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Article ; Online: A peculiar case of Paget's disease of the breast.

Plutino, Francesca Maria / Del Medico, Pietro / Vescio, Giuseppina / Fava, Maria Giovanna

2022 Volume 11

Abstract: Mammary Paget's disease is a disorder of the nipple-areola complex of the breast that, while rare, is often associated with an underlying carcinoma. The typical aspect is usually an eczematoid change of the nipple or a red and ulcerative nipple's lesion ... ...

Abstract	Mammary Paget's disease is a disorder of the nipple-areola complex of the breast that, while rare, is often associated with an underlying carcinoma. The typical aspect is usually an eczematoid change of the nipple or a red and ulcerative nipple's lesion or erythematous and crusted lesion, with or without mass-like lesion and infiltration and inversion of the nipple. It was described at first by Sir James Paget in 1874, [1] who classified the disease in mammary and extramammary type. The mammary type (Paget' s Breast Cancer: PBC) has rare frequency. PBC occurs in 0.5-5% of all cases of breast cancer, it affects the mouth of the excretory ducts of the nipple, which is characterized by lesion of nipple's large ducts. PBC can be a superficial lesion or a nodule-tumor and it can be associated with underlying carcinoma in situ (DCIS) in more than 95% of cases, especially in postmenopausal women. In a small percentage of cases, PBC can also be associated with an invasive breast cancer. Accuracy in the diagnostic phase, in order to distinguish PBC from others diseases is paramount and histological examination of lesion's biopsy has a crucial role. Prognosis and treatment depend on the type of underlying breast cancer and are based on the stage of cancer, but more importantly, on the prompt of an adequate multidisciplinary diagnostic pathway. KEY WORDS: Histopathological Report, Oncological Outcomes Paget's Breast Cancer.
MeSH term(s)	Adenocarcinoma/pathology ; Breast Neoplasms/pathology ; Carcinoma/pathology ; Female ; Humans ; Nipples/pathology ; Paget's Disease, Mammary/diagnosis ; Paget's Disease, Mammary/pathology ; Paget's Disease, Mammary/surgery ; Prognosis
Language	English
Publishing date	2022-05-05
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article: Therapeutic Targets and Tumor Microenvironment in Colorectal Cancer.

Gallo, Gaetano / Vescio, Giuseppina / De Paola, Gilda / Sammarco, Giuseppe

Journal of clinical medicine

2021 Volume 10, Issue 11

Abstract: Colorectal cancer (CRC) is a genetically, anatomically, and transcriptionally heterogeneous disease. The prognosis for a CRC patient depends on the stage of the tumor at diagnosis and widely differs accordingly. The tumor microenvironment (TME) in CRC is ...

Abstract	Colorectal cancer (CRC) is a genetically, anatomically, and transcriptionally heterogeneous disease. The prognosis for a CRC patient depends on the stage of the tumor at diagnosis and widely differs accordingly. The tumor microenvironment (TME) in CRC is an important factor affecting targeted cancer therapy. The TME has a dynamic composition including various cell types, such as cancer-associated fibroblasts, tumor-associated macrophages, regulatory T cells, and myeloid-derived suppressor cells, as well as extracellular factors that surround cancer cells and have functional and structural roles under physiological and pathological conditions. Moreover, the TME can limit the efficacy of therapeutic agents through high interstitial pressure, fibrosis, and the degradation of the therapeutic agents by enzymatic activity. For this reason, the TME is a fertile ground for the discovery of new drugs. The aim of this narrative review is to present current knowledge and future perspectives regarding the TME composition based on strategies for patients with CRC.
Language	English
Publishing date	2021-05-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10112295
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Article ; Online: Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer: a case report and review of the literature.

