Luciano Pezzullo | Fond. IRCCS Istituto Nazionale dei Tumori (original) (raw)
Papers by Luciano Pezzullo
The Journal of Clinical Endocrinology & Metabolism, 2007
We previously showed that BAG3 protein, a member of the BAG (Bcl-2-associated athanogene) co-chap... more We previously showed that BAG3 protein, a member of the BAG (Bcl-2-associated athanogene) co-chaperone family, modulates apoptosis in human leukemias. The expression of BAG3 in other tumor types has not been extensively investigated so far. The objective of this study was to analyze BAG3 expression in thyroid neoplastic cells and investigate its influence in cell apoptotic response to TNF-related apoptosis-inducing ligand (TRAIL). We investigated BAG3 expression in human thyroid carcinoma cell lines, including NPA, and the effect of BAG3-specific small interfering RNA on TRAIL-induced apoptosis in NPA cells. Subsequently, we analyzed BAG3 expression in 30 benign lesions and 56 carcinomas from patients of the Naples Tumor Institute Fondazione Senatore Pascale. The main outcome measures were: analysis of BAG3 protein in NPA cells by Western blot and immunocytochemistry; analysis of apoptosis in TRAIL-stimulated NPA cells by flow cytometry; and evaluation of BAG3 expression in specimens from thyroid lesions by immunohistochemistry. BAG3 was expressed in human thyroid carcinoma cell lines; small interfering RNA-mediated downmodulation of its levels significantly (P < 0.0195) enhanced NPA cell apoptotic response to TRAIL. The protein was not detectable in 19 of 20 specimens of normal thyroid or goiters, whereas 54 of 56 analyzed carcinomas (15 follicular, 28 papillary, and 13 anaplastic) were clearly positive for BAG3 expression. BAG3 downmodulates the apoptotic response to TRAIL in human neoplastic thyroid cells. The protein is specifically expressed in thyroid carcinomas and not in normal thyroid tissue or goiter.
The Laryngoscope, Jan 15, 2015
Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives progno... more Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives prognostic information regarding postoperative glottic function. Loss of the neuromonitoring signal (LOS) signifies segmental type 1 or global type 2 RLN injury. This study aimed at identifying risk factors for RLN injury and determining vocal fold (VF) function initially and 6 months after definitive LOS. Prospective study encompassing 21 hospitals from 13 countries. Included in this study were patients with persistent intraoperative LOS. At first postoperative laryngoscopy, early VF palsy was present in 94 of all 115 patients with LOS (81.7%): in 53 of 56 patients (94.6%) with type 1 injury and 41 of 59 patients (69.5%) with type 2 injury. In LOS type 1, women outnumbered men >5-fold. Traction produced LOS type 1 in 38 of 56 patients (67.9%) and LOS type 2 in 54 of 59 patients (91.5%). Course of the RLN posterior and/or anterior to the inferior thyroid artery, extralaryngeal branching, or...
Endocrine Pathology, 2015
Fine-needle cytology (FNC) is frequently used to diagnose thyroid nodules discovered by palpation... more Fine-needle cytology (FNC) is frequently used to diagnose thyroid nodules discovered by palpation or imaging studies. Molecular tests on FNC material may increase its diagnostic accuracy. We report a case of a classic papillary thyroid carcinoma combined with a mucoepidermoid carcinoma correctly identified on FNC. The papillary component had a classic immunophenotype (CK19+, TTF1+), while the mucoepidermoid one was only focally CK19+. Point mutations (BRAF and RAS) and rearrangements (RET/PTC) of the papillary component have been also investigated on FNC samples, with resulting concurrent rearrangements of RET/PTC1 and RET/PTC3, but no point mutations. The histogenesis of combined papillary and mucoepidermoid carcinoma of the thyroid still remains partly unsettled, and further genomic studies are needed to shed some more light on this peculiar neoplasm.
