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T Cutilli

Publications and source records attributed to T Cutilli.

18 recordsLinked to original sources
PubMed1998

p53 tumor suppressor protein and H-RAS oncogene in maxillofacial tumors: immunohistochemical and genetic investigation, induction chemotherapy response and prognosis evaluation.

The authors carried out immunohistochemical and genetic research on the tumor suppressor protein p53 and H-RAS oncogene in oromaxillofacial neoplasms. The purpose was to verify, genetically, the presence of correlations between the degree of histopathological overexpression (per cent) of oncogenes and chemoresistance. The study was carried out on 15 patients with squamous cell carcinoma of the oromaxillofacial region, of equal histopathological grade (G2), who underwent neoadjuvant chemotherapy: cis-diaminodichloroplatinum (CDDP, 20 mg/m2 i.v. days 1-5) and 5-fluorouracil (5-FU 1000 mg/m2 continuous infusion, volumetric pump 2 ml/h, for 5 days). Restaging was carried out after three cycles of chemotherapy to evaluate clinical response. The p53 immunohistochemical study (clone DO-7) showed a pathological overexpression in 9/15 cases; whereas the genetic exam (PCR method, wild DNA) showed mutations in 5/15 cases, with individual corresponding percentages of 95%, 80%, 70%, 45% and 95%. The H-RAS immunohistochemical study (AB-1) (clone 235-1.7.1) showed a pathological overexpression in 12/15 cases; the genetic exam showed mutations in 9/15 cases, corresponding to, respectively, 90%, 35%, 10%, 20%, 77%, 90%, 85%, 25%, 75%. The response to the neoadjuvant chemotherapy was as follows: 2 partial responses (PR) (90%) in 1 tumor of the cheek and in 1 tumor of the soft palate, with global survival (GS) of, respectively, 18 and 15 months. 1 PR (75%) and 4 PR (55%) in 5 tumors of the gum, with GS of, respectively, 10, 6, 8 , 9 and 8 months. Two objective improvements (OI) in, respectively, 1 tumor of the floor of the mouth and 1 tumor of the gum, with GS of, respectively, 5 and 6 months. Three patients had stable disease (S) in 2 tumors of the tongue and 1 tumor of the gum, with GS of, respectively, 10, 7 and 7 months. Three patients had progression (P) in 2 tumors of the floor of the mouth and in 1 tumor of the cheek, with GS of, respectively, 8, 8 and 6 months. This study showed some correlation between genetic analysis and immunohistochemical investigation of 73.3% of cases for p53 and of 80% of cases for H-RAS (Chi-Square Test: p=0.3089). These data do not permit definition of the range of oncogene overexpression which corresponds to mutation, thus serving as a marker of chemoresistance. However, the cases studied confirm that, in regard to p53, there is a certain degree of correlation between absence of mutations and sensitivity to neoadjuvant chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

[p53 mutation and chemoresistance in oral-maxillofacial squamous cell carcinoma. Role of p53 in the cell cycle control and in the modulating action of chemotherapeutic agents].

p53 is a "tumor suppressor gene" with a basic function in the cellular cycle control and subsequently in the induction of the neoplastic process. p53 found changed in the majority of malignant human tumors. In the oral and maxillofacial cancers p53 mutations varies from 4% to 60% of the cases. Researches in vitro in tumors of the colon-rectum, breast, lung, ovary, testicle, bladder and in leukaemia, show a correlation between p53 overexpression (mutation) and resistance to the anti-tumor agents. The functional connection between the p53 and the chemotherapic drugs action which cause a direct DNA damage, is the apoptosis, a physiologic mechanism activated by p53 for regulating cell growth but also indispensable for the cytotoxic effects (apoptosis is an irreversible process culminating in cell death). Loss of the p53 activity (mutation) in the tumoral cells determines non-activation of the apoptosis and the drug resistance. These results have led to early clinical applications. In the breast cancers the p53 is already utilized as chemoresistance marker, directing the therapy, if changed to alternative drugs (Taxolo) which have a p53-independent action. Even into cell lung cancers a retroviral vector containing the wild-type p53 gene was produced to mediate transfer of wild-type p53, noting tumor regression. In oral and maxillofacial tumors surgery is elective. It is emphasized that, in advanced cancers, it is included in multimode protocols where the neoadjuvant chemotherapy has an important clinical function, with precise indications. The possibility to determine previously the p53 "status" in the cancer cells by genetic study, may give a specific factor of screening, indicative of the tumor chemoresponse, together with other well-known prognostic factors, with advantage for the therapeutic programming and especially for the known surgical treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Unicentric angiofollicular hyperplasia (Castleman's disease) of the parotid: a case report.

