Tumor Progression from a Fibroblast Activation Protein Perspective: Novel Diagnostic and Therapeutic Scenarios for Colorectal Cancer.

In 2020, the Global Cancer Observatory estimated the incidence of colorectal cancer (CRC) at around 10.7% coupled with a mortality rate of 9.5%. The explanation for these values lies in the tumor microenvironment consisting of the extracellular matrix and cancer-associated fibroblasts (CAFs). Fibroblast activation protein (FAP) offers a promising target for cancer therapy since its functions contribute to tumor progression. Immunohistochemistry examination of FAP, fibronectin ED-B, and CXCR4 in primary tumors and their respective synchronous and/or metachronous metastases along with semiquantitative analysis have been carried out on histological samples of 50 patients diagnosed with metastatic CRC. The intensity of FAP, articulated by both "Intensity %" and "Intensity score", is lower in the first metastasis compared to the primary tumor with a statistically significant correlation. No significant correlations have been observed regarding fibronectin ED-B and CXCR4. Tumors that produce FAP have an ambivalent relationship with this protein. At first, they exploit FAP, but later they reduce its expressiveness. Although our study has not directly included FAP-Inhibitor (FAPI) PET/CT, the considerable expression of FAP reveals its potential as a diagnostic and therapeutic tool worthy of further investigation. This dynamic relationship between cancer and FAP has substantial diagnostic and therapeutic implications.

Orthognathic surgery: a randomized study comparing Piezosurgery and Saw techniques.

INTRODUCTION: The purpose of this study was to evaluate specific parameters: intra-operative time, facial swelling, degree of pain (VAS scale), recovery time and neurosensory disturbance in patients who underwent orthognathic surgery either using piezo or saw devices. MATERIAL AND METHODS: We designed a retrospective study, which included 100 patients who underwent bilateral sagittal split osteotomy (BSSO) surgery combined with maxillary Le Fort I. They were separated into 2 groups of 50 patients each. The surgeries were performed between September 2015 and April 2017 by the same surgeon. RESULTS: Intra-op time is unchanged but patients operated with the Piezo devices requested fewer painkilling medication and were dismissed on the second day after the surgery. Neurosensory recovery was statistically significant in the Piezo group. CONCLUSION: Far less post-op swelling and the reduction in the use of painkillers lead to a speedier recovery in patients who underwent orthognathic surgery using Piezosurgery. These patients also recovered more sensitivity in the lower lip area. KEY WORDS: Orthognatic surgery, Piezosurgery, Saw.

Rare case of giant lymphocele treated with supramicrosurgical approach.

INTRODUCTION: Lymphocele (or cystic lymphangioma) is a typical disease of the lymphatic vascukarization caused by lymphatic fluid leakage. Lymphatic leakage can result from traumas or as a complication of surgical procedures. Clinic is vague and surgical resection is still considered the most effective approach. Thereby, a standpoint should be the identification and treatment of afferent lymphatic channels which can be addressed by LVA. CASE PRESENTATION: The authors describe a rare case of a giant lymphocele occurred in a 56-year-old Caucasian woman treated for endometrial carcinoma. Lymphocele was refractory to percutaneous drainage and compressive treatment. Therefore surgical excision in combination with supramicrosurgical lymphatico-venular anastomosis (LVA) was scheduled. CONCLUSIONS: The aim of the report is to offer an overview on the main therapeutic options to treat lymphocele and to demonstrate the effectiveness of combining excision with lymphatic microsurgery. KEY WORDS: Inguinal lymphocele, LVA, Supramicrosurgery.

Maxillary fungus ball in a diabetic patient. An odontogenic origin.

INTRODUCTION: Fungus ball (FB) represents a granulomatous mass due to a fungal colonization which may disseminate and potentially lead to a systemic infection. Maxillary fungus ball is considered to be a complication of dental treatment and, according to relevant literature, it often stems from improper endodontic therapies. MATERIAL AND METHODS: The authors report the case of a 69-year-old caucasian woman with nasal respiratory distress and frequent sinusitis symptoms. According to clinical and radiological evidence, FESS surgery was planned, thus validating FB diagnostic hypothesis. CONCLUSIONS: Fungal infection should always be considered in patients with sinusitis and previous root canal theraphy. Misdiagnosis can lead to severe complications. Surgical removal seems to be effective and resolutive. KEY WORDS: Endoscopic surgery, Fungus Ball, Maxillary sinusitiss.

Indocyanine Green Sentinel Node in Merkel Cell Carcinoma of the Cheek.

Merkel cell carcinoma (MCC) is a rare malignant tumor with a neuroendocrine phenotype. The authors report a case of MCC of the left cheek region in an 85-year-old Caucasian woman who also received sentinel node biopsy using both Technectium-99m-labeled (99mTc) lymphoscintigraphy and indocyanine green lymphography.