The Laryngoscope, Jan 15, 2015
Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives progno... more Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives prognostic information regarding postoperative glottic function. Loss of the neuromonitoring signal (LOS) signifies segmental type 1 or global type 2 RLN injury. This study aimed at identifying risk factors for RLN injury and determining vocal fold (VF) function initially and 6 months after definitive LOS. Prospective study encompassing 21 hospitals from 13 countries. Included in this study were patients with persistent intraoperative LOS. At first postoperative laryngoscopy, early VF palsy was present in 94 of all 115 patients with LOS (81.7%): in 53 of 56 patients (94.6%) with type 1 injury and 41 of 59 patients (69.5%) with type 2 injury. In LOS type 1, women outnumbered men >5-fold. Traction produced LOS type 1 in 38 of 56 patients (67.9%) and LOS type 2 in 54 of 59 patients (91.5%). Course of the RLN posterior and/or anterior to the inferior thyroid artery, extralaryngeal branching, or...
Anticancer research
The aims of the present study were: to assess standard ultrasound and color-Doppler patterns for ... more The aims of the present study were: to assess standard ultrasound and color-Doppler patterns for the study and characterization of salivary gland tumors; to define the improvement in the color-Doppler ultrasound image after injection of a signal amplifier (Levovist); to compare morphological and vascular aspects of the neoplasm with data obtained during postoperative histopathological analysis. We used color-Doppler ultrasound before and after injection of the contrast medium to study 56 patients (32 males and 24 females) between the ages of 28 and 77 years old, presenting nodular pathology of the salivary glands. Only patients with less than optimal results of the basic color-Doppler examination (grade of vascularization 0-1) were included in the study. The data were then compared with the final histological results. According to B-mode ultrasonography, all neoplasms were hypoechogenous; 8 showed irregular margins and, of these, 6 were carcinomas. We did not obtain significant data...
Endocrine Abstracts, 2016
Tumori, 2003
In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenoma... more In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenomatous polyposis is reported. Desmoid tumors represent a particular type of fibrous neoplasms with a higher prevalence in females. They are extremely rare in the sporadic form, while they are found in about 10% of patients affected by familial adenomatous polyposis. Despite their benign histology and the absence of metastatic potential, they can be considered as fibrosarcomas with a low level of malignancy because of their locally invasive nature. The treatment of choice is surgical excision, as wide as possible, aimed at preventing recurrences, which are frequent in this tumor type. The usefulness of complementary therapies such as radiotherapy, hormone or chemotherapy, is not entirely clear.
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](Minerva gastroenterologica e dietologica
Minerva chirurgica
The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occl... more The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occlusive symptomatology. This type of diaphragmatic hernia is uncommon and characterized by an aspecific symptomatology which realize different problems in children and adult patients, in whom diagnosis can be made incidentally, executing analysis for other pathologies. Using Marlex mesh to repair hernia represents an improvement of surgery, because it enables to repair a great hernia with a better result, and no recurrence.
Journal of experimental & clinical cancer research: CR
Journal of Neuro-Oncology
A 46-year-old female patient with previously recognized Graves' ophthalmopathy, underwent tot... more A 46-year-old female patient with previously recognized Graves' ophthalmopathy, underwent total thyroidectomy. After thyroid surgery exophthalmos worsened and signs unsteadiness of gait appeared. Magnetic resonance imaging showed a lesion in the basal portion of the left cerebellar hemisphere. Therefore, the patient underwent surgery. Pathological examination revealed dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease).
I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
Merkel cell carcinoma (MCC) is a rare, malignant skin cancer, exhibiting neuroendocrine different... more Merkel cell carcinoma (MCC) is a rare, malignant skin cancer, exhibiting neuroendocrine differentiation, with a significant incidence of locoregional lymph nodal involvement (40%-73%). The accepted staging system classifies MCC as: stage I, localized skin disease; stage II, regional lymph node disease; stage III, metastatic disease. The clinical differentiation of stage I and II patients is difficult and understaging is frequent. Surgery, as first approach, represents the leading treatment for this neoplasm and, depending on stage consists in: local wide excision for stage I patients and local excision and lymphadenectomy for stage II. In our experience, lymphadenectomy, included in the initial treatment of all stage II patients, seemed to influence positively the prognosis. In comparing stage related recurrence and survival rates the results we obtained were better in stage II patients, where lymphadenectomy was included in the initial treatment than in stage I subjects, who receiv...