Angiofollicular lymph node hyperplasia, or Castleman's disease, is a condition of uncertain cause usually presenting with mediastinal lymphadenopathy. Occasionally other lymph node groups may be involved with or without associated systemic manifestations. A case of Castleman's disease involving parotid lymph nodes is reported in a 16-year-old female patient who presented with a painless swelling that initially was noticed at the age of 3 years. Diagnosis was established by histopathologic examination of the respected specimen. Histologic and clinical features of Castleman's disease are also discussed.

Adolescent↗
PubMed1989

[Dismorphism. Long face syndrome. Diagnostic and therapeutic considerations].

The Authors consider the main clinical aspects that characterize the Long Face Syndrome. In the more serious cases, where it is the global presence of the several elements which concur to the increase of the vertical facial dimension, it is suitable a precise diagnostic checking to the three-dimensional surgical correction to realize in one time. The Authors, in the treated cases, emphasize, on the one hand, besides the traditional cephalometry, the importance of the counter-party analysis of Enlow and, on the other, they emphasize the use of the present imaging means like CT and MR to the structural evaluation of the dysmorphism in the muscular and skeletal components. From the surgical aspect the Authors emphasize the favourable results obtained associating the surgical expansion of the upper maxilla with autogenous osseous graft to the traditional maxillary osteotomies, that favours: 1) the increase of the transverse diameter, to the orthognatodontic correction of the crossbite; 2) the correction of the nasal respiratory insufficiency; 3) the precise definition and the correction of the vertical dimension of the upper maxilla.

Adolescent↗
PubMed1988

[Role of magnetic resonance in the radiologic diagnosis of parotid pathology].

MRI findings in 13 patients with monolateral parotid tumor were compared with US, sialographic and CT findings. MRI did not allow an accurate diagnosis in 2 patients with diffuse chronic parotitis. MRI was superior to CT in 1 case in defining the intraglandular site of the lesion, and in 2 patients in showing the extraglandular involvement. MRI proved to be superior to CT thanks to its contrast resolution and to multiplanar imaging. MRI high contrast resolution made it possible to demonstrate neoplastic lesions of 4 mm in diameter. The lesion has low signal intensity on T1-weighted images and high signal intensity on T2-weighted. Parotid tumors cannot be characterized by signal intensity alone: only morphology allows to discriminate between benign and malignant lesions. To conclude, US is a screening method, while MRI is helpful in detecting multifocal lesions and in evaluating the tumor extent.

Adenoma↗
PubMedDate not supplied

Giant cervico-mediastinal lipoma. A clinical case.

The lipoma is a circumscribed mesenchymal tumour originating from adipose tissue. The lesion is usually small and asymptomatic, and is most frequently located in the neck region. The case of a 77-year-old woman with chronic extrasystolic arrhythmia caused by a non-specified ischemic cardiopathy is reported. The woman presented a swelling at the front of her neck, observed for the first time about 6 months previously. This swelling progressively increased in size, provoking dysphagia, dysphonia, persistent cough, dyspnea, light jugular turgor and palpitations. Chest X-rays showed and opaque area at the front of the neck, which extended beyond the jugular incisure by about 2 cm. NMR of the neck showed a gross lipomatous formation at the front, mainly of the left, continuing in the front mediastinal region; the trachea was dislocated to the right and compressed at the back; the vasculo-nervous fasciculus, especially on the left, was compressed and enveloped by the adipose formation. The Holter test confirmed the presence of ventricular and supra-ventricular extrasystoles. Surgery was carried out under local anaesthesia because the displacement of the laryngo-tracheal axes precluded intubation. Histological analysis of the 9 x 4 x 2.2 cm mass confirmed the diagnosis of lipoma. After removal of the mass all the symptoms, which had been provoked by compression, as well as the cardiac arrhythmias disappeared. The prompt disappearance of the latter was particularly surprising. The possibility of the external compression of the nervous structures of the neck should be taken into consideration in cases of ventricular arrhythmia of unknown origin, and systematic study of the region carried out.

