Metastatic Cutaneous Basal Cell Carcinoma: Report of 2 Cases Preceding the Hedgehog Pathway Antagonists Era.

Basal cell carcinoma (BCC) of the skin is the most common type of malignant human tumor. However, metastatic BCC is a very rare event with weakly effective therapeutic options and a poor prognosis, until a few years ago. In 2012, small-molecule therapies, capable of inactivating the hedgehog signaling pathway and thus reducing tumor growth and progression, were introduced into clinical practice for the treatment of patients with advanced BCC. We present retrospectively 2 personal cases of metastatic BCC of the skin, from the premolecular therapy era, from primary tumors that arose years before in the head and neck area. The former case occurred in a 45-year-old woman with a history of recurrent BCC of the retroauricular skin who eventually died due to diffuse metastatic spread. The latter case concerned a 70-year-old man also with a history of recurrent BCC of the nasal-perinasal skin who developed multiple subcutaneous and lymph node metastases in the neck. In both cases, the diagnoses were based on biopsies of the metastatic sites. The first patient died 5 months after the diagnosis of metastatic disease, while the second was alive and disease-free 2 years after neck lymph node dissection and external radiation therapy, and then lost to follow-up. We extensively discuss several tumor entities with basal or basaloid features that may enter the differential diagnosis with BCC in metastatic sites. In addition, we briefly summarize the advances in clinical therapeutics using small molecules, which are now an integral part of the treatment of such advanced BCC cases.

Cold benign thyroid nodule volume reduction predictability after percutaneous ethanol injection.

OBJECTIVE: To determine the effect of percutaneous ethanol injection (PEI), a suppressive therapy for cold benign thyroid nodules (CBNs), on cytology. STUDY DESIGN: The study group consisted of 31 CBNs, treated with PEI for 1 year, aspirated before and while the patients were on suppressive therapy. A control group consisting of 22 patients, whose nodule characteristic, PEI treatment and follow-up were similar to those of the study patients group, was monitored to confirm the results. By analogy with a similar study, the following factors were considered: an initial volume of the CBNs > 25 mL, abundant colloid, degree of cellular hyperplasia and presence ofdegenerative changes. To verify these hypotheses, we tested the differences using the t test for the initial volume and the Mann-Whitney U test for the remaining features. RESULTS: The study has proved the unpredictability of the volume reduction in a single nodule on the basis of cytologic evaluation. CONCLUSION: The lack of cytologic features that can be considered statistically predictive of large nodule reduction as a result of PEI treatment confirms that fine needle aspiration cytology may help establish the correct diagnosis.

Prevalence and genotypes identification of human papillomavirus infection in a population of South Italy.

BACKGROUND: A limited number of human papillomavirus (HPV) types account for the majority of invasive cervical cancer cases. OBJECTIVES: To assess, in a southern Italian region, where HPV infection had not yet been investigated, the prevalence of type-specific HPV infection. STUDY DESIGN: Multiplex PCR was used to test cervical specimens from 871 asymptomatic women. RESULTS: The HPV infection rate was 23.1%, with the highest prevalence being observed in women aged 20-30 years (32.6%). Type 16 was the most frequent HPV type detected either in mono-infected (39.8%) or in multi-infected (46.3%) women. CONCLUSIONS: The HPV infection rate was higher than reported from other Italian areas. Our results further emphasise the importance of vaccinations to immunize females before they acquire HPV infection.