World journal of surgical oncology, Jan 23, 2005
Parathyroid carcinoma is a rare malignancy, with an incidence of 0.5 to 4% of all cases of primar... more Parathyroid carcinoma is a rare malignancy, with an incidence of 0.5 to 4% of all cases of primary hyperparathyroidism. Surgery is the only curative treatment. We report the case of a 66-year-old man referred for a large suspicious substernal goitre associated with severe hypercalcemia due to hyperparathyroidism. After normalization of serum calcium levels, patient underwent surgery. The voluminous cervicomediastinal firm mass could not be removed through the cervical incision; therefore a cervicothoracic approach was employed. Histopathology revealed a giant parathyroid cancer of 450 grams. A review of the literature was also undertaken to summarize the current treatment approaches for this rare malignancy. Parathyroid cancer is usually not recognized either preoperatively or intra-operatively. En bloc resection of the tumour with the adjacent tissue is the treatment of choice and it is very important to avoid the rupture of the capsule during operation. Neither tumour size, nor th...
Tumori
In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenoma... more In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenomatous polyposis is reported. Desmoid tumors represent a particular type of fibrous neoplasms with a higher prevalence in females. They are extremely rare in the sporadic form, while they are found in about 10% of patients affected by familial adenomatous polyposis. Despite their benign histology and the absence of metastatic potential, they can be considered as fibrosarcomas with a low level of malignancy because of their locally invasive nature. The treatment of choice is surgical excision, as wide as possible, aimed at preventing recurrences, which are frequent in this tumor type. The usefulness of complementary therapies such as radiotherapy, hormone or chemotherapy, is not entirely clear.
Tumori
Two cases of a right non-recurrent laryngeal nerve were encountered during the performance of 992... more Two cases of a right non-recurrent laryngeal nerve were encountered during the performance of 992 thyroid operations. In its abnormal non-recurrent course the nerve passes transversely from under the carotid sheat hand takes a position which is at right-angles to the normal recurrent laryngeal nerve.
Tumori
Parathyroid carcinoma is a rare malignancy. We report the case of a 66 years old man referred to ... more Parathyroid carcinoma is a rare malignancy. We report the case of a 66 years old man referred to our department for a large substernal goiter suspected as a thyroid cancer associated with severe hyperparathyroidism. After normalization of serum levels of calcemia, total thyroidectomy and subtotal parathyroidectomy was performed. Histopathology revealed a parathyroid cancer of 450 g.
Chirurgia italiana
Drainage in thyroid surgery is still an area of controversy. We analysed the results of a prospec... more Drainage in thyroid surgery is still an area of controversy. We analysed the results of a prospective randomised trial conducted in our institution in order to assess the utility of drainage after thyroid surgery. Sixty patients were entered into the study, thirty of whom were drained after surgery and thirty who received no drainage. The two groups were well matched with regard to most characteristics. There was no difference between the two groups in terms of early or late postoperative complications. We therefore conclude that, in our experience, drainage after uncomplicated thyroid surgery is of no benefit.
Journal of experimental & clinical cancer research : CR, 1998
Minerva chirurgica
The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occl... more The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occlusive symptomatology. This type of diaphragmatic hernia is uncommon and characterized by an aspecific symptomatology which realize different problems in children and adult patients, in whom diagnosis can be made incidentally, executing analysis for other pathologies. Using Marlex mesh to repair hernia represents an improvement of surgery, because it enables to repair a great hernia with a better result, and no recurrence.