Aged↗
PubMedDate not supplied

[Symptomatic and surgical results after integrated CT-MR study of a central giant cell tumor of the maxilla].

The AA. examine the possibilities of the present imaging to the diagnostic definition of the extensive and destructive forms of the Central Giant cells Tumor of the maxilla. The CT and MR studies are compared with conventional x-Ray. The analysis performed evinces, besides the well-known semeiological CT superiority for the evidence of the osseous erosions, the ability to follow by MR imaging the evolution of the tumor, in the its relationships with the fascial, muscular, adipose and fibromucous soft tissues, when it exceeds the osseous barrier of the maxillofacial skeleton, enclosed therein the palatal plane.

Adolescent↗
PubMedDate not supplied

[Role of NMR in staging and treatment of extensive myxoma of the upper jaw].

The diagnostical possibilities of the RM in the study of the odontogenic myxoma at extensive diffusion in the upper maxilla are examined. Owing to its complexity and to close connections with the surrounding soft tissues, the midfacial region makes the conventional means of imaging difficult and inadequate. Really the tumor have very high local aggressivity. Where it is much bulky, invades diffusely the cavitary components, damages their walls with laminar structure, insinuates itself among the soft tissues of the jugal, pterygo-maxillary and infraorbital regions, taking up gorges where it slips the classical clinical an also the conventional instrumental diagnostics. The AA. have verified the utility of the MR imaging to the definition of the limits of the tumor, which makes the surgery more adequate to the necessities of an oncological treatment tending both to the radicality and to conservation of structures with high morphological and functional complexity.

Adult↗
PubMedDate not supplied

[Role of magnetic resonance in the staging and post-chemotherapeutic follow-up of malignant maxillo-facial tumors].

Ten patients with squamous cell carcinomas located in the maxillo-facial region were studied. In all cases the staging by Computed Tomography (CT) and Magnetic Resonance (MRI) revealed metastatic lesions in stage T3-T4. All patients underwent polichemotherapy before surgery. MRI proved to be more accurate in the staging of tumors in 3 cases only, while in 7 cases both techniques showed the same diagnostic accuracy. In the follow-up, MRI allowed the evaluation of the effect of chemotherapy on the carcinomas: it demonstrated the regression and necrosis of 9 tumors out of 10 (the patients could undergo surgery), and the progression of the tumor in 1 case. The study of bioptic specimens demonstrated the lack of correlation between histological grading of the tumors with MRI signal intensity and T1, T2 relaxation time, as measured by spectroscopy.

Aged↗
PubMedDate not supplied

[p53 mutations and chemoresistance in oromaxillofacial squamous-cell carcinomas. The results of a molecular genetics study of p53 in metastatic oromaxillofacial tumors and an evaluation of the response to neoadjuvant chemotherapeutic treatment].

MATERIAL AND METHODS: The authors carried out a p53 genetic research on native DNA in 15 oral-maxillofacial squamous cell carcinomas, lymph nodes metastasis, treated with neoadjuvant chemotherapy, checking the p53 "status" and the clinical response to the chemotherapeutic treatment (three 5-FU/CDDP cycles). RESULTS: The authors found p53 mutations in 3/15 cases. In these cases, at post-chemo restaging, it resulted 2 progressions and 1 stability of disease. In the 12 cases with wildtype p53: 4 objective improvements and partial responses (PR), respectively, of 55% (1), 60% (1), 65% (1), 70% (1), 75% (2) and 90% (2). The 15 patients were treated then by surgery and adjuvant chemotherapy (three C-F cycles). These results seem to confirm the outcome of the researches "in vitro" and they provide first correlations between p53 mutations and chemoresistance in oral squamous cell carcinomas. The survival evaluation also, in the examined cases, shows, but with medium-term follow-up, the tendency to a poor prognosis when p53 is altered. CONCLUSIONS: This research outlines the possibility, also for oral and maxillofacial tumors, to utilize, p53 as a prognostic and chemoresponse marker, useful, with the otherwise well-known prognostic factors, for the evaluation of advanced cancers, in the interests of a more suitable therapeutic protocol.

Aged↗