👤 Antonio Agostini

During endoscopic endonasal surgery (EES), inferolateral trunk (ILT) sacrifice may be required to efficiently and safely achieve tumor resection within the lateral compartment (LC) of the cavernous sinus (CS). The authors investigated the surgical anatomy and variations of the ILT, aiming to provide practical information to safely expose, coagulate, and transect this artery during EES. In this anatomical study, 24 postmortem, lightly embalmed, colored silicone-injected human head specimens were dissected and 41 sides were examined. The origin, course, branching pattern, and relation of the ILT with surrounding structures were investigated. Clinical charts of patients surgically treated for pituitary adenomas (PAs) with LC invasion from July 2018 to April 2023 at the authors' institution were also retrospectively analyzed. Illustrative cases are provided. The ILT was found in 93% (38/41) of sides, mainly arising from the inferolateral aspect (91%, 30/33 sides) of either the middle or posterior third (82%, 27/33 sides) of the horizontal segment of the internal carotid artery. After a short common trunk (mean length 3 mm), the artery divided into 2 (21%, 8/38) or, more frequently, 3 (74%, 28/38) branches, supplying blood to cranial nerves (CNs) III, IV, V1, V2, V3, and VI and the Gasserian ganglion. While the sympathetic plexus was always located anterior to the ILT, CN VI was found anterior to the ILT in 82% (31/38) of sides. The lateral parasellar ligament (LPL) enwrapped the ILT and its branches in 43% (15/35) of sides. In the coronal plane, the ILT origin was found at the level of the sellar floor (0 ± 1 mm) and the LPL (0 ± 2 mm), both of which can serve as surgical landmarks during lateral transcavernous EES. In the case series of 25 EESs for PAs with LC invasion, the ILT was sacrificed in 5 cases (20%) without any permanent postoperative CN deficits. This study served as a detailed anatomical investigation of the ILT, which is crucial when accessing the LC of the CS. The authors proposed two reliable landmarks to identify the ILT intraoperatively: the sellar floor and the LPL. Furthermore, investigations confirmed that the ILT can be sacrificed without causing permanent CN deficits given the existence of a collateral supply. Show less

Metastasis of head and neck tumors is responsible for a high mortality rate. Understanding its biochemistry may allow insights into tumorigenesis. To that end we carried out RNA-Seq analyses of 5 SCC9 derived oral cancer cell lines displaying increased invasive potential. Differentially expressed genes (DEGs) were annotated based on p-values and false discovery rate (q-values). All 292 KEGG pathways related to the human genome were compared in order to pinpoint the absolute and relative contributions to the invasive process considering the 8 hallmarks of cancer plus 2 new defined categories, as well as we made with our transcriptomic data. In terms of absolute contribution, the highest correlations were associated to the categories of evading immune destruction and energy metabolism and for relative contributions, angiogenesis and evading immune destruction. DEGs were distributed into each one of all possible modes of regulation, regarding up, down and continuum expression, along the 3 stages of metastatic progression. For p-values twenty-six genes were consistently present along the tumoral progression and 4 for q-values. Among the DEGs, we found 2 novel potentially informative metastatic markers: PIGG and SLC8B1. Furthermore, interactome analysis showed that MYH14, ANGPTL4, PPARD and ENPP1 are amenable to pharmacological interventions. Show less

Leiomyoma of deep soft tissue is a rare type of benign smooth muscle tumor that mostly occurs in the retroperitoneum or abdominal cavity of women, and about which very little genetic information exists. In the present study, eight leiomyomas of deep soft tissue were genetically analyzed. G-banding showed that three tumors carried rearrangements of the long arm of chromosome 12, three others had 8q rearrangements, the 7th tumor had deletion of the long arm of chromosome 7, del(7)(q22), and the 8th had aberrations of chromosome bands 3q21~23 and 11q21~22. The target genes of the 12q and 8q aberrations were HMGA2 and PLAG1, respectively. In the leiomyomas with 12q rearrangements, both HMGA2 and PLAG1 were expressed whereas in the tumors with 8q aberrations, only PLAG1 was expressed. In the cases without 12q or 8q aberrations, the expression of HMGA2 was very low and PLAG1 was expressed only in the case with del(7)(q22). All eight leiomyomas of deep soft tissue expressed MED12 but none of them had mutation in exon 2 of that gene. In two tumors with 12q rearrangements, RPSAP52 on 12q14.3 was fused with non-coding RNA (accession number XR₉₄₄₁₉₅₎ from 14q32.2 or ZFP36L1 from14q24.1. In a tumor with inv(12), exon 3 of HMGA2 was fused to a sequence in intron 1 of the CRADD gene from 12q22. The present data together with those of our two previous studies in which the fusions KAT6B-KANSL1 and EWSR1-PBX3 were described in two retroperitoneal leiomyomas carrying a t(10;17)(q22;q21) and a t(9;22)(q33;q12) translocation, respectively, show that leiomyomas of deep soft tissue are genetically heterogenous but have marked similarities to uterine leiomyomas. Show less

The p53-family member, p73, plays a key role in the development of the central nervous system (CNS), in senescence, and in tumor formation. The role of p73 in neuronal differentiation is complex and involves several downstream pathways. Indeed, in the last few years, we have learnt that TAp73 directly or indirectly regulates several genes involved in neural biology. In particular, TAp73 is involved in the maintenance of neural stem/progenitor cell self-renewal and differentiation throughout the regulation of SOX-2, Hey-2, TRIM32 and Notch. In addition, TAp73 is also implicated in the regulation of the differentiation and function of postmitotic neurons by regulating the expression of p75NTR and GLS2 (glutamine metabolism). Further still, the regulation of miR-34a by TAp73 indicates that microRNAs can also participate in this multifunctional role of p73 in adult brain physiology. However, contradictory results still exist in the relationship between p73 and brain disorders, and this remains an important area for further investigation. Show less