The Journal of Clinical Endocrinology & Metabolism, 2007
We previously showed that BAG3 protein, a member of the BAG (Bcl-2-associated athanogene) co-chap... more We previously showed that BAG3 protein, a member of the BAG (Bcl-2-associated athanogene) co-chaperone family, modulates apoptosis in human leukemias. The expression of BAG3 in other tumor types has not been extensively investigated so far. The objective of this study was to analyze BAG3 expression in thyroid neoplastic cells and investigate its influence in cell apoptotic response to TNF-related apoptosis-inducing ligand (TRAIL). We investigated BAG3 expression in human thyroid carcinoma cell lines, including NPA, and the effect of BAG3-specific small interfering RNA on TRAIL-induced apoptosis in NPA cells. Subsequently, we analyzed BAG3 expression in 30 benign lesions and 56 carcinomas from patients of the Naples Tumor Institute Fondazione Senatore Pascale. The main outcome measures were: analysis of BAG3 protein in NPA cells by Western blot and immunocytochemistry; analysis of apoptosis in TRAIL-stimulated NPA cells by flow cytometry; and evaluation of BAG3 expression in specimens from thyroid lesions by immunohistochemistry. BAG3 was expressed in human thyroid carcinoma cell lines; small interfering RNA-mediated downmodulation of its levels significantly (P < 0.0195) enhanced NPA cell apoptotic response to TRAIL. The protein was not detectable in 19 of 20 specimens of normal thyroid or goiters, whereas 54 of 56 analyzed carcinomas (15 follicular, 28 papillary, and 13 anaplastic) were clearly positive for BAG3 expression. BAG3 downmodulates the apoptotic response to TRAIL in human neoplastic thyroid cells. The protein is specifically expressed in thyroid carcinomas and not in normal thyroid tissue or goiter.
The Laryngoscope, Jan 15, 2015
Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives progno... more Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives prognostic information regarding postoperative glottic function. Loss of the neuromonitoring signal (LOS) signifies segmental type 1 or global type 2 RLN injury. This study aimed at identifying risk factors for RLN injury and determining vocal fold (VF) function initially and 6 months after definitive LOS. Prospective study encompassing 21 hospitals from 13 countries. Included in this study were patients with persistent intraoperative LOS. At first postoperative laryngoscopy, early VF palsy was present in 94 of all 115 patients with LOS (81.7%): in 53 of 56 patients (94.6%) with type 1 injury and 41 of 59 patients (69.5%) with type 2 injury. In LOS type 1, women outnumbered men >5-fold. Traction produced LOS type 1 in 38 of 56 patients (67.9%) and LOS type 2 in 54 of 59 patients (91.5%). Course of the RLN posterior and/or anterior to the inferior thyroid artery, extralaryngeal branching, or...
Endocrine Pathology, 2015
Fine-needle cytology (FNC) is frequently used to diagnose thyroid nodules discovered by palpation... more Fine-needle cytology (FNC) is frequently used to diagnose thyroid nodules discovered by palpation or imaging studies. Molecular tests on FNC material may increase its diagnostic accuracy. We report a case of a classic papillary thyroid carcinoma combined with a mucoepidermoid carcinoma correctly identified on FNC. The papillary component had a classic immunophenotype (CK19+, TTF1+), while the mucoepidermoid one was only focally CK19+. Point mutations (BRAF and RAS) and rearrangements (RET/PTC) of the papillary component have been also investigated on FNC samples, with resulting concurrent rearrangements of RET/PTC1 and RET/PTC3, but no point mutations. The histogenesis of combined papillary and mucoepidermoid carcinoma of the thyroid still remains partly unsettled, and further genomic studies are needed to shed some more light on this peculiar neoplasm.