Sena, Giuseppe / Gallo, Gaetano / Vescio, Giuseppina / Gambardella, Denise / de Franciscis, Stefano / Renne, Mariuccia

Journal of medical case reports

2020 Volume 14, Issue 1, Page(s) 67

Abstract: Background: Breast cancer is the most common cancer in women. However, in the management of breast cancer, paraneoplastic neurological syndromes represent a diagnostic and therapeutic challenge. The diagnosis of paraneoplastic neurological syndromes is ... ...

Abstract	Background: Breast cancer is the most common cancer in women. However, in the management of breast cancer, paraneoplastic neurological syndromes represent a diagnostic and therapeutic challenge. The diagnosis of paraneoplastic neurological syndromes is difficult due to the heterogeneity of symptoms, the timing of presentation, and the absence of antibodies, and it generally occurs before the diagnosis of breast cancer in 80% of patients who develop paraneoplastic neurological syndromes. We describe a 72-year-old woman with subacute ophthalmoplegia-ataxia syndrome who was subsequently diagnosed as having breast cancer and anti-Ri antibodies. Case presentation: A 72-year-old post-menopausal Caucasian woman, with a positive medical history for diabetes mellitus and hypertension, presented with a 3-month onset of blurred vision, diplopia, and progressive gait disturbance. Serological tests were positive for well-characterized onconeural antibodies (anti-Ri). A whole-body computed tomography scan revealed a nodular opacity under her left nipple and axillary adenopathy. A biopsy of her left breast was performed, and histological examination showed ductal carcinoma. She underwent a superoexternal quadrantectomy with left axillary dissection. The final diagnosis showed infiltrating ductal carcinoma of the breast (T1c N1 M0, stage IIA) associated with paraneoplastic ophthalmoplegia-ataxia syndrome. At a 6-month follow-up, she showed no clinical or instrumental evidence of neoplastic recurrence with partial clinical improvement of neurological symptoms, such as ataxia and diplopia. Conclusion: The diagnosis of paraneoplastic neurological syndromes is often late, as in this patient, but treatment at an early stage may provide a good prognosis. Furthermore, this is one of several cases of an anti-Ri paraneoplastic neurological syndrome not associated with myoclonus, which reinforces the belief that opsoclonus myoclonus syndrome is not pathognomonic of the associated anti-Ri paraneoplastic neurological syndromes.
MeSH term(s)	Aged ; Autoantibodies/blood ; Breast Neoplasms/diagnosis ; Breast Neoplasms/immunology ; Carcinoma, Ductal, Breast/diagnosis ; Carcinoma, Ductal, Breast/immunology ; Cerebellar Ataxia/immunology ; Female ; Humans ; Ophthalmoplegia/immunology ; Paraneoplastic Syndromes, Nervous System/diagnosis
Chemical Substances	Autoantibodies
Language	English
Publishing date	2020-06-12
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-020-02410-z
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Article ; Online: Mesenchymal Stromal Cell Therapy in the Management of Perianal Fistulas in Crohn's Disease: An Up-To-Date Review.

Gallo, Gaetano / Tiesi, Vincenzo / Fulginiti, Serena / De Paola, Gilda / Vescio, Giuseppina / Sammarco, Giuseppe

Medicina (Kaunas, Lithuania)

2020 Volume 56, Issue 11

Abstract: Crohn's Disease (CD) is a chronic inflammatory disorder that potentially involves the entire gastrointestinal tract. Perianal fistulizing CD (pCD) is a serious and frequent complication associated with significant morbidities and a heavy negative impact ... ...

