour of laminin 1 and type IV collagen in uninvolved psoriatic skin. Immunohistochemical study using confocal laser scanning microscopy.

Previous studies have demonstrated the presence in psoriatic lesions of ultrastructural and molecular alterations of the basement membrane and an altered polarized distribution of the integrins; this latter alteration has also been observed in uninvolved skin. The aim of the present study was to determine, by means of immunolocalization with monoclonal antibodies directed against laminin 1 and type IV collagen and using confocal scanning laser microscopy, whether there are also alterations of the main components of the basement membrane in uninvolved skin. The findings showed a discontinuous and fragmented staining of laminin 1 and a normal distribution of type IV collagen. Taking into account both these results and the results of studies on epithelial cell lines, the authors hypothesize the existence of a functional deficit in psoriatic keratinocytes affecting the synthesis of the alpha 1 subunit of laminin. This deficit would explain: (1) the incapacity to produce mature trimeric laminin; (2) the altered assembly into a distinct basal lamina; (3) the loss of keratinocyte adhesion to the basement membrane; (4) alterations in the polarized distribution of the integrins; and (5) the consequent total or partial block of the cell signals regulating the processes of cytomorphosis. Already present in uninvolved skin, and enhanced by various irritative stimuli, this situation could be decisive for the appearance of psoriatic lesions.

Adolescent↗
PubMed1996

Peripheral ameloblastoma: report of a case with malignant aspect.

Peripheral ameloblastoma is a very rare tumour with histological characteristics similar to those of the centrally located ameloblastoma. It appears in the gum and in the alveolar process of the jaws. We report a case of tumour of the left maxillary region, near the canine area. Histologically it presented itself with follicles and nests of cells with a trabecular architectural pattern. High mitotic index and clear images of perineural infiltration were present. The diagnosis was peripheral ameloblastoma with malignant aspects. At 12-month follow-up no local recurrence was noted.

Ameloblastoma↗
PubMed1996

Accuracy in the diagnosis of mandibular involvement by oral cancer.

Cancer of the mandibular region usually has a poor prognosis; this is particularly correlated to invasion of the mandible. To reduce the consequences of poor therapeutic planning, careful preoperative assessment of bone infiltration is necessary. We have examined the records of 50 patients evaluated by clinical examination, conventional radiography, computed tomography (CT), bone scintigraphy with 99mTc and magnetic resonance imaging (MRI). The highest sensitivity (100%) was attained by scintigraphy; the highest values of specificity (96.3%) were reached by CT scan and MRI. A CT scan showed the highest predictive positive value (95.4%) and efficiency (94%), this plus MRI have good values and the associated sensitivity and efficiency are higher than when these techniques are used alone.

Adult↗