The Laryngoscope, Jan 15, 2015
Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives progno... more Intraoperative neuromonitoring identifies recurrent laryngeal nerve (RLN) injury and gives prognostic information regarding postoperative glottic function. Loss of the neuromonitoring signal (LOS) signifies segmental type 1 or global type 2 RLN injury. This study aimed at identifying risk factors for RLN injury and determining vocal fold (VF) function initially and 6 months after definitive LOS. Prospective study encompassing 21 hospitals from 13 countries. Included in this study were patients with persistent intraoperative LOS. At first postoperative laryngoscopy, early VF palsy was present in 94 of all 115 patients with LOS (81.7%): in 53 of 56 patients (94.6%) with type 1 injury and 41 of 59 patients (69.5%) with type 2 injury. In LOS type 1, women outnumbered men >5-fold. Traction produced LOS type 1 in 38 of 56 patients (67.9%) and LOS type 2 in 54 of 59 patients (91.5%). Course of the RLN posterior and/or anterior to the inferior thyroid artery, extralaryngeal branching, or...
Anticancer research
The aims of the present study were: to assess standard ultrasound and color-Doppler patterns for ... more The aims of the present study were: to assess standard ultrasound and color-Doppler patterns for the study and characterization of salivary gland tumors; to define the improvement in the color-Doppler ultrasound image after injection of a signal amplifier (Levovist); to compare morphological and vascular aspects of the neoplasm with data obtained during postoperative histopathological analysis. We used color-Doppler ultrasound before and after injection of the contrast medium to study 56 patients (32 males and 24 females) between the ages of 28 and 77 years old, presenting nodular pathology of the salivary glands. Only patients with less than optimal results of the basic color-Doppler examination (grade of vascularization 0-1) were included in the study. The data were then compared with the final histological results. According to B-mode ultrasonography, all neoplasms were hypoechogenous; 8 showed irregular margins and, of these, 6 were carcinomas. We did not obtain significant data...
Endocrine Abstracts, 2016
Tumori, 2003
In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenoma... more In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenomatous polyposis is reported. Desmoid tumors represent a particular type of fibrous neoplasms with a higher prevalence in females. They are extremely rare in the sporadic form, while they are found in about 10% of patients affected by familial adenomatous polyposis. Despite their benign histology and the absence of metastatic potential, they can be considered as fibrosarcomas with a low level of malignancy because of their locally invasive nature. The treatment of choice is surgical excision, as wide as possible, aimed at preventing recurrences, which are frequent in this tumor type. The usefulness of complementary therapies such as radiotherapy, hormone or chemotherapy, is not entirely clear.
Minerva gastroenterologica e dietologica
Minerva chirurgica
The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occl... more The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occlusive symptomatology. This type of diaphragmatic hernia is uncommon and characterized by an aspecific symptomatology which realize different problems in children and adult patients, in whom diagnosis can be made incidentally, executing analysis for other pathologies. Using Marlex mesh to repair hernia represents an improvement of surgery, because it enables to repair a great hernia with a better result, and no recurrence.
Journal of experimental & clinical cancer research: CR
Journal of Neuro-Oncology
A 46-year-old female patient with previously recognized Graves' ophthalmopathy, underwent tot... more A 46-year-old female patient with previously recognized Graves' ophthalmopathy, underwent total thyroidectomy. After thyroid surgery exophthalmos worsened and signs unsteadiness of gait appeared. Magnetic resonance imaging showed a lesion in the basal portion of the left cerebellar hemisphere. Therefore, the patient underwent surgery. Pathological examination revealed dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease).
I supplementi di Tumori : official journal of Società italiana di cancerologia ... [et al.]
Merkel cell carcinoma (MCC) is a rare, malignant skin cancer, exhibiting neuroendocrine different... more Merkel cell carcinoma (MCC) is a rare, malignant skin cancer, exhibiting neuroendocrine differentiation, with a significant incidence of locoregional lymph nodal involvement (40%-73%). The accepted staging system classifies MCC as: stage I, localized skin disease; stage II, regional lymph node disease; stage III, metastatic disease. The clinical differentiation of stage I and II patients is difficult and understaging is frequent. Surgery, as first approach, represents the leading treatment for this neoplasm and, depending on stage consists in: local wide excision for stage I patients and local excision and lymphadenectomy for stage II. In our experience, lymphadenectomy, included in the initial treatment of all stage II patients, seemed to influence positively the prognosis. In comparing stage related recurrence and survival rates the results we obtained were better in stage II patients, where lymphadenectomy was included in the initial treatment than in stage I subjects, who receiv...