Abstract	Crohn's Disease (CD) is a chronic inflammatory disorder that potentially involves the entire gastrointestinal tract. Perianal fistulizing CD (pCD) is a serious and frequent complication associated with significant morbidities and a heavy negative impact on quality of life. The aim of CD treatment is to induce and maintain disease remission and to promote mucosal repair. Unfortunately, even the best therapeutic regimens in pCD do not have long-term efficacy and cause a significant number of side effects. Therefore, it is mandatory to study new therapeutical options such as the use of mesenchymal stromal cells (MSCs). These cells promote tissue repair via the induction of immunomodulation. The present review aims to analyze the existing updated scientific literature on MSCs adoption in the treatment of pCD to evaluate its efficacy and safety and to compare the use of bone marrow and adipose tissue derived MSCs, type of administration, and dose required for recovery.
MeSH term(s)	Crohn Disease/complications ; Crohn Disease/therapy ; Humans ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stem Cells ; Quality of Life ; Rectal Fistula/etiology ; Rectal Fistula/surgery ; Treatment Outcome
Language	English
Publishing date	2020-10-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina56110563
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Article ; Online: Ogilvie's Syndrome following spinal surgery.

Chirchiglia, Domenico / Chirchiglia, Pasquale / Vescio, Giuseppina / Murrone, Domenico

Journal of neurosurgical sciences

2017 Volume 63, Issue 5, Page(s) 612–613

MeSH term(s)	Colonic Pseudo-Obstruction/diagnosis ; Colonic Pseudo-Obstruction/surgery ; Female ; Humans ; Middle Aged ; Neurosurgical Procedures ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Spine/surgery ; Treatment Outcome
Language	English
Publishing date	2017-10-23
Publishing country	Italy
Document type	Case Reports ; Letter
ZDB-ID	193139-8
ISSN	1827-1855 ; 0390-5616 ; 0026-4881
ISSN (online)	1827-1855
ISSN	0390-5616 ; 0026-4881
DOI	10.23736/S0390-5616.17.04218-7
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Article ; Online: The prognostic value of KRAS and BRAF in stage I-III colorectal cancer. A systematic review.

Gallo, Gaetano / Sena, Giuseppe / Vescio, Giuseppina / Papandrea, Matteo / Sacco, Rosario / Trompetto, Mario / Sammarco, Giuseppe

Annali italiani di chirurgia

2019 Volume 90, Page(s) 127–137

Abstract: Background: Colorectal cancer (CRC) is one of the leading cause of cancer deaths worldwide. The aetiology of CRC is complex and involves interaction on environmental and genetic factors. The two most important pathways are the EGFR (Epidermal Grow ... ...

Abstract	Background: Colorectal cancer (CRC) is one of the leading cause of cancer deaths worldwide. The aetiology of CRC is complex and involves interaction on environmental and genetic factors. The two most important pathways are the EGFR (Epidermal Grow Factor Receptor) signaling pathway, with the involvement of KRAS and BRAF, and the DNA mismatch repair (MMR). Generally, KRAS and BRAF mutations are mutually exclusive. They are both able to cause RAS/RAF/MAPK signaling pathway upregulation and are necessary for CRC development. BRAF mutations confers a poor prognosis in Western CRC patients, particularly in metastatic CRC (mCRC) and its mutations occur in approximately 4-20% CRC, with the vast majority being the V600E hotspot mutation. KRAS mutations are observed in 30- 40% CRC patients and act as predictive markers of resistance to epidermal growth factor receptor (EGFR)-targeted antibodies in metastatic CRC. Initial patient management is defined by TNM stage at diagnosis but in patient with stage II and III CRC, TNM staging alone does not predict outcome in CRC patients who may be eligible for adjuvant chemotherapy. Furthermore, for stage II and III, non-metastatic CRC patients, the prognostic role of BRAF and KRAS mutations is still controversial, particularly comparing microsatellite-unstable (MSI) and - stable tumors (MSS). The aim of this study was to clarify the impact of KRAS/BRAF mutations on prognosis in patients with stage I-III CRC. Materials and methods: A systematic review of literature was undertaken to evaluate the prognostic value of KRAS and BRAF mutations in stage I-III colorectal cancer. Four major databases (PUBMED, EMBASE, WEB OF SCIENCE and COCHRANE LIBRARY) were searched. Results: Ninety-two studies were identified. After screening of titles, abstract and inclusion criteria sixteen articles were included. Of the selected articles, five were prospective, ten were retrospectives studies, and one was a combined retrospective/ prospective study. Conclusion: In our opinion, a combination of molecular markers, tumor location with the other clinical-pathological variables and microsatellite status is essential to have a correct prognosis. Nevertheless, this combination could be useful as a predictive factor in stage I-III CRC. Key words: BRAF, Colorectal Cancer, KRAS, Stage I-III CRC, Translational research.
MeSH term(s)	Colorectal Neoplasms/genetics ; Colorectal Neoplasms/pathology ; Humans ; Mutation ; Neoplasm Staging ; Prognosis ; Proto-Oncogene Proteins B-raf/genetics ; Proto-Oncogene Proteins p21(ras)/genetics
Chemical Substances	KRAS protein, human ; BRAF protein, human (EC 2.7.11.1) ; Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; Proto-Oncogene Proteins p21(ras) (EC 3.6.5.2)
Language	English
Publishing date	2019-03-25
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article: Mast Cells, microRNAs and Others: The Role of Translational Research on Colorectal Cancer in the Forthcoming Era of Precision Medicine.