World journal of surgical oncology, Jan 23, 2005
Parathyroid carcinoma is a rare malignancy, with an incidence of 0.5 to 4% of all cases of primar... more Parathyroid carcinoma is a rare malignancy, with an incidence of 0.5 to 4% of all cases of primary hyperparathyroidism. Surgery is the only curative treatment. We report the case of a 66-year-old man referred for a large suspicious substernal goitre associated with severe hypercalcemia due to hyperparathyroidism. After normalization of serum calcium levels, patient underwent surgery. The voluminous cervicomediastinal firm mass could not be removed through the cervical incision; therefore a cervicothoracic approach was employed. Histopathology revealed a giant parathyroid cancer of 450 grams. A review of the literature was also undertaken to summarize the current treatment approaches for this rare malignancy. Parathyroid cancer is usually not recognized either preoperatively or intra-operatively. En bloc resection of the tumour with the adjacent tissue is the treatment of choice and it is very important to avoid the rupture of the capsule during operation. Neither tumour size, nor th...
Tumori
In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenoma... more In this paper a case of vast desmoid tumor of the abdominal wall associated with familial adenomatous polyposis is reported. Desmoid tumors represent a particular type of fibrous neoplasms with a higher prevalence in females. They are extremely rare in the sporadic form, while they are found in about 10% of patients affected by familial adenomatous polyposis. Despite their benign histology and the absence of metastatic potential, they can be considered as fibrosarcomas with a low level of malignancy because of their locally invasive nature. The treatment of choice is surgical excision, as wide as possible, aimed at preventing recurrences, which are frequent in this tumor type. The usefulness of complementary therapies such as radiotherapy, hormone or chemotherapy, is not entirely clear.
Tumori
Two cases of a right non-recurrent laryngeal nerve were encountered during the performance of 992... more Two cases of a right non-recurrent laryngeal nerve were encountered during the performance of 992 thyroid operations. In its abnormal non-recurrent course the nerve passes transversely from under the carotid sheat hand takes a position which is at right-angles to the normal recurrent laryngeal nerve.
Tumori
Parathyroid carcinoma is a rare malignancy. We report the case of a 66 years old man referred to ... more Parathyroid carcinoma is a rare malignancy. We report the case of a 66 years old man referred to our department for a large substernal goiter suspected as a thyroid cancer associated with severe hyperparathyroidism. After normalization of serum levels of calcemia, total thyroidectomy and subtotal parathyroidectomy was performed. Histopathology revealed a parathyroid cancer of 450 g.
Chirurgia italiana
Drainage in thyroid surgery is still an area of controversy. We analysed the results of a prospec... more Drainage in thyroid surgery is still an area of controversy. We analysed the results of a prospective randomised trial conducted in our institution in order to assess the utility of drainage after thyroid surgery. Sixty patients were entered into the study, thirty of whom were drained after surgery and thirty who received no drainage. The two groups were well matched with regard to most characteristics. There was no difference between the two groups in terms of early or late postoperative complications. We therefore conclude that, in our experience, drainage after uncomplicated thyroid surgery is of no benefit.
Journal of experimental & clinical cancer research : CR, 1998
Minerva chirurgica
The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occl... more The authors described a case of hernia of Morgagni-Larrey in aged patients with an acute sub-occlusive symptomatology. This type of diaphragmatic hernia is uncommon and characterized by an aspecific symptomatology which realize different problems in children and adult patients, in whom diagnosis can be made incidentally, executing analysis for other pathologies. Using Marlex mesh to repair hernia represents an improvement of surgery, because it enables to repair a great hernia with a better result, and no recurrence.