Sammarco, Giuseppe / Gallo, Gaetano / Vescio, Giuseppina / Picciariello, Arcangelo / De Paola, Gilda / Trompetto, Mario / Currò, Giuseppe / Ammendola, Michele

Journal of clinical medicine

2020 Volume 9, Issue 9

Abstract: Colorectal cancer (CRC) is a heterogeneous disease, molecularly and anatomically, that develops in a multi-step process requiring the accumulation of several genetic or epigenetic mutations that lead to the gradual transformation of normal mucosa into ... ...

Abstract	Colorectal cancer (CRC) is a heterogeneous disease, molecularly and anatomically, that develops in a multi-step process requiring the accumulation of several genetic or epigenetic mutations that lead to the gradual transformation of normal mucosa into cancer. In fact, tumorigenesis is extremely complex, with many immunologic and non-immunologic factors present in the tumor microenvironment that can influence tumorigenesis. In the last few years, a role for mast cells (MCs), microRNAs (miRNAs), Kirsten rat sarcoma (KRAS) and v-raf murine sarcoma viral oncogene homologue B (BRAF) in cancer development and progression has been suggested, and numerous efforts have been made to thoroughly assess their correlation with CRC to improve patient survival and quality of life. The identification of easily measurable, non-invasive and cost-effective biomarkers, the so-called "ideal biomarkers", for CRC screening and treatment remains a high priority. The aim of this review is to discuss the emerging role of mast cells (MCs), microRNAs (miRNAs), KRAS and BRAF as diagnostic and prognostic biomarkers for CRC, evaluating their influence as potential therapy targets in the forthcoming era of precision medicine.
Language	English
Publishing date	2020-09-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm9092852
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Article ; Online: Excisional Haemorrhoidectomy: Where Are We?

Sena, Giuseppe / Gallo, Gaetano / Vescio, Giuseppina / Carpino, Antonio / Diaco, Elia / Papandrea, Matteo / Trompetto, Mario / Sammarco, Giuseppe

Reviews on recent clinical trials

2020 Volume 16, Issue 1, Page(s) 54–59

Abstract: Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most frequent and ancient anorectal conditions. Bleeding, during or after defecation, is the most common symptom. The color ...

Abstract	Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most frequent and ancient anorectal conditions. Bleeding, during or after defecation, is the most common symptom. The color of the blood is typically bright red covering the outer surface of the stools. The severity of HD is based on the degree of the prolapse. There are several excisional surgery treatments. In this review, we describe the most common techniques such as Milligan and Morgan, Parks, Ferguson and Whitehead technique. Despite significant improvements in conservative treatments, excisional haemorrhoidectomy techniques are the most effective treatment for III- and IV degree.
MeSH term(s)	Hemorrhoidectomy ; Hemorrhoids/surgery ; Humans ; Treatment Outcome
Language	English
Publishing date	2020-03-18
Publishing country	United Arab Emirates
Document type	Journal Article ; Review
ZDB-ID	2251879-4
ISSN	1876-1038 ; 1574-8871
ISSN (online)	1876-1038
ISSN	1574-8871
DOI	10.2174/1574887115666200319153439
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Article ; Online: Intervertebral thoracic herniation disc presenting as acute abdomen.

Chirchiglia, Domenico / Della Torre, Attilio / Stroscio, Carmelino A / Vescio, Giuseppina / Lavano, Angelo

Journal of neurosurgical sciences

2017 Volume 62, Issue 4, Page(s) 522–523

MeSH term(s)	Abdomen, Acute/diagnosis ; Abdomen, Acute/surgery ; Humans ; Intervertebral Disc/surgery ; Intervertebral Disc Displacement/diagnosis ; Intervertebral Disc Displacement/surgery ; Male ; Middle Aged ; Thoracic Vertebrae/surgery
Language	English
Publishing date	2017-01-26
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	193139-8
ISSN	1827-1855 ; 0390-5616 ; 0026-4881
ISSN (online)	1827-1855
ISSN	0390-5616 ; 0026-4881
DOI	10.23736/S0390-5616.17.03968-6
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Article ; Online: Multivisceral resection for occlusive colorectal cancer: Is it justified?

Rizzuto, Antonia / Palaia, Ilaria / Vescio, Giuseppina / Serra, Raffaele / Malanga, Donatella / Sacco, Rosario

International journal of surgery (London, England)

2016 Volume 33 Suppl 1, Page(s) S142–7

Abstract: Background: The only possibility of curative surgery in primary T4, locally advanced, adherent colorectal carcinoma (LAACRC) or recurrent disease with infiltration of adjacent organs is the en bloc resection of the invaded structures to achieve clear ... ...

Abstract	Background: The only possibility of curative surgery in primary T4, locally advanced, adherent colorectal carcinoma (LAACRC) or recurrent disease with infiltration of adjacent organs is the en bloc resection of the invaded structures to achieve clear surgical margins (R0). The role of extended resections for occlusive LAACRC remains unclear. We report on our experience on Multivisceral resections (MVR) for LAACRC patients between 2003 and 2012. Methods: Twenty-two patients, who were treated with MVR with curative purpose for non-metastatic disease were recruited. General epidemiologic data, clinical findings, surgical treatment and/or multimodal therapy, histo-pathological examination and follow-up were collected. In addition post-operative complications were classified. Patients with occlusive LAACRC (n = 6) were compared to patients with uncomplicated presentation (n = 16) defined according to the UICC classification. Results: No statistically significant differences were observed between the two groups, in terms of median age, gender and localization of tumors. R0 resection was performed in 14 (87.5%) patients with uncomplicated tumors and in all patients with occlusive LAACRC. R1 resection was performed in 2/16 (12.5%) patients with uncomplicated disease. No peri-operative mortality was reported in patients of both groups. In the group of uncomplicated tumors, 11 patients (68.7%) were classified as pathological (p)T4 and 5 patients (31.2%) were classified pT3 whereas in the group of occlusive LAACRC the majority of patients were classified as pT4 (83.3%). Lymph node involvement occurred in 9 patients (56.2%) of the fist group and in two patients (33.3%) of the second group, respectively. The 3-year survival rates in all patients with both uncomplicated and occlusive diseases were 58.4% and 33.3%, respectively. The 3-years survival of patients with locally advanced adherent rectal cancer was significantly lower than the observed survival of patients with colon cancer (p < 0.0001). Conclusion: MVR offers cure (R0 resections) in uncomplicated and obstructive LAACRC with three years survival in 40% of patients. Patients affected by rectal cancer with occlusive disease showed significantly decreased survival in comparison with those affected by colon cancer.
MeSH term(s)	Aged ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/etiology ; Survival Rate
Language	English
Publishing date	2016-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2016.06.021
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